CTV News: 20 Questions on COVID-19 with Dr. Abdu Sharkawy and Dr. Shimi Kang
TORONTO -- CTV News is working tirelessly to address the concerns Canadians have when it comes to the ongoing COVID-19 pandemic.
To help answer some of the questions Canadians might have, CTV’s Chief News Anchor and Senior Editor Lisa LaFlamme spoke with infectious disease specialist Dr. Abdu Sharkawy and psychiatrist Dr. Shimi Kang for “CTV News: 20 Questions on COVID-19, Part 2."
Viewers from across the country were asked to submit their questions -- through a 15-second video or an email -- about their concerns when it comes to the virus, how it’s spread, possible treatments and who’s most at risk.
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Sharkawy and Kang answered 20 of the most commonly asked questions (and one bonus question), including ways the virus might spread, how to cope with being inside for long stretches, and what the future might hold when it comes to the virus.
This is the second such instalment after LaFlamme and Sharkawy answered 20 similar questions during a special on March 21.
Below is a transcript of the interview (edited for clarity and brevity):
Question 1: When’s the coronavirus going to end?
Sharkawy: That's the answer we all want. The answer is that this will end when this virus runs out of susceptible hosts. When it has infected enough people who have become immune and have recovered from this, that it really runs out of new susceptible hosts. That will be helped if we have a proper treatment for it and preventative strategies, including a vaccine. That may take another year or so, so we're looking a little bit further away to say that this is really under control and has ended.
LaFlamme: Dr. Kang, I want to bring you and this is all confusing enough for adults to really understand. So it must be especially puzzling for the kids. What's your best advice for parents on how to explain this to their children and the patients that's required to get through it?
Kang: There's generally three principles in talking to kids -- and anyone actually -- and that's truth, optimism and action… Children these days, they are smart, they want the truth. We can't sugar coat it. Give age appropriate information to their questions based on inquiries. So if they don't want to know the death toll, don't tell them. But if they want to know when school is going to reopen, tell them the truth.
Secondly, use optimism. We have a negativity bias in our brains. A highway to catastrophe and worst-case scenario and a dirt road to positivity. So we have to keep a focus on the positive. So things that are going well in their community and in their family, lots of reassurance and then give them action, give them something to do.
It makes them feel empowered, whether it's washing their hands or wiping down the door handles or calling their grandparents, all of those will help young people at this time. Remember to do it repetitively, they need to hear the same message more than once and in different ways. So young kids “play” is really good. Draw a picture, use their stuffed animals. Older teenagers ask them open questions to see where they're at.
Question 2: What sort of coping tips do you have for university students during this difficult time?
Kang: We were looking at a mental health crisis on campuses even before the pandemic, and young people between the ages of 15 and 24 are most at risk for mental-health issues. I'm so glad Varun mentioned coping skills, because there are skills, they have to be practiced and mastered. I see they're in three categories: play, others and down time.
So downtime is unplugging from the world and reconnecting with yourself. So watch your screen time, walk in nature, listen to music, (practice) mindfulness, gratitude journaling, not multitasking, so having three different things going on at once, but having focus one thing at a time.
The others is our social connection and to remember socializing is not social bonding. This is the time to bond, have meaningful conversation, go a bit deeper, make sure that you're feeling emotionally supported.
And then play. Play is about pursuing our creativity, our passions, our hobbies. It seems like a very light thing in such serious times, but it is very powerful for our brain. It releases serotonin, a happy neurochemical. So pursue those learning opportunities and interests with gusto.
Question 3: I'm wondering at what point we can expand our personal quarantine network to include another trusted family member.
Sharkawy: That's a great question and certainly one that a lot of us are struggling with right now as we seek support from ones that are close to us, including family. While I'd like to say that that might be something acceptable, the reality is, unfortunately, that if we make a selective or modified strategy for this sort of thing before we have really flattened the curve and settled things down a lot, the boundaries will probably be loosened too much and it'll create a model that's not so good for others and I'm afraid that that would lead to recurrent waves of infection.
We need to recognize that our connections can be much further than we appreciate. So if a daughter spends the night with her boyfriend, for example, and then spends another night with her nuclear family in a different household, that nuclear family may then be connected to the same employer that that boyfriend was in contact with a week ago.
