Q and A: Experts discuss some key COVID 19 concerns | iNFOnews | Thompson-Okanagan's News Source

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Q and A: Experts discuss some key COVID 19 concerns

April 28, 2020 - 1:00 AM

With COVID-19 now affecting the lives of Canadians on so many levels, people across the country are seeking answers to numerous important questions they have about the novel coronavirus.


Allergies or COVID-19?

You feel a sneeze coming on, or a tickle in your throat, and the alarm bells start ringing in your head. Is it seasonal allergies or is it the beginnings of a COVID-19 infection?

While springtime pollen can cause sneezing, wheezing and watery eyes in allergy sufferers, a Toronto allergist says it's best to take precautions if seasonal symptoms start presenting like those more common in COVID cases.

Vadas, who's received an influx of questions about allergy symptoms in recent weeks due to the coronavirus pandemic, said that early spring brings with it two major allergens — tree pollen in the air that can travel from far distances, and outdoor mould spores caused by rain-dampened soil.

Grass pollen comes into play later in the spring, around May and June, Vadas added. He said checking the weather forecast for pollen and mould counts could help in determining whether symptoms are caused by outdoor allergens or something else.

The major distinction between allergies and COVID-19, Vadas said, is the presence of fever that's usually associated with the coronavirus.

The Centers for Disease Control and Prevention (CDC) in the United States lists cough, shortness of breath or difficulty breathing, chills, muscle pain, headache, sore throat and a new loss of taste or smell as other common symptoms of COVID-19.

Some of those, like coughing, can overlap with hay fever.

But Vadas says to watch for multiple symptoms. If just one is present, it's likely not due to COVID-19.


Should you lay out your wishes for end-of-life treatment options?

The COVID-19 pandemic is pushing a number of people to start preparing for the worst-case scenario.

While drafting a will is a good step, experts say it's equally important to lay out your wishes for end-of-life treatment options and name someone who can make decisions about your personal health care if you're unable to.

Dr. Chantal Perrot, a Toronto physician and psychotherapist, says she's seen an increase in the number of people wanting to make clear their end-of-life care decisions since the coronavirus pandemic reached North America last month.

And she encourages more people to think about it, especially now.

Some advanced treatment methods for COVID-19 symptoms can be especially tough on the body, including mechanical ventilators, and severe coronavirus cases may require even more interventions.

While the global pandemic has some Canadians more focused on such decisions, Perrot recommends we should have them ready at any time, in case of any emergency.

She says people need to think about a number of scenarios when drafting their end-of-life care instructions, including what kinds of medical interventions they want, and under what circumstances.

Speak Up Canada, an advanced care planning resource, offers on its website printable wallet cards, where a doctor or paramedic could find the name and number of your ``substitute decision-maker.''

The title for your substitute decision-maker may differ from province to province, according to the Government of Canada's website. Typically they are called powers of attorney (for personal care). End-of-life care plans or advanced care plans can also be listed as personal or health directives.

There are a number of online templates of forms that can be used for guidance when setting out end-of-life care plans, and Perrot suggested writing out decisions and bringing them to a lawyer to discuss with, then storing them with wills and other important documents.


Can a child's social development be affected?

Now that playgrounds, daycare centres, schools and after-school programs have shut down nationwide in an effort to quell the spread of COVID-19, some Canadian parents are concerned for his children's social development.

Caron Irwin, a child life specialist and founder of the Toronto-based consulting service Roo Parenting, says the ages between three and six are especially important for a child's social and emotional development, with school and daycare having major roles in those areas.

Irwin says lack of routine and limited socialization may cause young children to regress in areas like potty training, speech development and eating and sleeping habits.

But young kids are highly adaptable and constantly developing. So it can be easy to get back on track by implementing a stronger routine, Irwin said.

She suggests parents create "daily rituals,'' such as starting every day with a joke and reading a story together at night. Incorporating different kinds of play — structured forms of craft time and free play, for example _ can also help.

Dr. Cassandra White, the owner of Calgary Child Psychology Group, says parents operating in a work-from-home pandemic world, providing the kind of social stimulation children need can be tough.

White suggests carving out moments of the day — even just 15-minute intervals — where parents can focus on their children, play and communicate with them.

While the pandemic has forced adults to find virtual replacements for their social needs — like Zoom parties and regular FaceTime chats — White and Irwin say those methods can also apply to children.

Screen time should still be used in moderation, Irwin said, but having grandparents video chatting with kids can be a "beneficial experience.'' She suggests streaming the video chat from a cell phone to a television for younger children who likely are more interested in the phone itself than who's on the screen.

