#COVID19 – Path to Pasture

Decision Making in 2022

June 12, 2022June 12, 2022 granny18

Photo by Andrea Piacquadio on Pexels.com

The Decision-Making Matrix

Over the past two years, we have been thrust into constant risk assessment and priority-based decision-making. Decision-making strategies meant for big business moves were suddenly applied to a local hockey game, an anniversary dinner, or a vaccination.

COVID risk assessments will differ based on your age group, vaccine status, and the people you interact with (some of whom may be immune-compromised). My priorities will differ from yours. Undoubtedly.

The risk assessments have evolved as COVID and vaccine development have evolved. I turned 60 during a pandemic that had taken particular aim at my age group, my husband’s even more so. Into that realization, we strode… aware that we would minimize our contacts, wear a mask, wash our hands and all that jazz. It made sense for us. As each vaccination became available, we were first in line. We still wear a mask in some scenarios.

As travel began to open up, a long-held dream to travel to Tuscany began to peek out from under the trash heap of COVID. I wanted to go to celebrate my 60^th birthday.

But…SHOULD I?

Now, I come as a package deal, and my husband is the most cautious being on the planet. (Sometimes annoyingly so, to be honest!) His own risk and priorities needed to be considered too.

The situation had gone around so often that we were aware that it could change again.

There were lots of reasons NOT to go. COVID had not disappeared. COVID did sometimes break through vaccines. COVID is of particular risk to those with heart disease, and the moustache guy suffered a heart attack 20 years ago. It would cost money, and I’m cheap. (Scottish, don’t ya know?)

So why go?

We are growing older. If I was 30, I might delay a little longer to feel more confident, but 30 has been doubled, and my husband is getting to the point where travel insurance will be a considerable part of trip costs.

We both enjoy hiking on our travels, but admittedly the joints are beginning to protest. We feel compelled to do as much as we can as long as we can do it! (And time is passing quicker these days!)

We are fully vaccinated, travelling to a well-vaccinated location. Why does “fully vaccinated” matter? The most concerning things about COVID are landing in ICU or dying, right? There are a LOT of COVID19 statistics on the Alberta Government COVID statistics page. Still, I focused on ICU admittance and death (per 100,000) for the vaccinated vs. the unvaccinated. (per 100,000 gives us a truer picture. Percentages for ICU and death can be misleading. Remember, percentages among completely unvaccinated come from about 9% of the 12+ population. The percentages for fully vaccinated come from about 87% of the 12+ with at least 2 doses)

Let’s have a look.

ICU hospitalizations

COVID-19 ICU admission, count and rate (per 100,000 population), in the past 120 days in Alberta by vaccine status.

Age group	3 doses & admitted in ICU (rate per 100K)	2 doses & admitted in ICU (rate per 100K)	Unvaccinated & admitted in ICU (rate per 100K)
Under 5 years	0.00	0.00	20.54
5-11 years	0.00	0.00	4.33
12-29 years	0.88	3.62	7.68
30-39 years	0.84	4.26	15.07
40-49 years	5.38	11.96	35.42
50-59 years	10.71	24.55	93.39
60-69 years	21.43	48.57	361.04
70-79 years	39.46	72.16	619.93
80+ years	26.62	70.14	97.24

Deaths

COVID-19 deaths, count and rate (per 100,000 population), in the past 120 days in Alberta by vaccine status.

Age group	3 doses & died (rate per 100K)	2 doses & died (rate per 100K)	Unvaccinated & died (rate per 100K)
Under 5 years	0.00	0.00	0.00
5-11 years	0.00	0.00	0.00
12-29 years	0.44	0.33	0.00
30-39 years	0.00	1.14	3.01
40-49 years	0.38	0.75	12.32
50-59 years	3.35	5.87	40.86
60-69 years	12.68	38.68	165.05
70-79 years	49.09	109.48	782.29
80+ years	289.12	365.71	996.66

Remember our age group? 60 – 69. This part of the decision-making matrix was pretty straightforward. Get vaccinated, especially if you want to travel.

We are travelling from Alberta, Canada, with an 87% 2-dose vaccination rate and travelling to Italy. How protected are Italians? “So far, approximately 48.6 million people in Italy have received two doses, corresponding to roughly 90.1 percent of the total population over 12 years of age. Additionally, three out of four Italians have also received the booster shot.” (Statistica.com June 2022) Seems like Italians are pretty COVID conscious, not surprising given their start to a pre-vaccine pandemic.

