CTV News: 20 Questions on COVID-19 with Dr. Abdu Sharkawy

By | March 21, 2020

TORONTO — From examining possible treatments of COVID-19 to dispelling the misconceptions online, CTV News is working to address the concerns of Canadians when it comes to the ongoing pandemic.

As part of the commitment, CTV’s Chief News Anchor and Senior Editor Lisa LaFlamme sat down with infectious disease specialist Dr. Abdu Sharkawy on Monday to discuss 20 questions that matter most to Canadians amid COVID-19.

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.

Below is a transcript of the interview:

1. What is the difference between self-isolation versus quarantine? Can I go visit my 85-year-old mother who lives alone?

Dr. Abdu Sharkawy: The differences are subtle but important. Self-isolation is a strategy that is meant to separate someone who is ill or presumed to be infected from others so that they don’t spread the infection to those that are going to be vulnerable. Quarantine, on the other hand, refers to a strategy that is used to separate those who are not yet ill and not infected, separating them from a pool of others who may be. We’ve seen that deployed at a mass population level in China and Italy, for example.

In terms of visiting an elderly parent, that’s something I hear a lot. It’s important to make sure that no one when you’re visiting them, you employ excellent hand hygiene, you do wear a mask and try and maintain a distance of six feet at all times and remember that you should be there only for essential reasons: to provide food, medicine and other support that’s essential.

Don’t forget, you can reach out and connect in many other ways: by phone, by FaceTime, by texting, by email. You can stay in touch without having to be there physically.

Lisa LaFlamme: So many other Canadians are looking for answers on the rules around isolation. I got an email last night from Melissa in Manitoba facing the very same dilemma now. Her elderly parents both have underlying conditions but are otherwise healthy. So her question is: after 14 days, can Melissa bring her parents back into her home with her and her husband and her kids?

Dr. Sharkawy: It’s reasonable to have your parents in your own nuclear home and they need your support. It’s probably still preferable to maintain physical distancing and give at least 6 feet whenever possible.

LaFlamme: So the parents could move in after that 14-day period of isolation. They can move into a daughter or son’s home as long as they maintain that distance.

Dr. Sharkawy: Certainly. And I would always recommend that if there are young children in the home, please try and maintain a minimum of contact if at all possible.

2. How will we know when the curve is flattened?

Dr. Sharkawy: So the curve is essentially a graphic representation of the rate of rise of infections and how it’s spread out over time and the total number of infections that result during a given epidemic or pandemic. So when we talk about the rate of rise of new infections, that means that the infections are maybe doubling at a fairly steady rate and may increase exponentially over the course of a few days. That means that the curve is going to be very steep. The slope is going to go up rapidly. And the concern there is that that will overwhelm the capacity of the health care system to maintain it.

When we talk about flattening the curve, we talk about not necessarily changing the number of infections that are going to happen during a pandemic, but rather having them occur more gradually and spreading them out over a greater period of time, which means that you won’t exceed the health care system’s capacity to manage them and to prevent death.

We’ll know that we’re flattening the curve over a period of weeks when we see that the rate of rise is slowing and that we’re able to maintain our capacity to deal with new cases.

3. Is it possible the coronavirus has been circulating for a lot longer than we realize?

Dr. Sharkawy: It’s a tricky situation because, of course, COVID-19 emerged during seasonal flu and during the time we see a lot of different respiratory viruses circulating. It’s quite possible that Cindy, you and your other family members did have COVID-19. We don’t know exactly when community transmission began here in Canada and when it became travel linked, becoming community transmission. The good news is it sounds like you’ve recovered and hopefully you won’t have any ill consequences going forward.

LaFlamme: What about that antibody diagnostic test they’re trying to develop so that when this crisis is over, people can get checked to see if they had had it at some point earlier?

Dr. Sharkawy: That’s something that’s being worked on from a research and epidemiologic point of view. I think it’ll be helpful to look back and to understand the scope and extent of this pandemic, but I don’t think it’s something we should focus on at this point in time. I think the essential thing now is prevention and good infection control measures.

LaFlamme: So once someone is recovered from an illness, is there a way to test them for COVID-19? Or is it the test only effective if you’re showing symptoms?

