#Coronavirus: #COVID-19 Exposure and Transmission

Snapshot of Situation: February 29, 2020:

The World HealthOrganization (WHO) has not yet declared this a pandemic. However, the virus is being seen in 62 countries. Unfortunately, the real prevalence data and information may not be accurate due to a lack of testing, and surveillance by governments and public health authorities in many nations. 

It does appear as though this new virus is endemic, and will likely continue to spread, exposing, and being transmitted to people over the long term. While this is certainly not a good thing, it also isn't something that should panic people. Its information we should use to consider risks involved with certain behaviour, which is much more important for people who are at higher risk of complications from COVID-19. More severe, critical, and acute cases are associated with older age, certain health conditions, and immune-suppressed people. 

Prevalence data sources:

WorldOMeter: COVID-19; Coronavirus https://www.worldometers.info/coronavirus/

Johns Hopkins Global Data: http://coronaviruslivestats.com/

WHO Situation Reports (provide statistics): https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/

Exposure to COVID-19

Exposure: This occurs when a person comes into contact with the virus, novel coronavirus, now called SARS-CoV-2. 

Ways People Get Exposed: Viruses find a way to enter the body in some way. A lot of this is through our mucous membranes, such as our mouths, noses, and eyes. 

Breathing in/Inhaling respiratory droplets of the virus from someone who has breathed it out. For instance, someone sneezes, or coughs and we inhale the droplets that are in the air. 

Touching surfaces the virus has infected, and then touching an area where it can get into our body. For instance, you touch a surface, then rub your eye. 

Aerosolization: It’s a bit unclear/not confirmed as to whether the virus can remain airborne, or for how long. China, and its researchers, have reported that it can be airborne, and people can be exposed to the virus this way. 

Special note: For safety, its probably best to consider that it can be aerosolized, and we have a risk of picking it up that way, and be cautious in medium to higher-risk environments. 

Many health care providers have been developing health protocols for managing this when engaging in procedures that involve aerosolization. 

Exposure Risk Categories: 

Some people are at lower, medium, or higher risk for being exposed to COVID-19. These are just some guidelines. 

Lower risk: People who have limited contact with others, and/or may not spend much time in the community. Being in the same indoor environment as someone who may have it, but not being in close contact with the person, such as sitting on an airplane, or other transportation, but sitting over 6 feet/2 metres from them. 

Medium risk: Close contact with a person who has COVID-19. This includes living with, or sharing a workspace/working closely with someone. Being seated within 6 feet/2 metres, or two seats, of someone on an airplane, or other enclosed space with someone who is symptomatic (and possibly asymptomatic) with COVID-19.

High-risk: Living in the same household, providing care to someone, or our intimate partner if they have COVID-19, or are a carrier for it. 

Certain individuals, by virtue of their work, and contact with people who have COVID-19 are at high-risk for being exposed. This includes:

• Travelers who have returned from countries where medium to high person-to-person community spread and transmission is occurring (China, Iran, Italy, South Korea). This is going to change as the pandemic continues and escalates around the world. 
• Health care workers: Through their direct, front-line work with people with COVID-19 (tested/untested; diagnosed/undiagnosed). 
• People who work with the public: Border agents; people working in airports, flight crew on planes; retail workers; and others.
  

High-risk Exposure Locations

• Health care settings: family doctor and walk-in clinics; urgent care; and hospitals
• Airports and airplanes
• Public transit and other public transportation: buses, ferries, skytrain
• Locations where a high number of people with COVID-19/carriers may spend time: This could include restaurants, malls, other social, or commercial settings. 
• Crowds and Community Events: While the pandemic is continuing to escalate, and community transmission continues, crowds and events are going to increase in risk. 

Dr. John Campbell: Droplet v Airborne Transmission

Coronavirus Epidemic Update: 10: New Studies, Transmission…Prevention (2019-nCoV). (4:50)

References

Center for Disease Control. How COVID-19 Spreads. Retrieved from: https://www.cdc.gov/coronavirus/2019-ncov/about/transmission.html. 

Center for Disease Control. Interim US Guidance for Risk Assessment and Public Health Management of Persons with Potential Coronavirus Disease 2019 (COVID-19) Exposure in Travel-associated or Community Settings. Retrieved from: https://www.cdc.gov/coronavirus/2019-ncov/php/risk-assessment.html.

Government of Canada. Coronavirus Disease (COVID-19): Frequently Asked Questions (FAQ). Retrieved from: https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/frequently-asked-questions.html.