White said setting up virtual play dates can be another unique way to provide children with much-needed socialization — even if they're not doing much talking.


How to sleep better

Tossing and turning in the middle of the night. Lying awake for lengthy stretches. Waking up groggy.

The COVID-19 pandemic seems to be messing with a number of peoples' ability to get a good night's sleep these days. And sleep experts aren't surprised by that.

Amanda Jewson, a sleep consultant in Toronto, blames pandemic-related sleep struggles on our bodies' physiological response to stress and anxiety.

She said hormones such as cortisol and adrenaline spike when we're afraid, and that makes it difficult to get proper rest.

So what can people experiencing recent sleep trouble do about it?

Some tips include sticking to consistent sleep schedules, making your bedroom as dark as possible and limiting late-night screen time that interferes with melatonin production.

Jewson also suggested a journal activity where people write down their fears and anxieties before going to bed to "get them out of their brains.'' She urges people to include positive platitudes on their lists, too.

She says regulating the amount of negative COVID-19 news being absorbed daily can also help, especially in the hours before going to bed.

Jewson tells clients to tune out pandemic coverage early in the evening to give them a buffer zone of a couple hours before they turn in.


Virtual proms and online grad ceremonies

Some teens may turn to a virtual celebration of a high school rite of passage: prom.

Nafilia Sachedina, a psychotherapist at WellNest in Toronto who works primarily with adolescents, thinks that may be a good idea.

Sachedina described adolescence as a time of "forming identity and a sense of emotional well-being,'' and having life experiences like prom and grad ripped away from teens can be particularly painful.

She says prom marks the closing of one chapter before another begins.

Sachedina says teens and parents need to find creative ways to still "honour these experiences'' while staying safe and maintaining social distance.

One way to do that may be to take prom and grad ceremonies to an online platform, something event planning companies around the U.S. and Canada are currently doing.


Can COVID antibodies lead to vaccine?

The key to unlocking some of the still unknown aspects of the virus could be in our blood.

Dr. Danuta Skowronski, the epidemiology lead at the BC Centre for Disease Control, says antibody research _ like the blood-based studies currently happening in her lab — is useful in several ways, and knowing how many people actually had the virus is one.

She says antibodies stick around after the infection, which is like a signature of having been infected, and serosurveys, also known as blood serum tests, can identify the true infection rates.

Antibodies are blood proteins the body produces days or weeks after fighting an infection, and are also used in detecting things like HIV, hepatitis, Lyme disease, lupus and many other diseases.

But how long do coronavirus antibodies last and how long could they provide any type of immunity? These are some of the questions Skowronski and her colleagues are trying to determine.

Skowronski says the important step is to "validate'' the blood samples taken from all age ranges to discover how prevalent the virus was within that segment of the population and do them again during another phase of the pandemic.

The tests, when validated, can be particularly useful in the creation of an eventual vaccine, what Skowronski calls "the ultimate goal'' of the serological research.

Skowronski believes a vaccine likely won't be available for at least 12 to 18 months, a trajectory which she says is already accelerated.


Does social distancing apply to animals too?

Experts have a message for all the pet owners venturing out for a puppy promenade: physical distancing rules should apply to animals too.

Veterinarians say it's possible dogs and cats could carry COVID-19 without actually having the virus themselves; their fur could be serving as a potential vehicle for transmission.

Dr. Scott Weese, a veterinarian and a professor at the University of Guelph, says if a dog is petted by people out on a walk and then by its owner, then its the same as being in contact with others, which is what one is trying to avoid.

Even private interactions, like letting the neighbour's kids play with one's dog on your front yard, for example, are also to be avoided.

Dr. Ian Sandler, a Toronto-based vet who sits on the national issues committee of the Canadian Veterinary Medical Association, says people have to think of pets as a social extension of the family and so they really want to distance them.


Vet services still offered during the pandemic?

Veterinarian services are considered essential but certain restrictions are in place.

Vets say pet owners may not be able to physically enter a clinic along with the animal as the pandemic rages on.

Dr. Ian Sandler, a Toronto-based vet who sits on the national issues committee of the Canadian Veterinary Medical Association, says some services will be postponed — your vet may delay a spay or neutering appointment, for example — but things like medication, rabies vaccines, and flea and tick prevention should not be interrupted.

Dr. Scott Weese, a veterinarian and a professor at the University of Guelph, says people should call ahead before taking a pet to a clinic for any type of service.

