Physician: Limited hospital capacity means Revelstoke needs to take COVID-19 prevention seriously

"It would be great three or four months from now to say we all overreacted, as opposed to wishing we'd done more."

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Revelstoke’s small health-care system has been taking steps to prepare for COVID-19, but it needs everyone in the community to be vigilant about virus transmission prevention in order to avoid being overwhelmed with an outbreak.

That’s the key message from Selkirk Medical Clinic physician Dr. Cam MacLeod, who spoke to general Revelstoke health-care system COVID-19 preparedness and the clinic’s role.

In a video interview embedded with this story, MacLeod emphasized that while the risk to individuals is low — there have been no cases of COVID-19 in Revelstoke and two in the Interior Health region — the risk of overwhelming the health-care system with a spike in COVID-19 cases is real.

“The threat to the individual is very small, but the threat to society is very large,” MacLeod said.

Video interview: Selkirk Medical Clinic physician and spokesperson Dr. Cam MacLeod discusses Revelstoke health-care system preparedness for potential COVID-19 outbreak. Due to the fluid nature of the situation, some information is out of date since yesterday; for example, MacLeod noted the BCCDC recommendation of self isolation for 7 days, assuming they had no fever at the end of 7 days, has been changed self isolate for 14 days. Check back with the BCCDC website link above for the latest recommendations.

 

Revelstoke’s health-care system has only two respirators that can be used to treat patients in acute respiratory distress, highlighting the local medical system’s limited capacity to treat patients needing intensive care from a potential COVID-19 infection.

MacLeod said the Revelstoke health-care system runs near capacity during normal times, so the concern is a COVID-19 outbreak here could overwhelm it, highlighting the need for transmission prevention steps, such as frequent hand washing, avoiding touching your face, social distancing, and many other steps.

Prevention steps

For the latest advice and info on steps you can take to prevent COVID-19 transmission, see this B.C. Centre for Disease Control (BCCDC) webpage, which has detailed information on many situations and scenarios. There are many sources of COVID-19 information, but you should check in with this webpage because it syncs with B.C. government policy changes, such as travel and gathering restrictions.

See the link to the BCCDC COVID-19 web resources here:

http://www.bccdc.ca/health-info/diseases-conditions/covid-19

COVID-19 is a big test for the system

“In the time that I have been working, we’ve certainly never seen anything like this,” MacLeod said of the COVID-19 preparations. “I think we’ve got a fantastic and dedicated team of front line providers that are willing to go the extra mile. Everyone’s going to pitch in and do everything they can as this unfolds, whether it’s physicians, nurses, administrative staff — I’ve got full confidence in the team.”

But he looks at other countries, such as in Europe, that had medical systems and steps in place but nevertheless were quickly swamped in some places by a spike in infections requiring critical care.

“That said, you look around the world and what’s happening in … places like Italy, and I think we all have this fear in the back of our mind that that could potentially happen here.”

Goal: Flatten the curve

Queen Victoria Hospital is small, and its capacity is limited. It’s already a busy place offering an array of services, usually dealing with winter mountain recreation and highway MVI traumas this time of year.

Dr. MacLeod said for the Revelstoke health-care system, the goal is slowing down virus spread in order to “flatten the curve” of infections, meaning fewer infections coming at once. This means slowing down transmission as much as possible.

“I think that’s really our goal going forward here,” MacLeod said.

Everyone needs to take transmission prevention measures

COVID-19 prevention means quickly adopting many new transmission prevention measures, but the changes haven’t been uniform with everyone.

When asked about a his concerns about the Revelstoke’s adherence to transmission prevention steps, MacLeod noted we have a big population of young, healthy, outdoorsy people, some of who may not be as vigilant about the infection. The majority of those who develop COVID-19 don’t get critically ill and do recover.

The concern is the spread of infection also causes infection in those at greater risk, such as the elderly or those with compromised immune systems.

“I’m worried that younger people may not take this seriously,” MacLeod said, saying it can “put that vulnerable population” at risk.

Facilities in development

In addition to many routine changes, such as ramping up transmission and cleaning procedures to prevent transmission, MacLeod said other facilities were in place or in the works.

Queen Victoria Hospital has an isolation room for potential patients, and there is discussion of creating an off-site mobile testing facility, although plans have not been finalized.

The clinic is ramping up plans for tele-health appointments, where the doctor will see patients via video conferencing technology.

System capacity is exposed to risk, but individual risk remains low

From the health-care perspective, the bottleneck at intensive care capacity is the concern, but MacLeod said that doesn’t mean residents are at a heightened risk.

“The majority of people don’t need to panic, they just need to do their part in limiting transmission, and if everyone does that we have a pretty good chance of limiting transmission,” MacLeod said. “It would be great three or four months from now to say we all overreacted, as opposed to wishing we’d done more.”

Steps to help Selkirk Medical Clinic

MacLeod wanted to emphasize three points that will help the Selkirk Medical Clinic:

-Don’t come to the clinic with a cough or cold. Call first.

-Call the clinic ahead of time for COVID-19 questions.

-If you are requested or required to self-isolate, take it seriously