Our greatest protest for healthcare

https://pathtothepasture.com/2020/11/07/our-greatest-protest-for-healthcare/

Alberta had lifted its mask mandate, but airports and airlines still had theirs. Italy, at the time we were planning, still had a mask mandate in public places. Overall, I felt just as safe in an airport, an airplane, in Italy, as I was at home. That said, it’s HARD to overcome 2 years of constant vigilance, isn’t it? Still, we kinda sorta started planning.

The first step was to book vacation rentals, but only those with free cancellation up to 24 hours ahead. More were available than I expected; I imagine this comes from their own adjustment to the pandemic reality. Having free cancellation certainly gave them an edge in my case.

Next, medical insurance should we become ill, and new to me…COVID pandemic insurance. A medical policy is already pricier than it used to be. We paid over a thousand bucks just for insurance, but better safe than sorry!

The rental car was also chosen for their cancellation policy. (We will get into whether this agency was the right choice later!)

During our planning, the COVID19 test requirement was removed for vaccinated travellers, with only random travellers selected. That was one less hurdle!

My son-in-law donated (paid for renovation help) Westjet miles covering one direction, so the trip would be more affordable! In addition, I was reassured by HEPA filters in Westjet’s 787 Dreamliner. We booked the flights, and yes, these were flights that could be changed.

There were extra requirements to travel in this new world. Beyond checking our passport expiry, we had to set up ArriveCan accounts and download the app. We printed our new and improved vaccine certificates with “Canada” clearly displayed. Italy also required a Passenger Locator Form, and those details were entered. We bought both N95 masks (Canadian requirement) and FFP2 (European requirement) just in case one would not accept the other.

Risk Assessment? Fairly low.

Preparedness, just in case? Yes.

Priority? We discovered a love of travel a while ago and have really been missing it. We would like to cover a long list of destinations before we can’t. This Tuscany dream has been in the lens for decades. COVID appears to be settling in, in one form or another, for a while. We are getting older. Yes, this trip was a priority.

Decision made. Off we went and have returned with no regrets at all. Was it uncomfortable to wear masks like those for 8 or 9 hours? Yes. Would I do it again? Yes!

Buon viaggio!

I’ll be taking you along on our journey in future posts. I hope that YOUR “decision-making matrix” allows you to remain as safe as you need to be while discovering those things you may still be able to do. What does that look like for you?

#COVID19, 2021, Doing what's right, Health, mental health, Uncategorized

My Child, Me.

April 4, 2021April 4, 2021 granny18

Today I looked into the eyes of my child. (from an appropriate distance).
My child has children of her own, but today she was my child. She is in pain. I want just to hold her and hold her and hold her.

I cannot.

My child is a nurse. She doesn’t work in the city Emergency Department as often as she used to. The little she is right now, is enough to hurt a skin already scraped raw. She knows others are seeing the same things, doing the same things but doing them day after day after day. Her own experience hurts—her awareness of their’s hurts her too.

There has always been trauma in Emergency.
Emergency nurses know they will see traumatic things, even that they will see death. It’s an unavoidable part of the job they signed up for

But…

This is different.

As cases rise in our area and a more transmittable variant becomes ever more prevalent, COVID cases are pouring into hospitals in our area. And while age shouldn’t matter; (indeed, I said so near the beginning) https://pathtothepasture.com/2020/11/04/ageism/, there is something so painful about being a nurse to someone very near your age, knowing they, like you, have children at home. Knowing that in this wave, much younger people are in ICU. Knowing that much of this could have been avoided.

How do these people come to know the patient has children at home? These nurses (& their colleagues) get to know these patients more than they generally have time for. They hold their patient’s hands, sit down next to the bed and tell their patient they won’t leave them in their terror. As that patient slides into sedation, that same nurse may move to the far less human process of intubation. That shift from connected humanity is hard. So hard. Nurses and doctors are making these connections with their patients in ED, in ICU… as family members stay outside…hungry for updates. They connect with these families more than they sometimes have had to. And then they hook their recently connected patient to an ECMO machine, prone them, administer drugs, fight for their lives…often losing that fight.
This third wave is even crueler. It is traumatizing, and they haven’t rested long enough.

Then they get traumatized again. Leaving work, they hear people saying the virus “isn’t real,” “just the flu,” “only sheeple believe in it”…. “Don’t get the vaccine.”
Remember the story of the nurse waylaid by an anti-mask protest making her late for her ED shift? This kind of pain is visceral, and their fellow citizens are doing it to them. Some friends are doing it to them. Some family members are doing it to them. My daughter has been off social media for months because she can’t bear to see it.
These people are down, and you are kicking them. You are kicking us, the families of those in health care. We look into their eyes, and we see pain. These are not superheroes; though we value them highly, they are human beings…battered human beings.

They KNOW it is real; they KNOW it is bad; they KNOW the variants are thus far worse; they KNOW it should not have happened this way.