Dr. Sharkawy: The tests will likely only be effective if you are symptomatic or you’re within a specified period of time where the virus is still circulating in your body.

4. Since the 51-year-old from Milton, Ont. died of COVID-19 without having travelled or direct contact – local transmission being the source – are flu symptoms being taken more seriously by Public Health for testing? Or is self monitoring the symptoms until they worsen the only way to deal with this?

Dr. Sharkawy: That’s an absolutely tragic situation. My heart goes out to you, but I think it highlights the importance of recognizing that this virus and COVID-19 does have many faces and one of the lessons we’ve learned from these tragic examples is that we do have a heightened sense of awareness for symptoms that may be nonspecific, particularly in people who are immune compromised. And certainly that is something that is at the top of the mind of most health care professionals going forward. So rest assured, this is something that is not being taken lightly.

LaFlamme: Joanne is certainly not the only one asking that. I think this is such a mystery how Shawn got that virus in the first place. Doesn’t that impact the official count, though, if people who likely have the disease but are being told don’t be tested or doesn’t matter anymore, the official tally?

Dr. Sharkawy:  It still matters because ultimately we want to identify as many positive cases as we can and to inform them regarding the need for self-isolation and preventing contact with other people, but we do ask people to be very patient.

This is going to take some time for the testing leg to catch up with the demand and what you should do is, if you are waiting for your test results, try and self-isolate to the best of your ability until you can get the tests done. There’s really no other alternative right now.

5. I’m wondering what I can do as a 21-year-old to keep my parents and grandparents safe, who are all over the age of 50.

Dr. Sharkawy: It’s an excellent question and it’s a bit of role reversal. Our parents and grandparents have been taking care of us their entire lives. Now it’s our turn. We have to shelter them physically and literally. We have to make sure that we keep a distance from them, particularly when we’re talking about younger children who tend to be amplifiers of infection. Even if they don’t seem to get very sick from COVID-19.

If you are in close contact with your grandparents because you have to help them with food, with medicine, etc., wear a mask. Wash your hands vigilantly. Apply all of those basic common-sense measures and if you can keep them in their own space in a basement, for example, or some other suite where they have some freedom of their own without having to be encumbered by coming across other family members, by all means, you should take that opportunity.

LaFlamme: Annie is obviously a very conscientious young woman. But what about those who feel invincible, who are not exercising physical distancing? What’s your message to them?

Dr. Sharkawy: You’re not invincible. And all you have to do is look at the recent reports out of the United States where we’re seeing sometimes 20 per cent of the cases that are showing up in hospital are younger people, people under the age of 40 and some of them are getting very sick.

We have to remember that this virus is new. So the greater exposure it has to more human hosts, the more likely it is to mutate. The more likely it is that a more aggressive and lethal strain will be the one that you acquire. Everyone has to take this seriously. It’s not an old person’s disease. It’s not a weak person’s disease. It’s everyone’s disease. It’s everyone’s responsibility to do their part.

6. I’m 13 years old, I live with my mom in Hammond and my dad in Ottawa, my mom has a boyfriend and he has kids he shares with his ex-wife. What do we do with all the kids travelling from home to home?

Dr. Sharkawy: This is the time to be creative, to be accommodating and to try and compromise, remembering the fact that any movement that’s unnecessary between one domicile, one residence and another should really be avoided. So if that means that visitation can change temporarily so that one set of parents or one home can be the homestead for a few weeks rather than just one week, that’s probably preferable. If that compromise can’t be made. Obviously, you have to pay strict attention to hand hygiene. You have to make sure you’re disinfecting all common surfaces and really be vigilant about that, but that’s not the ideal option.

7. Can COVID-19 stick to my beard and mustache? Can my wife get sick from kissing me?

Dr. Sharkawy: The truth is that COVID-19 can really stick to any part of our bodies. The simple answer is try and make sure that that part of your body is clean and COVID-19 can easily be eradicated using soap and water, so if you’re able to maintain good hygiene, wash your face. Go ahead.