#PandemicPreparedness Planning for #Coronavirus: How to Enhance Your Individual, Family & Neighbourhood Response

Coronavirus Pandemic Preparedness Planning

The “window of opportunity” to contain and prevent the spread of #Coronavirus has closed in many places. Sustained, community person-to-person transmission has already been established. It is growing in many cities, regions, towns, and countries. This requires a shift in our thinking, and behaviour, to minimize the risks, harms, and poor outcomes for us, our loved ones, and our communities. This is the time to be practical, strategic, and focused on planning and getting prepared to take care of ourselves, our loved ones, and communities.

Preparing for a pandemic is essentially the same as preparing for any serious, or catastrophic emergency.  Because this concerns public and personal health we need to make some additional plans related to providing for our health care needs, or those we also care for, and trying to minimize, and decrease risks associated with viral transmission. 

At this point, my focus is on getting information and resources to people, as we may need to manage all manner of things on our own, in our local communities. It is important to not let fear and anxiety get in the way of solution-focused planning and enhancing our resilience for dealing with and managing the emergency situations, and increase survival rates. 

It is also crucial that people take personal responsibility for planning and readiness for themselves, and their loved ones. In crisis situations, people who haven't prepared will encounter more problems, and may not be able to have a successful and sustainable way of managing, or even surviving, what life is throwing at them. 

Emergency Preparedness Planning: Stocking up on Water, Food and Other supplies

• Water – Ensure you have enough for every member of your household for an extended period of time. 72 hours is a good start, but think longer-term. 
• Fresh, canned, and packaged foods – Prioritize having proteins, vegetables, fruit, especially antioxidant-rich foods. 
• First aid kits – Fully stocked, prepared for any medical emergency with the resources you may need. Take a First Aid & CPR course as part of your planning. 
• Food and supplies for your pets, including medications, if required. 
• Medications – Ensure you have several months worth of medications for those who need them. 
• Over-the-counter cold/flu & cough medicines for adults and children – You may be on your own to manage the symptoms. Fortunately, the current research is that approximately 81% of cases are mild. 
• Sanitation management - Plan ways to manage garbage, food waste, and other sanitary and hygiene issues if regular pick ups stop for a time. Consider a way to burn paper items, and how to manage liquid and solid waste in emergency situations. 
• Heat - Depending on where we live, being able to have a source of heat may be a survival priority. Fireplaces, heaters, blankets, and other ways to keep warm may become very important. 
• Light sources – Flashlights, candles, matches, lanterns. Batteries of different kinds. 
• Ability to cook without electricity – Whether that is a BBQ, Coleman stove, or over an open fire, make sure you have a way to cook hot food. 
• Food Storage – Have a way to secure and store your food, and a way to keep it fresh and cold, and out of reach of animals, if that becomes necessary. 
• Cleaning, Toilet and Laundry Supplies – Ensure you have bleach, bleach wipes, paper towels, and any other cleaning, and laundry supplies you need. Toilet paper is essential. Face tissues to help manage symptoms. 
• Masks and plastic gloves – N95 masks may help decrease the transmission of COVID-19 for those who have it. There isn’t evidence-based research that says they help people not get it. Plastic gloves can help potentially decrease risk associated with touching surfaces that could be infected, or when caring for others who may be ill. 
• Create a File Folder with Your Important Documents – Ensure you have your passport, identification, copies of your Power of Attorney, Will, and any other personal and financial planning documents arranged for your loved ones. Tell trusted others where these can be found.  
• Planning for your children and vulnerable adults – If you have children, elderly, and/or vulnerable loved ones, ensure there is a safety plan for who will provide care and support for them in the event of something happening to you. Go over the plan with your loved ones, and extended family. 
• Ensure a trusted person can care for you/your children/vulnerable dependents financially – This can be done formally, through personal and financial planning documents. Informal plans should also be in place in the case of you not being able to take care of your children/vulnerable dependents financially. See Nidus for more information and templates for personal, health care, and financial planning. 
• Prepare for Special health needs – If you, or family members have any special health conditions, and needs, ensure you have a document that explains what the conditions and needs are in a simple, straightforward way, including instructions for medications, procedures, or any special needs. 
• General and Manual Supplies – Can openers; scissors, exacto knives/cutting instruments; have supplies for anything you might need that requires equipment, and consider what you would need if you had no electricity for a time. 
• Have cash on hand – If banks, or the banking system wasn’t working, ensure you have enough money on hand to buy supplies. 
• “Grab and Go” bag/tote – If you had to leave your home/location quickly, having a grab & go bag/tote ready with essential supplies is important. 
• Buy an Emergency Kit – It may be worth the money to invest in an emergency kit. 
• Things to Occupy & Entertain – Children, teens, and adults will need something to do with their time. Books, games, puzzles, toys, cards, or any other things that will help people have a focus, or be entertained is a good thing. 
• Substances – You may want to ensure you have a supply of your “substances of choice” on hand. If that means a few bottles of wine, cannabis, or other things. I don’t endorse using these as a way of coping, but an emergency isn’t the time to realize you really need caffeine to survive/its not a good time to detox from anything. 
• Supplies for Quality of Life – There are all things we don’t need in emergency situations, but things we use that improve or enhance our quality of life in some way. Ensure you have a supply of the things that do this for you. This could be as simple as personal hygiene products, such as toothpaste, deodorant, 
• Mental Health Care & Support – Anxiety, fear, panic, and trauma for children, youth, adults, vulnerable people, and pets are real. In times of emergency, being able to have/share connection, care, and support with others enables our resilience to flourish, and can help us tap into our internal strengths and resources, which we can then share with others. 
• Connect with others at a neighbourhood & community level – Individual, family, and community resilience are enhanced when we find/create ways to connect with
• Get Your Garden On! – Local food security/access to food is often one of the major impacts of emergencies. Even if you have never gardened before in your life, if you have any green space in your yard, have a patio, or anywhere that has good exposure to sunlight obtain gardening supplies (pots/containers; soil, seeds, or “starts” (young plants) and get planting. Also connect with other local community gardeners/farmers. Sharing of seeds, tips, and other resources are all things we can do to boost local food security and community resilience. 
• Build Local/Neighbourhood Capacity & Resources – Having access to tools, experienced and knowledgeable people all help boost local responses, and help shift things from what might be a negative situation, to a more hopeful, positive, and strengthening experience. 
• Volunteer & Connect – Assess the safety risks in your area and consider finding ways to volunteer and help others out, or your neighbourhood. Check on vulnerable neighbours. Share helpful, factual information through your interactions with others.  
  