Somehow, the wearing of a mask became enough to make people disrespect people like my daughter. My daughter…One of the ones who will hold your hand in your terror if someday this virus reaches you and takes you down a grim path. One of the ones who will update you if someday one of your loved ones takes this terrifying journey.

A doctor I admire said this,
“For everyone yelling “but the Charter of Rights and Freedoms” – You might be forgetting the part it starts off with: “…subject only to such reasonable limits prescribed by law as can be demonstrably justified.”
There. Are. Limits.

Dr. Fung is right. The people you are endangering also have rights; people working in health care have rights. Your rights don’t supersede theirs. If we had all worked together to stop the spread, you might already have your lives back; Dr. Fung and I may be going for dinner. I might be able to hold (and hold and hold) my daughter.

We could be closer to the end of this pandemic. We could have been like the Atlantic provinces, whose citizens cared for each other and understood that public health restrictions were meant to protect those they held dear and those they had never laid eyes on, but loved anyway.

I’ve shown you deaths aren’t the whole story. I’ve told this story before but seeing my daughter today brought it back. Although not the entire story, I’ll end with this. COVID has killed 23,062 Canadian citizens…so far. Many more have long term effects. We are a long way from fully vaccinated; some variants are more apt to cause severe complications and cause them in younger people. For perspective, these deaths roughly equal the total deaths from —Pancreatic, Colorectal, Kidney, Breast, Cervical, Larynx, and Thyroid cancers in 2019. Imagine if we could have saved my Dad, my sister-in-law, my friend’s brother, and other mothers, fathers, sons and daughters by wearing a mask, washing our hands, social distancing?

Imagine…

#COVID19, 2021, Christianity, Doing what's right, Health

Love Thy Neighbour

January 1, 2021January 3, 2021 granny18

With Christmas recently behind us, I’ve been reflecting on the one whose birthday we were meant to be celebrating. I’ll admit I haven’t been inside a church for a while. It may have more to do with a misalignment between how I and others understood Christianity than with any loss of faith.

I am no theologian. I count among my followers, atheists, agnostics, Muslims, Hindus, evangelicals and those without labels.

I was appalled to see my brother’s church among those that filed a constitutional challenge about gathering. The youth group brought my other brother food when he fell on hard times. They sang at his funeral. How could they get it so right…and then so wrong?

This church has been offering online church for months so I was rather blown away to be honest. My brother misses people at church but this aging man with a developmental disability UNDERSTANDS. For the record, Jesus gathered wherever the people were. The people are at home, or should be. WWJD in 2020? Zoom Church? I think so.

https://www.cbc.ca/news/canada/edmonton/alberta-churches-file-court-challenge-to-covid-19-rules-as-cases-surge-1.5830233

Jesus said, “For where two or three are gathered together in my name, I am there among them” (Matthew 18:20) Not four, not ten, not 100, not 500. TWO or THREE. If you live alone, gathering via Zoom WORKS! Stand down churches. Your larger responsibility is to your community as a whole.

There are lessons attributed to Jesus Christ that hurt none of us to consider. Whether you believe he is the son of God, a prophet or a wise man roaming the countryside, this one benefits all of us.

“And the second is like unto it, Thou shalt love thy neighbour as thyself” (Matthew 22:37-39)

All of you…believers, non-believers, those of different faiths…

Love. Thy. Neighbour.

Thy Neighbour with COVID.

Thy Neighbour over 60.

Thy Neighbour with Co-morbidities.

Thy Neighbour working in health care.

Thy Neighbour who has been denied our usual grieving comforts and rituals.

Love Them.

On November 4^th I asked for love for our ageing neighbours.

https://pathtothepasture.com/2020/11/04/ageism/

On November 7^th, days after my daughter’s birthday, I asked you to love her and her colleagues. For Dr. Markland and his ICU compatriots, I asked my community to care for them. They are your neighbours too.

https://pathtothepasture.com/2020/11/07/our-greatest-protest-for-healthcare/

“We saw it in Italy with military trucks hauling away bodies, with Italian doctors and nurses having to choose who received care (and who did not) based on survival probability. Many didn’t “make the list.” These weren’t all COVID patients. Patients with other situations were hitting those hospitals at the same time. Triage, I imagine, was a nightmare.”

On November 11^th, I honoured our veterans, many of them seniors, by asking my community to love these heroic neighbours, saying,

“As deaths in long-term care once again reach a crisis point, as we in Alberta break hospitalization and ICU records, there are undoubtedly some veterans or those who love them, among the statistics.”

https://pathtothepasture.com/2020/11/11/they-protected-us-its-our-turn/

On November 27^th, I tried to shine a light on just how many of us, how many of our neighbours, have “co-morbidities”… how many of us are at risk.