Vets across Canada have also started adopting telemedicine practices and remote consultations, which Sandler calls "a major step forward'' in the effort to limit in-clinic procedures.

Weese says it's important to remember that animal care won't be forgotten during the pandemic.

And if someone's unsure what types of services can still be provided by their vet, they can just call and ask.


Can one find loopholes in social distancing?

We've seen the pictures.

Lawn chairs in driveways for socially-distant neighbourhood parties. Talking to one another from apartment building balconies. Driving to parking lots to chat from cars parked two metres apart.

While it may seem harmless enough, some experts say those social distancing loopholes are probably not worth the risk.

Microbiologist Jason Kindrachuk says the coronavirus is transmitted by respiratory droplets, which are released into the air when infected individuals breathe, talk, sneeze or cough. The droplets will generally travel about two metres before they hit the ground.

But when you're outside with nothing standing between you and the person you're socializing with, Kindrachuk says the barrier becomes much easier to blur.

Dr. Gerald Evans, a physician and chair of the division of infectious diseases at Queen's University in Kingston, Ont., says extra precautions would still need to be considered when trying to keep distant while socializing outdoors, like ensuring any object around a person — a chair, cooler, drink glass — also remains two metres apart from the other.


How does one stay safe in close quarters during COVID-19?

The elevator door opens and someone is already inside. Do you go in, or do you wait for the next one?

For those living in large cities across the country — especially those in apartment buildings or condo clusters — physical distancing is easier said than done.

Dr. Isaac Bogoch, an infectious disease expert based out of Toronto General Hospital, says people need to use common sense when navigating high-traffic areas like condo lobbies, elevators and shared laundry rooms.

And while guidelines and passenger limits are great to see, he agrees it's difficult to make sure everyone abides.

Natasha Salt, the Director of Infection Prevention and Control at Sunnybrook Health Sciences Centre in Toronto, recommends taking the stairs when possible.

With apartment buildings brimming with high-touch surfaces — think door knobs, elevator buttons, garbage chutes, the front desk and mail room areas — Bogoch and Salt both stress maintaining good hand hygiene, especially for people living in close proximity with what could be hundreds of others.


Itching to get outdoors?

Officials are urging people to stay home as much as possible and only go out for essentials such as food and medication.

Dr. Peter Donnelly, Public Health Ontario's president and chief executive officer, says if people want to get some exercise they should do so on their own, or in very small groups of people with whom they already live.

Those who don't follow the public-health rules of staying six feet away from others also risk getting ticketed in some jurisdictions.

Infectious disease specialists are also asking people to use common sense in choosing their destinations when they want to enjoy the outdoors.

That means crowded parks, boardwalks and beaches are a no-go.

Dr. Andrea Boggild, an infectious disease specialist and associate professor of medicine at the University of Toronto, cautioned against using picnic tables, playgrounds and even sports courts, characterizing all of them as "high-touch areas.''

Kevin Coombs, an infectious disease specialist and professor in the department of medical microbiology at the University of Manitoba, says COVID-19 can also stick "fairly well'' to clothing, and conceivably to hair.

He says he would definitely go out and get fresh air, carry out most of the normal things one would do, but advises to be cautious and respectful of social distancing.


What you need to know about takeout?

Experts say while the chances of transmission via food courier are quite low, taking a number of precautionary steps can help minimize risk and put the mind at ease.

University of Guelph food science professor Keith Warriner says there's more chance of being infected by a person rather than a parcel.

Research published in the New England Journal of Medicine last week suggests the virus can live for up to 24 hours on cardboard. On other surfaces, including plastic, it can survive for up to 72 hours.

Warriner says while there's a small possibility an infected person may have sneezed or coughed while handling your food order, chances that the virus will be passed along on the packaging are slim.

He says frequent hand-washing, particularly before or after handling food and containers, can further mitigate the risk.

So handling that pizza box shouldn't really be cause for heightened concern.


How to eat healthy during the pandemic?

Experts say healthy food options are still possible while practising social distancing and self-isolation, even if it means having to rely on frozen and canned choices in an effort to make grocery store trips less frequent.

Debora Sloan, a registered dietitian in Ottawa, is encouraging people to have fun with recipes and make things that they can freeze and store for later.

She says things like tofu, Greek yogurt, egg whites and cottage cheese are perishable protein items that "last longer than we think,'' and that lentils and canned beans, chickpeas and tuna pack a protein punch with a longer shelf life.

She says having a plant-based protein powder on hand to add to things like smoothies and pancakes can help too.

