When my husband John and I headed to Florida for a planned vacation at the end of February, there was no indication that we’d be returning home to two weeks of self-isolation.
After watching the coronavirus evolve quickly from an outbreak to a pandemic, and some increasingly sleepless nights, I woke up at about 4 am on March 12th deciding we needed to head home.
An epic 32-hour road trip followed, and once we were back in Fredericton, we heeded the advice of federal and provincial health authorities and began two-weeks of self-isolation.
Here are my thoughts on:
What all travelers returning to Canada are being told by the Public Health Agency of Canada:
For the next 14 days:
- self -isolate (stay at home and keep your distance from others);
- do not have any visitors, especially older adults or those with medical conditions, who are at a higher risk of developing serious illness;
- monitor your health for fever (greater of equal to 38 degrees Celsius), cough and difficulty breathing;
- wash your hands often with soap and warm water for 20 seconds, or use alcohol-based hand sanitizer if soap and water are not available;
- cover your mouth and nose with your arm when coughing or sneezing; and
- if you develop COVID-19 symptoms, separate yourself from others and visit your provincial or territorial public health website for more information, including when to contact your public health authority.
As a physician, I admit it is a difficult position to be in. As someone who maintains a full-time family practice ― including providing care in a long-term care facility ― I feel guilty about not being able to care for my patients myself during this stressful time.
Like many of my colleagues, I find myself in the difficult position of recognizing the best thing we can do for our patients and society as a whole is to stay away until we are certain we are not transmitting the coronavirus.
Self-isolation, as with social distancing, is the most effective way to prevent a spike in COVID-19 cases that could overwhelm the health care system.
I can only empathize with my colleagues who continue to deliver front-line care under increasingly challenging conditions. And for now, I will do what I can to help them from home, by guiding the CMA to help ensure the right resources and information are getting into physicians and the public’s hands.
For now, my husband and I are prepared to wait out this period as best we can, following public health guidelines for monitoring our own symptoms.
When you have COVID-19, here are the hygiene guidelines the Public Health Agency of Canada recommends for self-isolation:
- Stay in a separate room, away from other people in your home as much as possible and use a separate bathroom if possible.
- Avoid contact with pets if you live with other people that may also be touching the pet.
- Wash your hands often with soap and water, and dry hands with a paper towel, or with your own cloth towel that no one else shares.
- Wear a mask if you must leave your house to see a health care provider.
- Wear a mask when you are within two meters of other people.
- Clean all “high-touch” areas such as counters, toilets, sink tap handles, tabletops, doorknobs, TV remotes, and phones using regular household cleaners or diluted bleach (1-part bleach to 9-parts water).
- Put the lid of the toilet down before flushing.
We have provisions (with the exception of an extra supply of birdseed) and my children and grandchildren understand they will have to forgo visits during this time. This will be tough.
But John and I are also having some “in-house” meetings to work out a personal schedule and routine that keeps our spirits up, and with some proper timing, we should still be able to get outside, alone, to enjoy some fresh air. We are also fortunate to be able to enjoy ― from our home in isolation ― an unobstructed view of the Saint John River.
It’s now the midpoint in my self-isolation period, and my husband John and I are fortunate to remain symptom-free.
Self-isolation is not always easy, however, and I confess I felt a bit twitchy and unsettled for the first time today. On day seven, I have yet to even step off my property; the furthest I have gotten is my back deck.
We continue to stay well and most importantly, our kids, grandkids and my 88-year-old mother are all healthy. But today it really sank in that dealing with the COVID-19 pandemic is going to be a marathon and not a sprint.
At the end of the 14 days, I’ll be able to end this isolation and go back to work in the community. But there will be a new normal and new challenges. I’m concerned about the isolation facing our seniors as we continue to fight this pandemic and the impact this could have on their health. I’m also concerned that the focus on the coronavirus will mean that patients will not be making us aware of other new medical problems, unrelated to COVID-19.
Even though I’m confined to my home, I’m able to keep in touch with my practice and my local community and fulfill my duties as the CMA president-elect. Rarely a day goes by when I don’t have a virtual meeting or teleconference.
During these daily calls, I’m hearing some confusion and frustration from my colleagues around the lack of consistent messaging on COVID-19. They’ve also expressed concern about the potential lack of personal protective equipment and the need to make sure we’re all properly equipped – not just my colleagues in hospitals but also those in private practice working in the community. This is an issue the CMA continues to work on with federal and provincial partners.
Being in isolation is teaching me more about myself, including the fact that I really do need a routine and I need to keep busy. I’ve also taken to heart the perspective that there are things over which we have control, and things over which we don’t. And we should focus on those things we can control, such as planning our day, and let go of the things we can’t.
I’m also trying to look beyond the immediate challenges we’re facing, and the potential positives that may come from how we’re dealing with COVID-19.
For instance, I believe this pandemic will ensure that virtual care becomes an accepted practice across Canada — a shift that will benefit so many patients, especially in isolated and Indigenous communities.
This is the kind of silver lining I’m looking for these days.
It’s all over and it’s just beginning.
Having completed my two weeks of self-isolation, tomorrow I can rejoin my colleagues. I feel pretty good and I’m looking forward to getting back to my office and connecting with my patients.
By the end of our isolation period, I had come to think of self-isolation as safe isolation. We were in isolation to keep ourselves and others safe from the COVID-19 pandemic.
I now emerge to a world that is very different from the one that existed when my husband and I started our isolation in our Fredericton home. The pandemic has grown and with it our understanding of the appropriate precautions needed to protect both health care workers and our society.
In my family practice, I will be interacting with my patients by virtual means. In-person routine care is no longer an option because we know the risk of community transmission is a reality.
But even if it is by telephone or video, my patients have ongoing, routine, non-COVID-19 related problems that need attention. Some of my patients have had a cancer diagnosis. Some have just found out they're pregnant. Life is going on.
Other roles I am returning to are more daunting.
I care for patients in a long-term care facility and I will need to visit some who have not had direct access to a physician during my absence. The institution where these patients live is in lockdown and the stories about infections in other long-term care institutions in Canada are troubling.
Later I will become a hospitalist, providing continuity of care for patients who have to be in hospital.
Both situations raise questions about the type of personal protective equipment (PPE) I will need to do my job – to protect both myself and my patients from infection. Will that equipment be available for me?
It’s a bit scary and worrisome. It’s only human to admit that. I will need to learn what is recommended for someone in my situation and act on this advice.
On a personal level, day 15 is not going to be too different from day 14 in our household. Physical-distancing is the new normal, so although I will be taking the opportunity to visit with my grand-daughters, it will be from a safe distance and sadly, with no hugs.
Everyone has a role to play in this new reality, whether it’s self-isolation or physical distancing. We can all contribute to dealing with the pandemic and making Canada safe again.
As a physician, I am now rejoining the front-line. I have some trepidation, but at the same time I am eager to be able to do the job I was trained for.
More from Dr. Ann Collins' COVID-19 experience:
This material is for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. The opinions stated by the authors are made in a personal capacity and do not necessarily reflect those of the Canadian Medical Association and its subsidiaries.