Additional Resources

Preparing a Family Emergency Kit in Plain English video

How to Make a Dollar Store 72 Hour Emergency Kit

Emergency Supply List from FEMA: https://www.fema.gov/media-library-data/1390846764394-dc08e309debe561d866b05ac84daf1ee/checklist_2014.pdf 

Your Emergency Preparedness Guide – An excellent printable resource to get your important information and plan down on paper. Discuss and include all members of your family so they know what the plan is, and review it.
Link: https://www.getprepared.gc.ca/cnt/rsrcs/pblctns/yprprdnssgd/index-en.aspx

Prepare for An Emergency from the Government of Canada: 

Link: https://www.getprepared.gc.ca/index-eng.aspx

Get Your Kit Together Videos: Emergency Kits for Home, Work, Older Adults & Kids; Grab & Go kit:

Link: crd.bc.ca/prepare-yourself

Videos: https://www.youtube.com/user/prepareyourselfca

Nidus Personal, Health, and Personal Planning in British Columbia (templates)

Link: https://www.nidus.ca/

How to Prepare for Death Needs – Catastrophic emergencies leave families struggling to cope with their grief, as well as the practical needs to make arrangements for the death, cremation, and/or funerals for loved ones. One of the most important things we can take responsibility for our proactive planning while we're still here to make these arrangements. This also reduces stress, strain, and struggle for our loved ones. 

This BC website outlines how we can receive support for this planning. Check to see if your province/state/territory has anything similar by googling: 'memorial society planning [your area]'. 

People’s Memorial Society of BC & Vancouver Island Memorial Society

Link: http://www.peoplesmemorialsocietybc.com/

#Coronavirus: #COVID19 - Introduction, Facts, Timeline and Terminology

                 

Introduction

The emergence of a new virus, now being called, #novelcoronavirus, which manifests in the illness called #COVID19, is part of the coronavirus family. This new virus has led to a great deal of false information, misinformation, and disinformation on the parts of many. In an effort to counter this, what some might consider a 'disinformation war,' I decided to create a series of posts to provide information that is:

• Evidence-based; 
• Arises from credible research data, and peer-review studies in reputable publications and journals;
• Informative, timely and helpful; 
• Includes evolving and emergent information, data, and research on this new virus. 
  

Facts

 In early December, 2019, a new virus, called, novel coronavirus, first appeared in the Hubei province of China. Several patients in Wuhan, China, presented with severe symptoms of pneumonia.  

Early research on the first set of patients who presented with this new virus indicated that some who presented with the new virus did not have a connection to a local "wet market" in Wuhan where a wide variety of animals, including wild life, were slaughtered for food. At this point, it is unclear if the outbreak originated in, and/or was restricted to Wuhan. 

The World Health Organization (#WHO) identified this as: "A novel coronavirus (CoV) is a new strain of coronavirus that has not been previously identified in humans.  The new, or “novel” coronavirus, now called 2019-nCoV, had not previously detected before the outbreak was reported in Wuhan, China in December 2019."