LaFlamme: You know, it’s funny because soul patches and side whiskers got the attention of the U.S. Centers for Disease Control. We all sort of had a laugh at the time. But if we remember that that graphic where they had the various facial hair, give us an explanation, the reason behind the seriousness of this.

Dr. Sharkawy: Well, I think the facial hair issue is more relevant for health-care workers or those that are going to require a tight seal mask and N-95 mask for high risk procedures. For those people, any degree of friction between the skin that is brought about by facial hair, especially a beard, is going to impact the tightness of that seal and may make it faulty. So really, this is something that relates specifically to health care workers and to the subset that are doing high risk procedures. For members of the general public, I don’t think this is important. If you are helping with an elderly parent or someone else who may be at risk, a surgical mask or some other substitute is more than adequate.

8. My question is about folks driving taxis. We’re being told to come into work and we’re happy to get people from one spot to another, but we are in an enclosed space. Are we considered an essential service? I’m happy to help my neighbours, but what should we do?

Dr. Sharkawy: Thank you for taking people to grocery stores, to pharmacies, to hospitals and urgent medical appointments. It’s really as an essential service and it’s important to protect yourself. And really the simplest things you can do is to make sure that you address hand-washing. So have a model of hand rinse or hand sanitizer next to you and use that between pick ups of customers before and after and open your window trying to open one or two windows to get some air circulation and some air flow so that if there is a possibility somebody is infected with this, hopefully it’ll go right out the window and not into you.

9. Now that most restaurants are closed and we might be looking to order, I realized when food arrives at the house, we need to be diligent with the wrappings. But my question is how much do we need to worry about the source, the kitchen where it was prepared, the people that prepared it and the journey to my home?

Dr. Sharkawy: Excellent question. I think obviously we have to have some degree of confidence in the hygiene standards that we are getting or our food from, whatever that source may be. But more importantly, we have to remember that the COVID-19 virus is not believed to be transmitted through food. We don’t think that it lives on the surface of food wrapping or anything and thriving in great quantities. So the best thing to do is to take the food out of whatever container it is, dispose of those containers immediately. And remember that you’re getting the virus, number one, by touching it with your own hands and then touching your own face. So if you are diligent with your hand hygiene and you’re not introducing anything to your mouth, your eyes or your nose, you’re going to be just fine.

10.   Should I be concerned about bringing groceries home that may have been handled or touched by someone who has the COVID-19 virus? Are there any precautions I should be taking?

Dr. Sharkawy: I think the need to be excessive about wiping things down is really something we should not be too terribly concerned about. Remember that grocery store employees are coming in not sick. Hopefully they don’t have the virus. And again, hand-washing is going to be much more important.

When you bring your food home, if you’ve got fruits and vegetables, wash them like you ordinarily would. If you’re talking about dry packaging, a cereal box, etc. again, the virus is not going to thrive on these surfaces. So as long as you’re maintaining diligence with respect to your own hand hygiene and avoiding touching your face. You’re going to be just fine.

LaFlamme:  So you don’t have to take a wipe and clean off the tuna can or whatever, whatever you bring in.

Dr. Sharkawy: If it makes you feel better and gives you peace, peace of mind, go ahead. But it’s absolutely not necessary.

LaFlamme:So let’s try as well as we can to clear up the mystery of how long does it stay on the surface?

Dr. Sharkawy: Yeah, it depends on the surface. So it can last as little as a few hours if we’re talking about gloves. It can last a few days when you’re talking about wood or glass or other surfaces. So that speaks to the importance of wiping down high-contact surfaces. Handrails, chairs, desks, table tops, countertops, doorknobs, light switches, all of those areas are areas that are high-contact touch surfaces and we should be very diligent about wiping those down at least once a day, if not more often.

LaFlamme: We’re also getting a lot of questions from people even in our own newsroom — we are down to a very diminished staff — but people are saying: “Ok, what about my clothes when I go home? Should I take all my clothes off in the garage or whatever and then immediately wash them?” What is the smartest advice on clothes? Anybody bringing it in?