That seems complex and almost unfathomable, but that's the problem that we're in right now. We need to be patient a little bit longer.
LaFlamme: Dr. Kang, I want to bring you in. Obviously, families are FaceTiming all the time, but I sense people are coming to a breaking point… How do you reboot that inner strength to remain vigilant?
Kang: We're missing our families. I have an 87-year-old father and it's hard to stay away, but like Dr. Sharkawy says, it's important and remember the goal here, which is the health of everyone and health of our loved ones, so reminding ourselves of why we're doing this and then bringing in those replacement strategies.
What we're looking for is oxytocin, it's our bonding chemical. It's released directly from the heart, so any kind of thoughts of love, compassion (and) gratitude can all release that too, eye contact, having shared memories, so looking at old photo albums and talking about stories from the past.
So maybe changing the quality of the conversation and the connection to make sure that you're going further and deeper and feeling really those emotional bonds with our family.
Question 4: If my partner and I adhere to the two-metre physical distancing rule, would it not be safe for us to have one or two close friends sit outside on our deck, even though they're not part of our household?
Sharkawy: Certainly not an unreasonable consideration to explore, but again, my caution is around the idea of this serving as a model for others and human nature is such that if we see others engaging in one type of practice, we will be very much tempted to do that and probably go a bit further and that's my only concern that someone will see this (and) perhaps not react in the most responsible way.
We have seen young people hanging out in parking lots with the five foot or six foot rule trying to be applied and we know that there have been cases that have been spawned from those sorts of meetings. So unfortunately, I think we're going to have to continue to wait just a little bit longer and again, pay attention to all those great pieces of advice from Dr. King. Look for other ways to connect and bond until we get there.
LaFlamme: Certainly technology had helped, Dr. Kang, but how do people cope without that real in-person connection? What is it in our psyche that wants us to now come up with these work-arounds?
Kang: We humans, we're fundamentally social beings, our brain evolved because we are so social and made us more social. So the video conferencing is better than a phone call or text or email. There's studies that support when we (see) each other's faces, look in each other's eyes and hear each other's voices, that that is definitely better.
Also, I have to make a comment on laughter. So intentionally, deliberately bringing in those aspects of our social bonding and making them a priority. What's happening with this question is really this idea of community and that's why we like to have friends. We have to recognize we don't need a lot, but we definitely do need a few and prioritize your time and prioritize the depth of those connections.
Question 5: Can COVID-19 be transmitted in a lake or ocean through swimming or playing in the water with your immediate family?
Sharkawy: First of all, in terms of chlorination, chlorination will kill the virus itself, but it's not going to kill the virus that may be inside somebody who's already infected. So if you're with others who are exposed to you while you are swimming vigorously, there can be respiratory secretions that are expelled from your nose or mouth and those around you could theoretically acquire the virus.
Now, if you're doing this with your immediate nuclear household, there's nothing wrong with that, because theoretically you can do what you need to do with your immediate household, but you shouldn't go to a communal setting like a community pool where you'll be near others.
LaFlamme: So chlorine does not kill the virus?
Sharkawy: It will kill the virus in the pools, it will not kill the virus that you happen to be in close contact with someone and you happen to expel those secretions and you're within six feet of that person. It's a very important distinction.
LaFlamme: Dr. Kang, we've spoken a bit about mental health. What about the importance, though, of… physical exercise during this lockdown as a way to maintain discipline?
Kang: The mind and body are fully connected. What's good for the body is good for the mind and vise-versa. So we want to keep active and we actually know that cardiovascular exercise -- so getting your heart rate up to the point where you might have trouble speaking in full sentences -- that's really good for our mental health.
Twenty minutes, three times a week is as effective as medication for mild symptoms of depression and anxiety, so if you have any of those symptoms, have your exercise, make it a routine like medicine and it's something we all should be doing and can benefit from right now.
Question 6: If you live in a building that has more than one dwelling, is it possible for the coronavirus to be transmitted between units via the ventilation system?
Sharkawy: I don't think it's too serious an issue, but I think it brings up the importance of trying to be as proactive as possible.