“Dr. Hinshaw said that having a chronic medical condition is quite common, with nearly a quarter of Albertans over 20 living with a medical condition. (Almost 800,000 people) Ten percent of Albertans have two conditions, and eight percent have three or more—conditions like hypertension, heart disease and diabetes.

Hypertension is found in 87 percent of Albertans who died of COVID19. Almost 70 percent of Albertan men over 65 have high blood pressure. (My hubby, the moustache guy, is in this group). Having co-morbidities does not equal at death’s door.”

https://pathtothepasture.com/2020/11/27/club-comorb/

As we enter into a new year, hope lies on the horizon in a vial of vaccine. I ask again, “Love thy neighbour.” The vaccine rollout will take a while before it gets to all of us, and until it does, there continues to be a risk of spread. Health care workers and senior home residents come first, which will hopefully drive our mortality rates down significantly.

BUT

Many seniors and those with co-morbidities live in the community and will be waiting a while yet.

During this holiday week, the province reports approximately 1300 new cases. Of those, the WHO estimates about 5% become critically ill. We’ve consistently had around 1200 new cases per day over the last week or so. (Other than one low testing rate day) So we are looking at 48 – 65 people becoming critically ill each day. It is important to remember the cumulative effect. Those entering the hospital are added to people already there. Those in ICU will be there for a while; even once out of ICU, they will use significant resources. (See the November 7th blog for Dr. Markland’s overview of the possible resources required)

As of our last update a few days ago we have 921 in hospital (average age 63, range 0 – 104)

Average age for COVID cases hospitalized with an ICU stay is 59 years making me REALLY excited about that upcoming birthday (range: 0-89)
A total of 1046 deaths. (average age 82, range 23 – 107
23 is younger than our youngest death was previously…

The deaths matter. Every single one.

Deaths
	November 4th	Dec 31
Age 20 to 29	2	4
Age 30 to 39	2	6
Age 40 to 49	3	10
Age 50 to 59	8	23
Age 60 to 69	26	100
Age 70 to 79	79	211
80 +	223	691

While deaths in younger folks are rising, most alarming to me is that folks in my husband’s age group have now hit triple digits. And those “Aged” folks? The ones many don’t think matter, mattered to someone … and this is not an easy way to go.

And our neighbours working in health care…it’s gotten harder.

Dr. Markland’s ICU team in Edmonton is well beyond capacity now. Calgary hospitals are also beginning to see strain. He is regularly working 36 hour shifts. He is an empathetic soul. That’s a tough thing to be these days.

“It’s easy to turn this pandemic into numbers, but it’s so much more than that. These are mothers, fathers, sisters and brothers. That tickle you feel in your throat is how it started for them. Their death leaves scars.” Dr. Darren Markland

ICU admissions
November 7th	Dec. 31
Under 1 year		7
1 – 9 years	1	4
10 – 19 years	4	8
20 – 29 years	8	21
30 – 39 years	11	30
40 – 49 years	22	62
50 – 59 years	41	118
60 – 69 years	56	183

Dr. Daisy Fung has been hurting from the deaths in the LTC homes she covers. Her tweets give us insight on how the world looks from her vantage point.

“I had to tell a child that they had lost BOTH parents today. That was the start of my day. There were similar calls made. People think Christmas is stolen bc they can’t go shopping? I break news regularly that Christmas is devastated for families, stolen from patients.”

On December 5th she wrote,

“Words I heard today: ‘I wish I knew #COVID19 was serious. I now know & will tell everybody.’ Said as I keep their loved one comfortable as they die of COVID.

Albertans need to get it straight that it’s serious, we need to protect our vulnerable. Now.”

Yesterday she shared her joy about vaccines for these people.

“Ended work for 2020 by giving orders for all my #LongTermCare patients to receive the #Moderna #COVID19 #vaccine. Ended 2020 with a prescription for hope, provided by a feat of science and medicine. It’s kind of perfect”.

There are real people behind available” beds” and these people are becoming decimated by the constant struggle, the constant death of their patients.

If you can’t find it in yourself to love thy aged neighbours, your veteran neighbours, your neighbours with co-morbidities, your healthcare neighbours, I know you love someone.

Risking further strain on our healthcare system can affect any of your neighbours. It can affect you.

The same healthcare workers who accept COVID patients right now are those you will need if you have a heart attack, a severe car accident, a diabetic coma…that your child might need. While COVID mostly minimally impacts children, if they show up at an Edmonton ER for any issue, you want them to be cared for. Note that the Stollery Children’s Hospital is using space for adult patients and double-bunking kids.