Dr. Sharkawy: Yeah, I don’t think that that’s necessary, frankly. I certainly the people who work in higher risk exposure settings like health-care workers may want to take extra caution in terms of changing their work attire and maybe having a dedicated laundry solution for their clothes when they’re changing out of them and washing them at high temperatures. I think for everyday people, you probably don’t have to do that. Let’s not forget, you shouldn’t be out of your home very often anyway. So you shouldn’t have to change your clothes.

LaFlamme: But if you go out for a walk on your own and you walk back into the house, you should be fine.

Dr. Sharkawy: You should be just fine.

LaFlamme: If you have not been in contact with anybody else, I guess is the key to.

Dr. Sharkawy: That’s correct.

LaFlamme: I think that’s the thing we don’t realize, like when you brush your teeth, you should right away clean the tops your faucets right away?

Dr. Sharkawy: Well, ideally, you can do this in a systematic fashion. So if you spend a few minutes doing particular parts of the house, wiping down doorknobs, faucets, sinks, light switches, that sort of thing, remotes, game controllers, your phones or devices, your tablets spend some time dedicated to doing that so that you don’t forget. If you’re doing it by and by I think it’s going to be easier to lapse.

11.   Can you please suggest ways to strengthen our immune system so that our bodies can fight off the virus or keep it in a mild form?

Dr. Sharkawy: The old answer is really: ‘Do the common basic things that you would to take care of yourself.’ We can’t overemphasize the importance of sleep that’s detrimental to the immune system when there’s a deficit there. So sleep whenever you can, get as much rest as you can, eat a healthy, balanced diet. Hopefully not all takeout, exercise, don’t forget that that’s important. You can still go for walks, for exercising, not socializing, and fluid intake is important, but this idea that hot fluids or anything else, that’s a supplement to somehow going to protect you specifically against COVID-19. That’s a dangerous myth to buy into.

Please don’t believe what you’re reading on the internet. Try and get your information from trusted, credible sources and use common sense. Reduce stress as well. Yoga, music, meditation, whatever you need to bring down your stress level. That’s going to help your immune system a great deal.

LaFlamme: That’s good to know and while we’re on the top topic, the U.K. government was roundly criticized for a policy suggesting herd immunity may be a good way forward, a good strategy. Tell us, first of all, what is herd immunity?

Dr. Sharkawy: So herd immunity refers to the concept of having enough exposure to a particular infection within a given population so that enough people become immune and the reservoir shrinks. So, for example, if enough children has been infected by something and have recovered from it, they may be the main reservoir spread to older, more susceptible adults and with enough immunity that stops happening.

The problem with COVID-19 is this is practically brand new within the human population. We’re all learning how to adapt to it, including our immune system. We simply don’t have the time and the luxury to wait for herd immunity to happen. We need to prevent the infection in the first place and prevent it from being transmitted to others, especially those more vulnerable.

12.   As a survivor of H1N1, ARDS, where I was incubated in an induced coma on full life support, tracheostomy, what are my chances of survival if I was to contract COVID-19?

Dr. Sharkawy: I’m glad that you were able to recover and you’re here to ask such a great question for us. It’s important to recognize that the influenza virus, including H1N1, is an entirely different family of viruses from the coronaviruses, so there is no “cross immunity” between them. There’s really no relationship with them. We have to do our utmost now to prevent the infection from happening in the first place.

To address your question in specific terms, without knowing more about your medical history, your age, etc., it’s difficult for me to predict what your likely response would be to the COVID-19 virus if you were infected. But again, the message should be let’s try and prevent being exposed in the first place. That’s why distancing is so critical. That’s why hand hygiene is so important. Don’t touch your face.

LaFlamme: We did see a lot of submissions coming in about re infection. So if you’ve already recovered from COVID-19, the question is, can you be reinfected?

Dr. Sharkawy: You can, but fortunately, this is an extremely rare phenomenon. We will learn more as our testing strategies evolve and we do have hopefully a serology test that can confirm people have become immune. We do have testing strategies right now to confirm that people have become COVID negative if they have gone through an illness phase and they are recovering from the disease. So we’ll learn more in the future. So the simple answer is yes, you can, but the good the good part of that is it’s very unlikely that it will happen.