I would say that if the ventilation system is one in a high-rise apartment, for example, that it is unlikely that someone on the top floor will come in contact with the same virus that went through the ventilation system on the bottom floor. However, it's a smaller shared dwelling, there is the possibility it could run through the ventilation system.
My recommendation would be try and keep windows open for a few hours a day, whenever possible, to allow air to safely circulate and minimize that risk and that will likely mitigate the problem quite significantly.
LaFlamme: What about the elevator or shared spaces like laundry facilities and all those high-touch surfaces?
Sharkawy: So high-touch surfaces need to be disinfected regularly and if you're using a laundry room in a shared facility, it's a good idea to make sure you have your own hand hygiene on hand and to have sanitary wipes if you need to use them.
Again, remember that the way in which you're going to acquire a virus from these sorts of settings is by touching one of these surfaces with your hands and thereafter touching your nose, your eyes or your mouth and introducing it without clean hands.
The virus will not aerosolize from these surfaces on their own, so there's no need to be panicked or concerned about that in particular.
Question 7: I'd like to know if it's possible to catch COVID-19 from second-hand smoke.
Sharkawy: First of all, obviously we know that the risk of second-hand smoke is quite high when it comes to just the damage it's doing to all of our lungs, but more importantly, if we're talking about COVID-19, remember that the virus is fairly heavy and it is spread by droplets, so even if that cloud of cigarette smoke wafts beyond six feet, it's unlikely to carry with it the virus beyond that six feet radius, so I would say there's no need to be extremely concerned if you are beyond that protective radius, but obviously, it goes without saying try and avoid any exposure to second-hand smoke whenever possible.
LaFlamme: Dr. Kang, I want to bring you in here, because there are a lot of smokers who see that connection and they want to quit right now, so what advice do you have for someone trying to quit in what is already a stressful time?
Kang: So I think the first question is to figure out where you're at in terms of your relationship with smoking.
Not all smokers are addicts or have an addiction. Some are recreational, some are habitual, so if that's the case, then make that decision to quit. It's a really good time, it won't be as difficult.
If you have an addiction, which means that you're having cravings or you're having consequences of your use or it's out of control, then there is help. I would encourage online peer support -- there's programs like QuitNow.ca -- and talk to your family doctor about nicotine replacement strategies and there are medications that can be used.
I also want to make a point of vaping as well because of the health effects of that with COVID and in general.
Question 8: Does heavy foot traffic and the effects of gravity on our sneezes, our coughs, our droplets, mean that floors in grocery stores, beer stores, hospitals and especially senior-care facilities have the highest concentration of the COVID-19 virus? If so, when we get home or to our workplace, are we spreading this visitor throughout the place from our shoes to floors, socks (and) hands?
Sharkawy: I think we have to assume that anywhere that we're walking outside of our own nuclear dwelling, there’s the possibility that there may be viral particulate matter that can be picked up on our shoes and that means that when you come home, it's important to take your shoes off immediately.
Ideally, you should have a sanitary wipe or something (to) clean the bottom of those shoes and then wash your hands immediately. If you happen to be in a situation where you're more comfortable wearing your shoes at home, that's fine, but you need to again wipe your shoes down with something that is a sanitary wipe of some kind and ideally mop those floors very regularly to make sure that they are disinfected.
Question 9: We've heard about how long the coronavirus can live on different surfaces, but how long can it live on skin? For example, if I touch a contaminated doorknob and can't wash my hands immediately.
Sharkawy: Well, theoretically, it could live on skin for a very long time, anywhere from several hours to potentially days, depending on what the burden of the inoculum is, which means how much virus happens to be on the surface that you touch.
Again, I understand it's not always convenient to be able to wash your hands, but what I do is I try and be prepared and make sure that I have hand sanitizer as abundantly available as possible, particularly in locations where I know I'm coming in and out of and I know that there's a high risk I may have contaminated my hands, so I keep the hand sanitizer at the front entrance of my home, I keep one in the kitchen, I keep one in my kid's play area, I keep one in the car, my wife keeps one in her purse.
It doesn't have to be big, as long as it's something small and portable that's easy to find and easy to use. It's a good way to make sure you get into a habit and not run into those predicaments.
