Navigating through this Thanksgiving weekend with Dr. Zain Chagla
Dr. Zain Chagla, infectious disease physician and medical director of Infection Control, has become a clear local, provincial and national leader when it comes to COVID-19 advice and the COVID response. We are so fortunate to have him working with us right here at St. Joseph's Healthcare Hamilton. And I am so lucky to be able to ask him some questions as I try to navigate my way through Thanksgiving Weekend, a traditional time for my family to get together.
MELISSA: The direction from Public Health and the province has been a bit confusing lately as it relates to social bubbles. Can you elaborate on why the latest recommendation is for us to stick with household bubbles only (with a few exceptions)?
DR. CHAGLA: When the province advertised social circles, it was trying to get people to have some close social contact with one another after a rough lockdown period. The concept made sense, as long as people remained relatively vigilant in distancing and indoor masking, amongst others. However, many things made this model hard to continue. Community rates increased. Some people created multiple circles. Finally, as we went back to normal lives, more people went back into workplaces, and kids went back to schools, increasing the number of contacts in everyone's lives. Those complications not only made it harder to keep circles/bubbles together, but also led to increasing transmission in people's homes. For now, given the complexity of the situation, it's much safer to keep to a household bubble to reduce the risk of spreading in private homes. For those living alone, or as a couple, they can consider joining with a single other household to support social interactions.
MELISSA: What I have been asked the most from friends and family as of late, is why do they need to reduce their social bubbles but they can still meet with friends in bars/restaurants/gyms, etc.?
DR. CHAGLA: We all need to think of the ways we can meet safely with rates rising in our community. We know restaurants, bars, and gyms have had transmission, and often are environments where masking isn't used. If it seems confusing that we shouldn't socialize in a household but can socialize in a restaurant, it is. The reality is if we're within 2 metres for a prolonged amount of time, without masks, and particularly indoors, the risk of COVID-19 is the same in your own home or in a restaurant. Ultimately, restaurants, bars, and gyms will not police people being within their own households interacting, but it's up to us all individually to do that. We can still safely interact, just incorporating physical distancing and masking while indoors. Using the outdoors is still a fantastic way to interact, whether it's sitting distanced on a patio, or going for a hike.
MELISSA: The second most common question I hear is - my kids are at school and interacting with teachers and a classroom of kids, why do I need to reduce my social bubble when my kids are with lots of people all day?
DR. CHAGLA: The goal with this second wave, is to keep kids in school, keep as many people working and try to keep our healthcare system taking care of everyone who needs care. This is very different than the first wave. While we know there are interactions we cannot avoid, like our workplaces, or our children going to school, minimizing other high risk interactions still has effects on reducing COVID-19. We also know that kids can acquire COVID-19 from their parents and bring it into schools, and so it's important for your children's health and their peers/teachers to limit these interactions to allow schools to function normally.
A similar analogy is driving. We all know may have to drive from place to place as part of our normal lives, and there is always a risk of getting hurt in a car accident, but we still try not to drive aggressively and wear our seatbelts to reduce the risk.
MELISSA: What’s your best advice for our staff, physicians, learners and volunteers in terms of how to navigate this issue particularly for this upcoming thanksgiving weekend?
DR. CHAGLA: Thanksgiving has the potential to do serious harm to our control efforts, as people are traditionally inside, eating together (without a mask), and come together from different communities and go back to them. If there is widespread COVID-19 transmission, it will enter many regions and have serious downstream effects.
Think about the people you love and how you can interact safely with them, without necessarily having an indoor meal. The weather will be fantastic this weekend, especially on Saturday, so consider doing an outdoor hike, going to the playground with the kids or having an outdoor meal while physically distanced. Use virtual means to interact with those who are vulnerable and at risk. Avoid the indoor meal and sleepovers, except in those small bubbles that need social supports. It's a time to be thankful and enjoy the time with family, we just have to think about doing it safely this year.
MELISSA: What are you planning to do with your family this weekend and how are you staying positive in this time of sustained crisis?
DR. CHAGLA: We're planning on spending Saturday together outdoors with my parents, while adhering to the safety protocols, going for a hike and the playground with our little one and having a nice distanced meal on the patio. I'm thankful the weather is good and we can enjoy interacting in-person safely. There is definitely hope with everything moving forward - our patients surviving better with COVID, and hopes of more therapeutics and a vaccine in the pipeline. While life may not be totally normal at the end of this, I think the progress made will make COVID-19 a manageable disease in the next year.