There wouldn’t be room for you to stay the night and hold your child’s hand (or puke bucket…let’s get real…been there).

A situation like we are currently experiencing holds potential to affect every corner of our community and our lives.

When our neighbours get cancer, there’s little we can do to slow the spread.

In this, we have an opportunity. A Merry Christmas. A Happy New Year. A chance to really matter.

An opportunity to save lives.

Loving our neighbour is such a simple way to do it. #StayHome #WashYourHands #SkipHawaii

#COVID19, Doing what's right, Health

Club CoMorb

November 27, 2020November 27, 2020 granny18

We’ve heard a lot about COVID patients with comorbidities in the last while. Alberta’s government has shared data on how many people who have died from COVID also had comorbidities. An Alberta MP went so far as to point out that only ten people with no co-morbidities have died…

As if comorbidities were something rare in Alberta.

There you are, saying, “GREAT!” as you count yourself among the “non-comorbid.”

Here’s the thing.

My husband would have counted himself among those with no comorbidities back in late November 2003. He had just had a physical and was given a clean bill of health.

On December 3^rd, he had a heart attack at the age of 49, entering a club that, in our COVID19 world, has become just a little more undesirable.

The club is not as exclusive as you might think. On November 20^th, our Chief Medical Officer of Health told Albertans a little about comorbidities. It became clearer that if not us, many we love, may belong to Club Co-Morb.

Dr. Hinshaw said that having a chronic medical condition is quite common, with nearly a quarter of Albertans over 20 living with a medical condition. (Almost 800,000 people) Ten percent of Albertans have two conditions, and eight percent have three or more—conditions like hypertension, heart disease and diabetes.

Hypertension is found in 87 percent of Albertans who died of COVID19. Almost 70 percent of Albertan men over 65 have high blood pressure. (My hubby, the moustache guy, is in this group)

Having comorbidities does not equal “at death’s door.”

The moustache guy is an active Grandpa, goes hiking in our nearby Rocky Mountains, and often helps our kids out with household projects.

This project left him with some handy equipment…perhaps he can get us some groceries?

The moustache, and the man it’s attached to, have a lot of living to do. Chances are you know someone with a comorbidity that doesn’t show. It’s misleading to see “the person who died had co-morbidities” and discount the risk of COVID.

Canadians with diabetes are hardly a fragile group and include current hockey players like Max Domi and past players like Bobby Clarke. There are diabetics across the athlete spectrum.

Juno award-winning singer George Canyon is a popular fellow here in High River. He performed at a local drive-in concert with Aaron Pritchett this summer to raise money for the High River District Health Care Foundation.

George has Type 1 Diabetes.

All you need to know is this. The person who died has people who miss them. That’s all we, the public, should be focusing on here. Unless, of course, you have high blood pressure, diabetes and the like, then you should probably take extra precautions.

But so should everyone else, really.

Let’s take care of each other.

Dr. Hinshaw also recently reminded us that “Severe outcomes are not limited to those already at the end of their lives, and it’s a mistake to think so. About one in four people who need to be hospitalized and one in six who are in ICU do not have any pre-existing medical conditions.”

Dr. Raj Bhardwaj, a Calgary physician, seconds Dr. Hinshaw’s thoughts and says those statistics don’t tell the whole story. He says that some of the most common comorbidities in those who have died of COVID19 are conditions that hundreds of thousands of Albertans have. Bhardwaj says the cases and deaths should not be just statistics, either.

“People die of COVID19, not of their comorbidities.” Dr. Bhardwaj went on to say, “If you’re crossing the street and somebody hits you with their car, we don’t say, ‘Oh, it’s okay, that person had diabetes.’ It’s the car hitting you that kills you.” (via Jordan Kanygin CTV News Calgary)

COVID19 is the car; when it hits you, it could kill you.

“We can’t let the numbers dehumanize the people who are dying here – the friends and the family members who are dying of COVID” ~ Dr. Raj Bhardwaj November 2020

#COVID19, Doing what's right, Health, mental health

They protected us; It’s our Turn

November 11, 2020 granny18

Today we honoured veterans, including those from World War II and the Korean War. I hesitated to intrude on this day with another blog post but watching the surviving veterans compelled me to say something about what we owe them.

Approximately 33,000 Second World War veterans are still alive, with an average age of 94. 6400 Korean veterans remain with an average age of 87. (Veterans Affairs – Demographics)

These folks are “old,” those that many in society devalue and say should stay locked up at home, so younger people don’t have to wear a mask into a store.

As young men, these guys went to war against a tangible threat.

The veterans interviewed today and telling their stories were young men once, as the ones we lost forever will be.