LaFlamme: Dr. Kang, over to you. How should we go about calling out family members or friends who still are not practicing proper hand hygiene?
Kang: I just want to take a minute to explain what might be happening. When we're under stress or fear, we have what's called a stress response and it's a very classic freeze, fight or flight, many people have heard of it.
What's happening in our mind, our freeze is anxiety. We don't know what to do, we procrastinate even. It might look like they're not taking something seriously like washing their hands, but they may just be in a state of anxiety or worry about it.
We might fight to get irritable and grumpy and angry or we might flight, which is actually a mental escape, we avoid the problem, we don't want to think about it.
So when you see behaviours that don't seem to make sense to you, my first question is perhaps that's that individual's stress response. Be empathic, not judgmental, be kind and patient.
What works is empathy, so try to put yourself in their shoes, think about what they might be thinking.
Common goals, so come together shoulder to shoulder and bring up the conversation about both of your healths or well-being.
Problem solve, offer solutions and then always end with a sense of optimism, like, “I think this could work out if we try it this way.”
LaFlamme: I guess after an argument, you can't hug it out anymore, so what kind of impact is all this loss of touch from no hugs, no handshakes having on people? Is it at some level tearing away at self-esteem?
Kang: Well, loneliness was actually very much of a concern before the pandemic. We know rates of loneliness were going up, they were going up in the elderly and teenagers and our social bonding and emotional connection is really key to that, but I have to say, the most lonely people are actually those… who are married or living with other people, are living in apartments or who have a lot of socializing, so it doesn't necessarily mean that we have to suffer with the physical distancing if we make those adaptations or if we knew beforehand what really gave us the joy and connection and trust.
Part of it is being a bit vulnerable, opening yourself up. Now is a great time because you will compensate for any kind of sense of distance or disconnection from each other.
Question 10: Is it possible that UV lights can be used to sanitize or disinfect N95 masks or other medical equipment?
Sharkawy: So UV light works based on the principle of damaging DNA or, in the case of COVID-19, the RNA and that genetic material being damaged means that the virus is no longer viable.
There has been a lot of work that's been done on this. Unfortunately, a lot of the studies have been relatively small in scale and the other concern with using UV light to disinfect is that it works only where the light is shining. So you can imagine that a mask that does not have a uniform surface with different bumps and ridges in it may theoretically have spots where the light has not been exposed to it and may not completely disinfect whatever you're using.
Even though this has been touted by some as an option or a substitute renewing PPE, I don't think it's a solution.
Question 11: For those of us who are claustrophobic and can't wear a mask, what do we do if wearing a mask in public becomes mandatory?
Kang: Phobias and anxieties are very common, but they're also very treatable, so for phobia in particular, like a really strong fear, cognitive behavioral therapy, we know four to six sessions can be very effective, there are online support, quite a few different places, including the Center for Addiction and Mental Health.
I do want to say that part of claustrophobiais a sense of breathing and not getting enough air and breathing in itself is an extremely powerful coping skill. When we stretch those receptors in the top and bottom of our lungs, we send a signal to our brain (that) we’re OK and it shuts down that stress response I mentioned.
So when you are doing something that scares you, let's say wearing a mask, pre-breathe, spend a couple minutes doing that deep, slow breathing and as you are wearing the mask as well, it will keep your body in that relaxation system and away from that stress and cortisol that we don't want and reduces our immune system.
LaFlamme: Dr. Sharkawy, I think everyone assumes that masks will eventually become mandatory like they have now in New York City and in other places, but… for some, wearing a mask is just so much more difficult. So what's the solution?
Sharkawy: Well, I have to wear a mask for several hours a day and so do many of my colleagues and I think what we try and do is try and take frequent breaks whenever possible, so that we're in a safe place where we can release the mask, get a breath of fresh air and whenever possible, try and go outside, even if it's for a minute or two. It makes a world of difference.
Question 12: I want to know if there's any little helpful hints that can help me to get back to sleep quickly.
Kang: Sleep is fundamentally the centerpiece of our physical and mental health, so it is a priority, period. What I would recommend is we start actually right when we wake up, so we know early morning sunlight actually helps our sleep at night. So we start with opening up the windows and getting our eyes looking at sunlight.