LaFlamme: So as China, for example, is sort of slowly opening up from its two-month lockdown, we’re only going to know as the months progress whether some of those people are infected again?

Dr. Sharkawy: It’s quite possible and one of the concerns we have is there may be a second wave of infection if our strategies for containment and for infection control are not good enough, and that’s why it’s really important for everybody to adopt a very consistent attitude and philosophy that we’re in this for the long haul. Let’s try and adopt healthier lifestyles and healthier habits and maintain them.

13.   Should my first responder husband distance himself from me and our young kids? Is it safe for him to be coming home right now?

Dr. Sharkawy: Excellent question, it’s one that I get asked. I’m a health-care worker. My colleagues are health-care workers. They’ve asked me the same thing. I think right now what we’re recommending is that we try and minimize any sort of contamination that might occur both with our skin or our mucous membranes and any attire that might be contaminated with the COVID-19 virus. So I think that if we are commonsensical about changing our work clothes, for example, dedicating a particular laundry cycle to that, wiping down shoes when you come home, taking a shower, making sure that you wash your hair, those are reasonable enough strategies.

The good thing is most of us as health-care workers and frontline workers are not in the highest risk exposure categories in terms of aerosolizing procedures and others that are really going to bring us higher risk in terms of acquiring the infection. So if we employed those strategies that I refer to, I think we’ll be fine. We don’t want people to be away from their families unnecessarily.

LaFlamme: We ultimately need to protect the people who are protecting us. People like you and your colleagues in the hospital, stuff that you just said, something interesting. So when they come home, say they are in the health-care industry. They should come home and wipe off their shoes as well.

Dr. Sharkawy: Yeah, I think it’s a good idea. I think anything that may be in contact with other surfaces in an environment where the Coronavirus might be and we’re bound to see more of it in hospitals as weeks evolve, that’s probably a reasonable thing to do.

LaFlamme: We should also say that you yourself are taking such extreme precautions to be here to provide this information to Canadians, but also working in a hospital. So tell me the precautions in the newsroom each day you do?

Dr. Sharkawy: Yeah. I mean, I’m very diligent about making sure I’m maintaining a distance of six feet between anyone. We are, you know, religious and fascist, if you will, about wiping down everything from pens that we use to keyboards to surfaces. So thank you, CTV, for leading the way.

14.   I’ve heard that the hospitals are running out of N-95 masks. Would it be of assistance if volunteers here in Canada start sewing masks for our healthcare workers? If so what are the specifications (i.e. pattern, fabric)?

Dr. Sharkawy: Thankfully, right now, I don’t think that we are in a dire situation in most health care institutions in terms of the shortage of N-95 masks. That is a problem in some of our urgent care clinics and family medicine clinics. So thank you for that offer. I think more importantly, when we talk about who needs these and N-95 masks, if we’re talking about people who are looking after elderly parents or elderly people as personal support workers and you need a mask and you can’t get one, there are lots of different ways that you can make your own mask. You can use cotton. You can use an anti-microbial pillowcase if you want. You can use pretty much anything that is going to withstand a little bit of moisture and be rewashed.

LaFlamme: So it does protect you then to have that even cloth over your mouth?

Dr. Sharkawy: Yeah and remember, the more important thing is also you don’t want that to be a substitute for hand-washing. You don’t want it to be a substitute for not touching your eyes, remote mouth and your nose around that mask. But that’s not going to be needed for the general public, this is for people specifically either looking after patients or those taking care of elderly people or those that are immune compromised.

LaFlamme: That sewing idea was an initiative that started in Seattle, Washington, which was the largest in the first cluster in the United States, they’ve even put the pattern online. So your advice to the people out there sitting at home who really do want to do something, anything that they can do is it may down the road be something helpful.

Dr. Sharkawy: Sure. And it’s a wonderful initiative and it’s wonderful to see people reaching out to and helping others. That’s a fantastic spirit that we certainly want to celebrate and embrace further.

LaFlamme:  What about those people who’ve been hoarding medical supplies? I mean, the impact that has on the people who need it most, as I say, the people who are protecting us,

Dr. Sharkawy: It’s obviously upsetting and it’s entirely inappropriate. We will run into a situation at some point that if this practice goes on unchecked, we are going to be in a serious shortage situation and those that are going to need these items for personal protective equipment are going to put themselves at risk.