On December 31^st, 2019, China reported an outbreak of the novel coronavirus to the WHO. 
On January 30th, 2020, the WHO declared the novel coronavirus a "public health emergency of international concern." 

On February 11th, 2020, the WHO renamed the virus #COVID-19, with the head of the WHO, Dr. Tedros Adhanom Ghebreyesus stating, "the disease represented a "very grave threat" for the world." He also stated that there was still a "realistic chance" of stopping it. 

Timeline

CBC Timeline: https://www.cbc.ca/news/health/coronavirus-timeline-1.5438115

Wikipedia: Timeline of the 2019–20 Wuhan coronavirus outbreak in December 2019 – January 2020.

Link: https://en.wikipedia.org/wiki/Timeline_of_the_2019%E2%80%9320_Wuhan_coronavirus_outbreak_in_December_2019_%E2%80%93_January_2020

Terminology

The WHO will not call this a #pandemic, although this is the organization's definition:

                           "A pandemic is the worldwide spread of a new disease." 

WHO: “An influenza pandemic occurs when a new influenza virus emerges and spreads around the world, and most people do not have immunity. Viruses that have caused past pandemics typically originated from animal influenza viruses.”

Symptomatic: People who are experiencing symptoms that may be associated with a viral infection, such as COVID-19. The most identified symtoms in the research are: fever; 

Asymptomatic: People who have been exposed, but do not have symptoms associated with a virus. 

Incubation: The period of time between exposure to a virus, and when the individual develops symptoms.  

“Shedding” the virus: transmitting the virus in some manner. 

Transmission: how the virus spreads, or is transmitted to others.

“R Naught’: Reproduction rate related to the rate the virus spreads from one person to others. 

• Currently, credible research is indicating the R rate for COVID-19 is believed to be 2.6 (uncertainty range: 1.5-3.5), which means one person can transmit the virus to between 2-3 people. 

"Super-spreaders:" Individuals who are exposed to a virus who appear to transmit it to a higher number of individuals (increased 'R' rate), across

• Research from the SARS epidemic (2002-2003) identified that there were certain individuals who were identified as spreading/transmitting that form of coronavirus to a higher number of people, over a larger geographical distance, and may trigger a cluster, or outbreak in a particular setting, or area. 
• These individuals have come to be called, "super-spreaders" in the research on viral epidemics and outbreaks. 
• Super-spreaders are considered "outliers" as they are seen to have a different transmission rate, or R rate, than is the norm for a particular virus. 
• There is no scientically identified, or specific number of people associated with these individuals. 
• Some individuals may transmit a virus at a higher rate than others, but there has not been any evidence identified as to what characteristics these individuals may have that leads to this. 

Cluster: A group of individuals who are connected in some way who become symptomatic from a virus. For instance, a family, friends, or a work group, could end up being exposed, and then developing symptoms of the virus.
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#novelcoronavirus #coronavirus #2019nCoV #COVID19 #COVID-19 #pandemic #CoronavirusCanada #publichealth #publichhealthcanada 

#WorkSafeBC: Letter to the Editor: Call for WorkSafeBC rebates is premature.

Call for WorkSafeBC rebates is premature

Young, T. (June 6, 2016). Call for WorkSafeBC rebates is premature. Vancouver Sun. Retrieved from: http://vancouversun.com/opinion/letters/june-6-lng-right-to-die-poverty-worksafe. 

Re: WorkSafeBC rebate for business owners is overdue, Opinion, May 30

Laura Jones’ argument that WorkSafeBC should rebate business owners due to “overfunding” falls flat. A likely source of the “overfunding” is the numbers of injury claims WorkSafeBC denied workers over 2014 and 2015.

WorkSafeBC revealed 146,814 injuries were reported by workers in 2013. WorkSafeBC disallowed 8.6 per cent of claims. There is no data about claims accepted or disallowed for 2014 or 2015, a serious oversight in terms of  transparency and accountability. 

Another concern is that one per cent of WorkSafeBC decisions on denied worker injury claims were overturned at the Workers’ Compensation Appeal Tribunal (WCAT) “due to perceived error in the application of legislation or policy.” This is an increase over 2014 numbers. 

As a registered social worker and counsellor I have assisted people injured or disabled in the workplace and many have been failed by the system, often leaving these workers and their families in crisis. 

The B.C. Supreme Court recently ordered WorkSafeBC to reopen and investigate a claim they denied where a man was bullied, demeaned and harassed by a supervisor. How many other such claims has WorkSafeBC denied? Until they report this, it is premature to talk about rebates for employers.

Tracey Young, Catalyst Enterprises BC: Counselling, Consulting, Coaching

#WorkSafeBC #workplacesafety #occupationalsafety #OHS #bcworkplaces