We have to be careful of our daytime routines, so we don't want to nap too late in the day. We don't want to have coffee, caffeine, too late in the day.
We want to try to have a wind-down routine at night, best to have it at the same time every day, whether it's a warm bath, warm milk, gratitude journaling, meditation, mindfulness and if you wake up in the middle of the night, (it’s) really important not to stare at an alarm clock, so shut that off or turn it around.
Some people say reading something kind of boring is helpful because it distracts the mind and there are studies that show that.
Keep the light dim, so don't overstimulate and again, journaling, getting your thoughts out on paper all those worries.
Cortisol levels peak in the middle of the night, so I tell everybody to make sure you talk to your doctor (to make sure) there's not something else going on, it could be a symptom of depression when we wake up early in the morning and really just prioritizing sleep. It is not a luxury is such an essential thing.
LaFlamme: So many people are experiencing really strange nightmares right now that linger longer into the morning. We can actually remember them. So what does that mean?
Kang: I think what it means is really our mind is very active. So, we have a stress response -- that freeze, fight or flight -- and cortisol flooding our system and we're trying to make sense of everything and the nightmares or dreams is our storytelling and we're all experiencing that at a greater degree right now.
I wouldn't be scared of it. I would say this is part of what we're collectively experiencing. If it gets to the point where it's not going away, the trend’s not going downwards, it's not just one bad day, but it's several bad days and despite all of that self-care and tips that you're hearing and you're not getting better than it might be time to look at more professional-based treatments, talk therapies or even medications.
LaFlamme: Dr. Sharkawy, I'm going to bring you back in and remind us again about the importance of sleep, especially when it comes to not getting sick.
Sharkawy: There's no question there's an enormous amount of evidence in the literature to prove and establish the fact that a sleep deficit is linked to all kinds of adverse health outcomes, including an impaired immune response.
So if you're not running on all cylinders, you are much more likely to acquire any given infection, especially if it's circulating within your community.
I also just want to echo one more point on Dr. Kang's excellent advice. It's really important to turn off devices. It's really important not to fool your brain into thinking that it still needs to stay awake, even if it's late at night and you're still up. You've got to turn those devices off at least an hour or ideally even longer than that before going to bed, so the signal to your brain is turned off and it tells it it's time to get some restorative sleep.
Question 13: If the World Health Organization is advising people not to drink so much during this pandemic, then why are liquor stores considered essential?
LaFlamme: It's such a good question. Interestingly, Prince Edward Island, Dr. Sharkawy, originally closed liquor stores, but then reconsidered the idea with strict physical distancing rules in place. But what's behind the WHO warning about alcohol consumption.
Sharkawy: Well, I think the concern is that our coping mechanisms will not necessarily be the healthiest and that the tendency will be to use alcohol as part of that plan to manage our stress and we know that there are certainly enough people who have a tendency towards addictive habits and that alcohol overindulgence could lead to a problem and that can spawn all sorts of issues in terms of mental health concerns and we know that the liver is at risk if we overindulge in alcohol.
We're at increased risk of all kinds of other adverse health outcomes. So we just need to be careful and mindful of the fact that moderation may be safe, but if we open ourselves up too much to using this as a coping strategy. There are lots of problems that could ensue.
LaFlamme:So many people wrote in about the fact that they are using food to get through the stress or the boredom. So at what point does it become concerning? What are the signs that we're overindulging?
Kang:So we're turning to these things because they give us short bursts of pleasure through something called dopamine. So, you know, whether it's a buzz from alcohol or sugar or video gaming or gambling or shopping even, what we're looking for is that short rush and that's why we tend to go to it when we're more stressed and panic eat.
You know, it's a problem when it impacts three different aspects. So when you're having cravings, you're thinking about that in the middle of dinner with your family or in the middle of work, when there are negative consequences. So it's impacting your physical house, your ability to sleep, your weight, impeding your recreational activities.
When it's out of control, when you make a commitment and you say: “You know what? This weekend, I'm just not going to drink too much” or “I'm going to avoid the video gaming or the gambling app” and you find yourself doing it again.