Louis Dautremont, lost in the Netherlands, age 25, April 21, 1945

As Robert Laurence Binyon wrote in his 1914 poem,

“They shall grow not old, as we that are left grow old:

Age shall not wear them, nor the years condemn.

At the going down of the sun and in the morning,

We will remember them. “

My daughter bringing an Afghanistan veteran into our family truly brought home how young those lost were, how much life they had to live.

Some came home and carried on with their lives, though often not without significant scars from the battles they fought. Globe and Mail’s Les Perreaux paid tribute in 2016 to 31 of the then 70 Afghanistan veterans who lost their lives to suicide after returning home, in his article The Unremembered.

I have no doubt we lost some the same way in those earlier wars.

Those that survived World War II and the psychological aftermath are among the seniors most at risk for serious complications and death from COVID 19.

These people went to war for our country…

to protect others…

I think it’s time we return the favour.

Let’s protect these strong (but vulnerable) soldiers of our country. Let’s protect the partners who waited for them to come home. Don’t let them die in such a horrific way after what they have given.

To reference Mr. Binyon,

They have grown old,

Age has worn them; the years have condemned,

At the going down of the sun and in the morning,

We will remember them too.

As deaths in long-term care once again reach a crisis point, as we in Alberta break hospitalization and ICU records, there are undoubtedly some veterans or those who love them, among the statistics.

217 in hospital (average age 62 years – range 0 – 102)
46 in intensive care (average age 60 years -range 4 – 89)
7 new deaths reported, 383 total (average age 82 years – range 27 to 106)

Pay tribute to these veterans.

Wash Your Hands

Stay Home if Ill

Sanitize Surfaces

Social Distance

Wear a Mask Indoors Where Social Distancing is Difficult.

They protected us. It’s now our turn, and our honour, to protect them.

#COVID19, Doing what's right, Health, mental health

Our greatest protest for healthcare

November 7, 2020November 7, 2020 granny18

Alberta hit 919 cases today. We don’t know our hospitalizations or ICU admissions currently; our system is experiencing technical difficulties at an inconvenient time. (My experience with technical difficulties is that’s ALWAYS when they hit.)

We had five additional deaths reported…

These deaths are a tragedy, no matter their age, no matter the circumstance. If you’ve lost someone, you know, it’s a tragedy for these five families.

Death is the most tragic part of this illness.

We know we will add deaths to our COVID total if this continues. We need to know we may have additional deaths from other causes too, unless we get this under control.

Let’s talk about our health system.

Anyone keeping track of your province’s Chief Medical Officer of Health (or their equivalent elsewhere) has heard about “overwhelming the health system.”

We saw it in Italy with military trucks hauling away bodies, with Italian doctors and nurses having to choose who received care (and who did not) based on survival probability. Many didn’t “make the list.” These weren’t all COVID patients. Patients with other situations were hitting those hospitals at the same time. Triage, I imagine, was a nightmare.

We saw it again in New York. Bodies were stored in refrigerated trucks when the morgue and funeral homes ran out of room for the bodies.

Mothers, fathers, wives, husbands, sons and daughters…in a reefer van

And here we are. We are talking about an “overwhelming” of the system here in my home province. The metropolitan city north of me is feeling the strain. As of a couple of days ago, 30 percent of non-urgent and elective surgeries in Edmonton have been postponed for the foreseeable future to ensure hospitals have the capacity to withstand any outbreaks.

Calgary, just 25 minutes from my town, is bracing itself. ICU departments are holding emergency meetings because (typical of 2020) ICU departments are already experiencing higher than normal levels of NON-COVID ICU admissions…and the COVID wave is headed their way. Of the 919 cases today, some proportion will hit the Emergency Department; will go to acute care, others to ICU. Again, our data has not been updated for current numbers, but this is what I have.

The age breakdown for total COVID ICU admissions we have to this point is:

1 – 4 years – 1 admission

10 – 19 years– 4 admissions

20 – 29 years – 8 admissions

30 – 39 years – 11 admissions

40 – 49 years – 22 admissions

50 – 59 years – 41 admissions

60 – 69 years 56 admissions

70 – 79 years – 49 admissions

80 + years – 21 admissions

(Looks like my husband’s age group is winning the ICU lottery…)

The last current data we have is 171 COVID patients in hospital including 33 in ICU. 9 hospitals have outbreaks.

Resources for ICU are expensive, but it doesn’t stop there for those that recover, especially older patients.

Dr. Darren Markland, an ICU doc in Edmonton, took to Twitter to share some information on COVID ICU admissions for older patients. (shared with permission from @drdagly) We know mortality is high for this demographic, Dr. Markland shared that should someone over 80 need ICU, their mortality pushes 80%.

