Nipun introduced our guest speaker: Dr Mangesh Inamdar, Emergency Physician at Oakville Trafalgar Hospital, graduated from McGill University. 

 

Dr Mangesh Inamdar answered the members' questions on the current situation of Covid-19 in Halton and Canada. 

 

Situation in Halton?  We are actually doing quite well. There are no cases in Oakville Trafalgar Hospital. Across Halton there are 1 case in Milton 1 case in Burlington hospitals and a handful of cases under investigation. 
 

How is testing going? Anyone who wants a test can get it. 70k people tested. 8k tests pending. Turn around time is about 5 day. 
 

Treatment? Dr Mangesh Inamdar mentioned the Dexamethasone with positive preliminary results on patients on oxygen or ventilator. 60 yo patients seems to be responding best to the treatment. He nevertheless recommended caution: Data have not yet been published or peer reviewed. 
 

Mask wearing? He supports mandatory mask wearing. Current studies are in support of mask wearing. If 80% of the population wear a mask it could make a significant impact on the number of cases. 

Chance of a second wave? This is a delicate topic. What is a 2nd wave? From what change in shape of the curve can we talk of a 2nd wave - If one asks 5 experts, he may get 10 different opinions. Dr Mangesh Inamdar expects we will do quite well in Canada, but the difficulty is modeling human behavior - there is no past experience to rely on. It is important to note that in Sweden where no strict confinement was implemented, only 6% had antibodies to the Covid => herd immunity is probably not going to happen. In the world: most countries are still in the first wave. We also cannot really look to the South as a predictor as the situation is very different. 
 

Next 12 months? Situation will probably stay where we are: social distancing + masks. He expects an exception for children going back to school: studies seem to show children are not super spreaders in general. Only way to really get the virus away is mass vaccination.
 

Do we have access to sufficient PPE? Hospital has 90 days supply for most PPE - situation is secured. 
 

Wearing gloves? He does not see wearing gloves has a positive protection for the general population. Virus sticks as well on a hand than a glove. He recommends washing hands instead. 

Point of care testing: 15 minutes tests are under investigation. Attention: tests are not perfect - all tests can have false negative or false positive. Right now those short time tests are not where we would want them to be in terms of accuracy.
 

Herd Immunity?  Ottawa will launch some studies to test more broadly on the immunity - however antibodies may not stay very long in the body. It is difficult to make a definitive statement. 

 

Travel? Travel advice will change day to day. Main criteria is where to go - how many cases at your destination country/location. He recommends staying away from our southern border right now. 

Recommendation on mask construction: practically whatever you can do. Basic cloth is already giving some protection. Of course N95 is the best but there are both supply issues and the difficulty to keep it on all day. The official recommendation is to use a non-medical mask. His recommendation to wear a mask that you are comfortable to wear for a long time. A mask is better than a shield. In hospital they use both. If one has to choose either mask or shield, he would go for the mask. 

 

Vaccine? Will the virus mutate and need to tweak the vaccine every year or will the vaccine be efficient on all strains at once. His gut feeling is that a single mass vaccination will not be sufficient to get rid of the virus once and for all. 

 

Worse of the pandemic in Halton? We never outstripped our capacity or been overwhelmed. Halton Hospital canceled a lot of elective surgery in a preventative manner, ensuring the situation did not go out of hand. They are still not back to normal in terms of elective surgery. For now they are restarting mainly with "simple" surgery or day surgery without the admission.

=> They want to keep at least 15% capacity available at any time. 

Trouble spots in Ontario are diminishing. The last one was Windsor. Now the whole province is in Phase 2. Peel & Toronto have more cases than Halton but they are also not overwhelmed. It is to be expected to have more cases in more populated areas, which is why GTA, Quebec and Alberta lead the number of cases country-wide. 

Melbourne Australia: Can't comment - any country with wide spread testing & contact tracing should be capable to quash any small outbreak. Problem is if cases go above a threshold where you can't do tracing anymore.