It's difficult because 70 to 80 per cent of Canadians drink and there's some benefits when we look at kind of blue zone data and longevity. It's conflicting studies, but at the same time, 10 to 15 per cent of Canadian’s lives can be devastated from drinking. So really, the question is, what is it for you and what's your relationship with these addictive substances and behaviours?
LaFlamme: Do you have any tips on how to back down and help couples get through this without needing a divorce lawyer by the end of the pandemic?
Kang: It's a real reality. I believe the rates of divorce went up almost 25 per cent in China during the pandemic. I definitely tell people don't make any big life decisions in the middle of a crisis unless you have to. Of course, there's issues of abuse and there is one in 10 women are concerned about domestic violence right now. So that is very important.
However, if you're in a relationship and you're feeling cooped up, I think it's important to recognize the stage of your relationship. Often we go through the initial stage, which is all about being a couple and then there's something called differentiating where we want our own identity and individuality and then at some point, we figure it out that we can be both. We can be a couple and an individual.
So pay attention to where you're at and I say there's three different interpersonal relationships styles. It's really easy to remember them. If you think of the animals, the shark, jellyfish and dolphin. A shark is aggressive, overbearing, controlling. That doesn't work, but you also can't be a jellyfish and not speak up for things that are important to you, especially when it comes to safety and particularly with the virus. So be a dolphin, be in that middle place where you're firm but flexible, you're collaborative, you're community minded, you're shoulder to shoulder, so you're very firm in what you want and need, but you're flexible in how you communicated and problem solving together.
Question 14: What exactly are the experts looking for and what criteria are they using to determine when the physical distancing requirements can be lifted, allowing us to reopen our businesses?
Sharkawy: There's a lot of metrics that go into determining when it might be safe to reopening up the economy and businesses, but I would say that probably the most important is to see that we are not just flattening that curve, but we're seeing the incidence of communities spread become very sporadic, which means that we're seeing very few cases on an ongoing basis.
So right now, we're having hundreds of cases every day in Ontario and Quebec. We need that to realistically come down to single digits if we think we're going to reopen up the economy safely and limit physical distancing.
Question 15: For the population who have underlying conditions and are currently working, what is your recommendation for us to stay safe?
Sharkawy: If the nature of your work allows you to work from home or remotely, obviously, that should be pursued as frequently as possible. If that's not an option, make sure that when you are working, that you use vigilant hand hygiene practices. If it can't be avoided to be within six feet of others at all times, wear a mask and if you happen to be anywhere where you can open a window and allow air to circulate safely, do so.
Question 16: Do inhalers used for treating patients with asthma have any effect on patients would COVID-19?
Sharkawy: Unfortunately, there doesn't seem to be much benefit that's conferred from using puffers. If you are suffering from COVD-19, unless you have an asthma exacerbation that is triggered by this, which thankfully is pretty uncommon. So I would say use your maintenance and rescue puffers as regularly directed by your physician and try and stay away from anyone who may be a potential exposure.
LaFlamme: So many Canadians with conditions like asthma -- and Dr. Kang, I want to bring you in -- are worried about even leaving their homes to go to the grocery store, for example. So how should we all manage the risk versus giving into that fear?
Kang: That negativity bias can be really strong and we can catastrophize or go to what's called “black and white thinking,” I either have to stay home or I can go out and not in between.
So really listening to the good advice of Dr. Sharkawy and our experts and asking questions again, don't be shy to ask the same question if you're unsure and to find that balance based on logic and what works for you.
Question 17: Reported case numbers are underestimated, but does that mean that buildup of immune cases from asymptomatic and recovered individuals is also underestimated? At what point does this building immunity start slowing down the infection rate?
Sharkawy: Well, there are more pros and cons, and hopefully as the pandemic starts to settle down more, that will be abundantly evident. There's no question that there are probably a lot of people in our communities who had COVID-19 and were asymptomatic and have hopefully become immune through recovery.
Over time, that will help and the virus will run out of susceptible hosts to infect and people will not be able to transmit the virus as vehicles between one another.