Frozen fruits and vegetables also provide plenty of nutrition, says Sloan, adding that frozen options can be even better than fresh produce that has been sitting on a delivery truck after it has been picked.


Is online shaming of COVID 19 rebels effective?

Experts in psychology and sociology are divided.

Hilary Bergsieker, an associate professor of psychology at the University of Waterloo, says it's a tough one because to do it on the scale that would have impact, the audience really matters.

For teenagers, she says, sometimes the disapproval of others can almost be like a badge of honour.

Harris Ali, a sociology professor at York University in Toronto, believes that type of online shaming can work.

He sees the situation as one of "social control,'' which he describes as influencing people to change their behaviour, and likened online shaming to earlier public health campaigns against smoking or drunk driving.


How well can cellphones carry COVID 19?

A microbiology specialist from Edmonton says cellphones are like an extension of a person's body.

Jason Tetro says people have to think of their cellphones in the same way that they would think of their hands or feet and keep it as clean as they would normally keep their limbs.

Tetro, the author of "The Germ Files,'' says a cellphone — like any other surface — can be contaminated by the coronavirus if it comes into contact with droplets from an infected person.

Those droplets, he says, can remain infectious for "several hours,'' though the degree of their ineffectiveness depends on how long they've been there.

Tetro, who also goes by "the Germ Guy,'' cleans his own phone multiple times a day — one thorough cleaning followed by periodic wipes.

He suggests using a damp cloth with soap to disinfect, being careful not to use too much liquid on an electronic.

He says eye glass cleaning solutions, which typically contain some form of detergent, also work.


What you need to know about WFH?

Experts say separating home office from living areas is important and that means no to using your laptop on the couch, and no to transforming your dining room table into a makeshift desk.

Toronto-based interior designer Laura Stein says the novelty of wearing PJs all day and taking important phone calls even when one hasn't taken a shower can wear off pretty quickly.

She also says natural light from windows is another must-have to avoid eye strain and depression.

Ashley Vancardo, an instructor at the Interior Design Institute of Canada, says as social distancing and self-isolation practices continue into the future, people may have to consider upgrading their current home office equipment, which includes ditching the dining room chair for an ergonomic option.


Can online AA and NA meetings help?

Dr. Nancy Hurst, a psychologist in Edmonton, says maintaining connection will be key for those suffering with addiction throughout the duration of the pandemic.

Alcoholics Anonymous and Narcotics Anonymous meetings are operating nationwide using Zoom, Google Hangouts and other video-conferencing systems.

Hurst called the online AA meetings "absolutely essential,'' and says she would encourage those who need help to find a support group "that fits for them.''

She says social distancing and self-isolation can lead some to "fall into a negative mindset and into destructive patterns.''


Is there love in the time of COVID-19?

COVID-19 has upended the dating scene.

Experts say people who live alone will be among the hardest hit by the emotional effects of the coronavirus, with stress and uncertainty only compounding the loneliness of isolation.

Ramona Pringle, the director of the Faculty of Communication & Design's Creative Innovation Studio at Ryerson University, isn't surprised that singles are seeking refuge in dating apps.

She says people should be profoundly grateful that they've got these tools, and while dating apps are not going to be for one-night hookups, they're going to be satisfying the need for human contact.

She says people need to be leaning into the ways that they can be there for each other digitally, and that's why dating apps are "so, so, so important.''

However, Newfoundland and Labrador's health minister is urging people to think twice before meeting up with an online match as they swipe through dating apps during the COVID-19 pandemic.

John Haggie added a plea for safe usage of digital dating tools as he stressed the importance of physical distancing to slow the spread of the disease.

He says dating apps are seeing increased use as people spend more time at home and seek out company, but they come with risks.


How should you talk to kids about COVID-19?

An expert in child psychology says parents should do their best to answer children's questions, but they should also be selective with the info they choose to share.

Psychotherapist Alice Wiafe says children need to know that they should be extremely cautious about touching things, wash their hands, use proper sanitization, and not be too close in proximity to people who are not their immediate family.

She says they don't need to know that a thousand more people died over the weekend because it does nothing for them to know that.

Wiafe acknowledged that parents may be fearful of the spreading coronavirus, but being mindful of how they're presenting that anxiety is important.

With kids also tending to pick up behaviours by watching their parents' actions, she says modelling healthy habits during a stressful time can go a long way.


This report by The Canadian Press was first published April 28, 2020

News from © The Canadian Press, 2020
The Canadian Press

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