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Social distancing key to stopping spread of COVID-19

“All it takes is about 15 episodes of transmission in a crowded area before you’ve reached into the millions of possible contact,” said medical director of the Banff Mineral Springs Hospital Dr. Matt McIsaac said. “You get this exponential curve of the spread that happens because it’s not just the one person who goes onto spread it.”
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Main Street in Canmore sat nearly empty on Saturday (March 14). The community, like the rest of the province, has been asked to practice social distancing to reduce the potential for the spread of the COVID-19 novel coronavirus. EVAN BUHLER RMO PHOTO⁠

BOW VALLEY – Local doctors are calling on Albertans to take proactive steps to ensure the COVID-19 virus does not push the valley's health care system past its threshold.

Social distancing will play a key role in limiting the spread of the virus, said Dr. Alina Constantin of the Three Sisters Family Medical Clinic, because COVID-19 is spread by contact droplets and is not airborne.

“If somebody coughs, or sneezes or talks, and expectorates [cough out phlegm from the throat or lungs] while doing it, unfortunately, that is a sure way to transmit the virus,” she said.

Alberta’s chief medical officer of health announced that as of Tuesday (March 17) afternoon there were 95 confirmed cases of the COVID-19 virus in the province.

“Outside the body, it [COVID-19] dies in hours,” Constantin said, explaining it can exist for a maximum of 24 hours.

“Outside the body, the virus is not potent – if we don’t allow it to multiply that’s how we flatten the curve and hopefully stop the spread.”

The key, she said, is to clean anything people touch, be it door handles to phone cases, to toilet seats and everything in between, to prevent transmission.

If anyone has symptoms, self-isolation is necessary, she added, for about 14 days based on recommended guidelines.

Constantine said people with COVID-19 can appear healthy and noted that 80 per cent of people infected may have very mild symptoms similar to a cold, 20 per cent could have severe respiratory complications, which largely affects older people, have underlying health conditions, chronic illnesses and five per cent will become very ill.

“The World Health Organization stipulates two-metres, six-feet, or spitting distance,” Constantin said. “It’s a safe distance to be from one and other.”

The virus multiplies very quickly, she said, and carriers can infect about 2.5 people. This number increases exponentially in crowded places.

“Social distancing is paramount to not allow the virus to spread,” Constantin said.

“Practice good hygiene like washing your hand regularly, stay at a very safe distance … and cover your mouth if you actually have symptoms, or even if you don’t, for your own self-protection would be very, very good practice to actually promote health and stop the virus from spreading.”

While maintaining physical distance is important, Constantin added that it is also vital to stay connected with friends and family to maintain mental health.

“You can still talk on the phone, you can still converse on social media, you can still meet in person as long as you keep that safe physical distance,” Constantin said.

“We do not want to foster poor mental health in the process of being fairly vulnerable right now with what is going on.”

Dr. Matt McIsaac, Mineral Springs Hospital medical director and a physician with Banff Sport Medicine Canmore Clinic, said the province is approaching the critical point of the COVID-19 pandemic, making social distancing essential to help curb the spread of the virus.

“All it takes is about 15 episodes of transmission in a crowded area before you’ve reached into the millions of possible contact,” McIsaac said.

“You get this exponential curve of the spread that happens because it’s not just the one person who goes onto spread it.”

The Bow Valley is a community that loves the great outdoors, McIsaac said, and while it is OK to go outside, social distancing is critical.

He said the virus replicates best at around 8 C to 9 C and as one breathes in the air it creates the perfect incubator for COVID-19. A further challenge created by the virus is that carriers may not show any symptoms for up to 24 days before they become symptomatic.

This can prove challenging in the Bow Valley because many tourists who could have been transmitting the virus have been interacting with locals, McIsaac said. He added this danger is increased in Alberta because there are at least two cases in the province that occurred through local transmissions between community members.

“Behave as though you have it,” McIsaac said. “You might and you wouldn’t necessarily know that you didn’t have it.”

A major danger of COVID-19 is that it causes unpredictable pneumonia that especially affects older people, particularly those who are 80 or older. Pneumonia can in some cases lead to acute respiratory distress syndrome.

It is currently believed the infection rate falls between 30 to 50 per cent, although some estimates are as high as 70 per cent. The current fatality rate based on the reported cases of the virus is around 3.5 per cent.

Half of those with a serious infection rate will require medical attention in an intensive care unit (ICU).

It is crucial to flatten the curve of infection, he said, because this helps reduce the risk of fatalities because the health care system will not go over capacity.

McIsaac said across Canada there are just over 3,000 ventilators available to treat those experiencing the most serious effects of COVID-19.

“The purpose of social distancing is to limit the massive spike in new cases because if we have all those cases happen at once, we’re going to have need of all those ICU beds – you can see how quickly that would become overwhelmed if everyone got sick at the same time," McIssac said.

In Banff, there are four portable ventilators within the hospital’s emergency and EMS services and three anesthesia machines that can be used as ventilators. The Canmore General Hospital has three ventilators.

McIsaac said it is critical to work within the threshold of the health care system because while the cases of COVID-19 are increasing exponentially, other health events are still taking place.

“It’s not as though heart attacks are going to stop all of a sudden just because COVID-19 is here,” McIsaac said.

If the threshold is crossed in the health care system McIsaac said, “people start dying.”

The doctor cited the experience of Italy as a terrible, but excellent example of what happens if a health care system is overwhelmed with COVID-19 cases because people did not immediately practice social distancing, self-isolation and quarantine.

Those infected with the virus quickly overwhelmed hospitals forcing them to the point of triaging patients, McIsaac said.

“That’s a horrible decision to have to make,” McIsaac said.

“Our ability to flatten this curve will greatly help health care workers and reduce the mortality burden of this illness on the population in general.”


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