The virus will hopefully run out of steam and eventually flatten out so that it's just very sporadically transmitted, but that's going to take a long time. It may take the order of a couple of years potentially, but if that vaccine is available, that will hopefully accelerate that timeline significantly.
Question 18: What do we know about the vaccine? Will it eradicate COVID-19 permanently like we did with smallpox or will it comeback in some form every year like the flu?
Sharkawy: Well, unfortunately, we don't know more than we do know and hopefully that will change over time, but I want to highlight with the example of the influenza piece that was put there that very few vaccines are 100 per cent effective, which means that they can reduce the burden of that particular infection within a community, they can attenuate the course so that if you become infected, it's less severe than it would be otherwise, or ideally it could prevent the infection altogether.
We see that the flu happens every year, even though we've got a treatment for it and a vaccine. I frankly think it's more likely that we'll see something similar with COVID-19 and hopefully we'll have nowhere near the same burden of mortality or morbidity that it's showing us right now, but we need more time to find out.
LaFlamme: Is it a good idea for people to focus on a future vaccine when the emergency is here and now? Is it helpful to look forward to a potential solution or kind of deflating when we know that timeline?
Kang: I think it's actually very important to look forward with a sense of optimism and hope. Studies show that other times in history, where there is war, disaster, certainly including the Holocaust, really having a sense of hope, optimism, solutions, problems, not magical thinking. We still want to be practical and follow precautions, but having that practical optimism.
Question 19: My daughter (is) due for her 15 month vaccine and I'm not sure whether I should just take her right now or do I delay things until things settle down a bit.
Sharkawy: I would really want to highlight the importance of making sure everyone is aware that despite the pandemic, our system has not closed. It has not closed down to things that are important and vital for health maintenance and unfortunately, we're seeing lots of examples of people feeling that they need to avoid hospitals and health-care maintenance and that's a real concern that I have.
So I would recommend to you, please don't defer these vaccinations, the clinic or family doctor looking after you, will, I'm sure, do their best to make sure that it's a safe environment for you…and to anyone else out there who needs vaccines, don't delay the timetable, if it's avoidable at all.
LaFlamme: How can (parents) ease their anxiety as they try to make the right choices and not fall down that trap of sort of questioning their own parenting skills?
Kang: I think a key part is to take care of yourself as a parent. Sometimes we're so busy focused on our kids or other responsibilities, we lose ourselves. So all the really commonsense basic things have enough sleep, routine, regular exercise as a parent.
Use your community or village. So talk to people, talk to parents of older children, your health-care professionals. It's OK to reach out and ask for that help, especially now. Be vulnerable and asking for that help.
Trust your intuition. You know your child best. Pause. Be reflective and take a few breaths and ask yourselves what you feel is the right thing for your child and your family. This is a really difficult time and I think for parents and especially, we need to lean on each other.
LaFlamme: Talk about parenting in the time of pandemic when frustrations may be heightened.
Kang: Parenting was really stressful again before the pandemic and we were seeing all kinds of stressors and helicopter parenting and micromanaging and kids with a lot of anxiety and families were getting further disconnected.
So now I hope that there is a bit of a course correction happening because we're talking about meaningful bonding and taking care of ourselves and mental health, that this will apply to how we parents as well.
For children, I want to say kids are really resilient. They are very simple in many ways, but don't be fooled, simple is not easy. They need routine regular sleep, they need play, lots of play. It's great for their brain. It's a superfood.
So not stress too much about academics. Of course, that is very important, but we do have the summer to catch up and children learn through trial and error and exploring their environments.
Trust your village or your pod or your community because this is when we have to reach into each other. Be that dolphin parent, that middle ground.
Question 20: I’m going to be first-time grandma in July and my question is, am I going to be able to hold my grandson once he's born?
Sharkawy: I'm moderately optimistic that by July, the degree of new cases arising in most of Canada will be low enough that there will be some loosening of restrictions, particularly with respect to family members. I certainly can't promise anything, but I'm hopeful that if we continue to remain vigilant with respect to distancing and hygiene and everything else, we're doing great now that the dividends will show and that you'll be able to hold your beaming new grandson.
LaFlamme: Dr. Kang, I want to bring you in. That's got to be our most asked question from grandparents and grandchildren wondering when they can be reunited and I go back to that question of maintaining family connections. Do you have any tips for bridging the generational divide when you cannot be physically together?