“Consequently, they rarely are admitted to ICU. This means:

ICU occupancy lags hospital admission rates significantly and is an insensitive metric for healthcare capacity and strain.
These are preventable deaths that take a significant number of quality years with them. “

Dr. Markland also points to the weeks of treatment required for these sickest patients.

He talks additionally about those that survive the ICU and how they continue to need augmented support in the hospital for an extended duration. Physiotherapy, occupational therapy, and nutritional support. If not cared for, he says they can end up back in this rapidly filling ICU.

Finally, Dr. Markland tells us,

“This situation is preventable. Our hospitalization numbers are a serious warning that mandatory measures are needed now. But while we wait for direction. Please do not go to work if you are sick. No more in-person parties until there is a vaccine. Wear your mask around people.”

He ends with…

In the middle of this, people in healthcare are stressed by a government that has chosen this particular time to address health care costs. I’m a fiscal conservative; I get it. The old Alberta Advantage seems to be a page in history. However, our health minister appears to be hesitant to collaborate with doctors for cost savings, refused arbitration and ended their contract early. He’s announcing layoffs of the very people specifically trained to clean to COVID protocols (while hiring private folks without that training). It looks like he’s eliminated overtime at a time when health professionals need to use it the most, needing to cover shifts for those self-isolating, caring for kids who are isolating…becoming ill.

Before the second wave of COVID19 completely hits our health system, we have a group of fragile people on the front line.

They are already tired.

Our government has put the burden on us to try to turn this tide. Many people posit that the government should be doing more. It’s a hard call to make. There’s no question the spring shut down negatively affected business owners across the province; many closed. Most restaurants have done a stellar job of adopting COVID protocols to keep their customers safe, and very few infections have come from those types of gatherings. Is it fair then to shut down a restaurant owner, many who operate on the thinnest of margins at the best of times? Maybe not. I don’t have the answer.

Personal responsibility, however, has led us to 919 cases in one day. We don’t appear to be a very responsible lot. Why? Again, it probably relates in a big way that it’s mostly “old people” who die. Here’s where I say,

If you can’t get behind saving the lives of the aged, could you get behind saving the lives of the general public who may suffer harm from an overwhelmed system?

Can I appeal to you to “protest” for our health care workers by protecting them from this onslaught? Is wearing a mask, sticking to your own household, sanitizing etc. harder than walking a picket line? Maybe not.

Is it more meaningful at this moment in time than honking your horn as you go by or clapping for them as they leave the hospital?

I daresay, your actions to bend the curve on this thing will be the single most loving and impactful thing you do for our health care workers.

I know. I love a couple and hold the rest in my heart.

#COVID19, Doing what's right, Health, Retirement

Ageism?

November 4, 2020December 1, 2020 granny18

It’s been a good long while since I put up a blog. I’ve had something to say but honestly was reeling at the idea that it had to be said. And it was going to be so darn long.

Let’s talk about ageism.

I always knew it was a bit of a “thing.” Sure.

But COVID has brought to light the fact that our seniors are incredibly devalued in our society. It isn’t helped by an Alberta premier who declares in the legislature,

“It is critical as we move forward that we focus our efforts on the most vulnerable, on the elderly and the immunocompromised,” adding that “the average age of death from COVID in Alberta is 83 and I remind the house that the average life expectancy in the province is age 82.”

Factually accurate at the time (we now have an average COVID death of 82), it was nonetheless unsettling. That average age of death includes people aged 27 to 105, remember. Every one of them matters to me. Let’s look at COVID deaths in our province. Out of 318 deaths:

2 were age 20 to 29
2 were age 30 – 39
3 were age 40 – 49

Then we see things begin to climb a bit, around triple for each decade older:

8 were 50 – 59 (Hello Granny18, mild asthmatic)
26 were 60-69 (Hello Grandpa18, heart attack survivor)
79 were 70-79

And yes,

223 were over 80

So he’s not wrong; it does affect the elderly more than the rest of the population. Now let’s unpack,

“…It’s critical we focus our efforts on the most vulnerable, on the elderly and the immunocompromised.” Many people have taken that to mean that anyone over 60 should stay home for months while they blithely go about their lives. This guy. Stay home for months, stay away from our family.

Me too, because I can’t bring it home to him right?

They attack me when I suggest those people have a right to feel safe in the community, feel that their community might be interested in protecting them as much as they are able, help THEM to continue living THEIR lives. Yes, we’ll act responsibly in our actions to protect ourselves, but help a sister out, okay? I’ve been accused of being “scared” and told to “go hide.”

I’m not scared when I put a seatbelt on, and I expect others to belt up too. I’m not scared when I don’t drink and drive, and I expect others to do the same.