Kang: We are meant to live in intergenerational families and communities and I do think this pandemic is bringing that to light, how important it is for the generations to interact.
In addition to all the things we've already mentioned, I would talk about maybe trying something new and something common between the two and the arts is a really great place to do that. So whether a grandparent has the ability to draw or saying or play music or vise-versa, finding those creative ways to bond and connect and maybe even have a passion project together, that's how our memories are made and that's how our bonding occurs. It seems like people are still very busy despite all of the restrictions. So slowing down and making those deliberate choices on a day-to-day basis.
Bonus Question: After the governments will declare the end of the Earth emergency, will we be able to leave as usual? Or should we be waiting until next year to get back in a normal situation?
Sharkawy: Well, I think we're all reexamining what the definition of the word “normal” is and I think we can foresee that normal probably is not going to be what it used to be any time too soon.
In terms of a timeline, realistically, with respect to lifting of physical distancing and other containment strategies, including opening up schools and work environments the way it used to be, I think that's going to take a very, very long time.
We're looking at probably at least several months to maybe more than a year. Ideally, that would be a gradual process, so we're not where we are right now, but I think we should all prepare ourselves that this will be a gradual reopening, a gradual reconnection, and we should do everything that we can right now to remain in a positive mindset so that we don't feel too much despair.
LaFlamme: This has been such a sobering realization for Canadians that we may be in this for a much longer haul than initially anticipated. So give us some thoughts on how to absorb this information and to stay sane.
Kang: I think on one end of the spectrum, for some people, it will never be back to normal. Those who lost loved ones or even have been traumatized, which I'm hearing from frontline workers or their children.
This is a defining event of a whole generation, but on the other hand, when we look at studies of community and difficulties, we also see often a better normal. People who have more perspective, a better sense of gratitude for those little things that they would have taken advantage of, deeper connections and understanding of coping skills and now mental health.
So I think it's going to be across the board. On one hand, we may see ongoing issues of depression and PTSD that we need to support for years to come and on the other, we can be encouraged by a collective evolution of our society and coming together.
LaFlamme: As if the pandemic was not enough, we now have the worst mass shooting in Canadian history. So a final word to you to both of you. Dr. Kang, I'll start with you on how to best get through this.
Kang: I think with this new news in addition to everything we're experiencing, it's important to understand that there's certain stages we'll all go in. Initially a shock or denial, then we find we're angry, we want someone to blame or something to blame.
Then we move into anxiety or overwhelm and ultimately, it's a place of acceptance and action. We're all in different stages. Your neighbors may be in different stages, our family members. So recognize behaviors that you might see.
Ask yourself: “How is that person coping?” as opposed to judging, be kind and compassionate with each other.
Our nation is grieving. We're all under stress. But this, too, shall pass with all of those things that have always kept us collectively strong.
LaFlamme: Dr. Sharkawy, any final thoughts from you on that question?
Sharkawy: I think it really defines us as a people, and what this pandemic has really done for me personally is it has really shocked me into a sense of perspective and a need to prioritize things that are the most important in my life, including my family and those that are close to me.
I think it's given me an opportunity to really focus on those small moments and those commitments of time that I can use to embrace closeness and connections between myself and my family and others that I care about. Those opportunities are still very much there.
This is a unique opportunity to embrace. I'd encourage everybody to take advantage of that and to turn this from something that is a struggle and a difficulty and a challenge into something that we can be proud of and we can use to become healthier as people and as a society afterwards.
LaFlamme: So many people say to me: “Oh, Dr. Sharkawy must be so exhausted” and I have to ask you, how are you getting through this day in and day out in that hospital?
Sharkawy: I am tired. I certainly won't hide that but I'm also buoyed by the incredible support of my family, my colleagues who have been working tirelessly even when I'm not working and by the great community around me, of all Canadians who showed me incredible love and expressions of kindness in their comments and support towards me, we need to share as much of this as possible with one another. It helps us. It releases that wonderful oxytocin and serotonin that we talked about through Dr. Kang and that wonderful advice. We all need more of that.