To protect others.

One fella posited that drunk driving killed more people than COVID has. He was in the U.S., so I looked up the U.S. numbers. 10,000 people were killed by drunk driving in 2018 versus 229,000 U.S. COVID deaths as of this writing. Why is it that people are okay with drunk driving laws but think a mask or gathering restrictions are horrific? Why? Because it’s mostly “old people” who are dying.

Damn it. Old people hold our history; they hold so much wisdom we could learn from; I love several of them and lost several “too soon.”

Who are these “old people”?

My husband is 66. Please don’t make him the 26th death in his age group.

Don’t write off someone’s Dad, Mom, Grandpa, Grandma because they are over 70 or 80 or 90 or even, by jove, 100.

70’s

My Dad, a huge volunteer with the Alberta Council on Aging while still running a company, died from Cancer at 76. The Premier of our Province presented him with a volunteer award just four months before he died. In the month before his death, he received the Queens Jubilee medal to recognize his efforts for his community. I still remember thinking he had so much left to do.

My brother in law retired from politics at the age of 70.

80’s

Rachel Wyatt published her first novel at the age of 82. I have an article about her up on my bulletin board to remind me there’s still time to get my book published.

An Ontario man named Bill Wall began riding in the Ride to Conquer Cancer in his early 80’s. He rides tandem because Bill is blind.

90’s

Bill turned 92 this year. He is still riding in the Ride to Conquer Cancer, raising $21,168 for Cancer.

Byrony Burrell is a 94-year-old British Twitter phenom (@lifeofbryony) with 67,000 followers. She shares humour,

“If I could go back in time to 1947 when I was 21 and speak to myself about life in 2020, the talk of a global virus would probably scare my younger self less than hearing her older self describing talking to a doorbell, surfing nets and webs on an apple and typing on tablets.”

And wisdom,

“You know nothing about a person when you first meet them. You may see age, race, gender or clothing, but what does that really tell you? Nothing. Assumptions pop into your head because your brain likes to categorize things, but that way of thinking limits your outlook on life.”

100

Her countryman Captain Tom celebrated his upcoming 100^th birthday by setting a goal to raise money for the National Health Service during the onset of the pandemic. The Captain walked the length of his garden back and forth 100 times, in 10 lap increments, assisted by his walker. He planned to complete the laps by his 100^th birthday on April 30. His goal was 1000 pounds. Cute right? 24 hours later, he had raised the equivalent of 11,666 Canadian dollars. As his fundraiser wrapped up, Captain Tom had raised almost 33 million pounds (almost 57 million Canadian Dollars.)

100-year-old Captain Tom was knighted for his efforts. The youngster who laid the sword upon his shoulder was the 94-year-old Queen of England.

Some seniors are in care, who won’t be able to hike, volunteer, write novels, join Twitter or even do laps in the garden. They matter too. We owe it to them for what they did for us before their minds or bodies gave out. My mother in law was a phenom, walking every day and babysitting Great-grandchildren into her 70’s. Dementia found her. She was still valuable to our family. We remembered all her years of helping us, and dementia brought us the unexpected gift of her talking more about the war years in England.

Will many of these people over 80 have died anyway? Maybe. But not like this. Not. Like. This.

This is not a painless slipping into the night, and they deserve better from us.

Alberta cases are rising rather alarmingly these days, with Edmonton already cancelling elective surgeries as they near capacity. Yesterday’s report from our Chief Medical Officer Health told us we had 15 deaths since Friday. We added 581 cases on October 30, 525 October 31, 592 November 1, 570 November 2. More concerning for me are the increases in hospitalizations and ICU admittance. Alberta overall has 167 (27 in ICU) in hospital, 100 of those in the Edmonton zone. What we need to worry about is two weeks out. A majority of the cases have untraceable origins. Someone out there spread it, and we don’t know who they are or who they were in contact with.

The young won’t necessarily be alarmed, but they should be. Although the young rarely die unless they have comorbidities, it does happen. Even those with a mild case are still sometimes taking a long time to get back to their pre-COVID selves. This thing spreads so easily. We have outbreaks in hospitals and nursing homes despite extreme measures to prevent spread. One nursing home outbreak was traced back to a family gathering. Dr. Hinshaw once said we shouldn’t fear COVID, but we should RESPECT it.

What does respect look like?

Stay home if you’re sick.

Limit your circle.

Practice Physical Distancing.

Wear a mask where physical distancing might prove difficult.

Sanitize or wash your hands frequently.

Try not to touch your face.

Sanitize high touch surfaces regularly.

It’s such a simple way to show respect for the seniors in your community.

(We’ll talk about care facilities another time…)

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