I want to remind people there are 17 doctors who have died in Italy from this. We’re talking about putting our lives on the line. We ask people to really respect that, to do your part and recognize where things are needed most.

15.   If the doctors and health-care providers are taking every possible precaution, wearing PPE equipment, then how is that some of them have contracted virus and died?

Dr. Sharkawy: I think there are a number of different possibilities for why that might be the case. First of all, we have to recognize that not every case is COVID-19 is necessarily acquired in the hospital. So it’s quite possible that those who did acquire this or unfortunately died of it maybe it’s more exposed outside of a hospital environment. Second of all, there’s always the possibility that there may have been a lapse in an infection control protocol and remember, the greater the volume, the greater the intensity, the greater the amount of stress that these health care workers are under. The greater the likelihood is that something will give and that’s something we want to avoid, too.

LaFlamme: So I have to ask, what’s it like inside the hospitals right now for you and your colleagues?

Dr. Sharkawy: It’s stressful. There’s no question about that, but I’m incredibly heartened and impressed by the level of commitment, the level of selflessness that I’m seeing in my colleagues, both in the emergency room and my internal medicine colleagues, my critical care colleagues and a whole host of others who have pitched in and rolled up their sleeves and said, “I’m going to do what I need to do.” It’s a fantastic spirit of cooperation. We need that same spirit of cooperation to spread throughout our entire community.

LaFlamme: All those retired nurses, the appeal, what we first slide in the province of Quebec. We’re seeing it elsewhere. How quick is it for you to say, “OK, we’ve got 10 retired nurses who want to come back to your hospital, Toronto Western. Let’s get them in there?”

Dr. Sharkawy: Yeah, it’s amazing the result that people have shown and you know, our bureaucratic processes and red tape has fortunately been cut dramatically and so we now have a system in place where people do want to come out of retirement and help, it’s a relatively seamless one.

16.   Is there a proper technique to using disinfectant wipes? Can you use the same wipe to clean a series of door knobs? Or should it be one wipe per job?

Dr. Sharkawy: I think we have to use our common sense as to how much of a surface area you’re using per wipe. So doorknobs have a relatively small surface area. It’s quite reasonable to use the same way to wipe off a series of doorknobs, maybe light switches, game controllers, remote controls and things of that nature. You probably want to move to a different series of wipes that you’re talking about wider surface area situations like countertops, table tops, desks, keyboards, phones and devices. So I would say use at least, you know, four or five wipes if you’re going to be going through one floor of your home at a minimum. Obviously, the bigger your home, the more you’re going to have to use.

LaFlamme: So obviously we’ve seen the footage. The shelves are empty. Wipes are harder and harder to find in stores across the country. So we got an email from a retired firefighter, Don Middleton, who asked if some sort of bleach concoction. I’m going to read it exactly so I don’t get this wrong but like five per cent bleach in a liter of water would do the same thing. That is how they disinfect their equipment in the fire hall. So what is your opinion on that?

Dr. Sharkawy: This is where it’s great to be resourceful and to get a lot of DIY tips to manage this and there are a plethora of options that you can consider and there’s lots of really good credible information online, much of which has been validated by the World Health Organization. The bleaches a simple one because it’s still relatively plentiful and available in most places and the solution that I would recommend is about four teaspoons of bleach in a liter of water, put it into a spray bottle like you might use for a Windex.

You can spray that on whatever surface you need. Let it sit for a good 10 minutes and then wipe it off with a cloth. Remember that bleach is a bit caustic and it’s don’t get to inhale, so if you’re going to be using it, make sure you open some windows and try not to inhale it directly as much as possible. If you’ve got a mask, that’s the time you should be using it.

LaFlamme: It’s also very destructive on really nice colored clothing. So warning to everyone out there, if you’re going to use the bleach technique, don’t get any on your clothes. Speaking from personal experience on that one, but that is a really good practical tip, you could do a mix of bleach and water in one of those spray bottles. Clearly marked bleach, spray the countertops, whatever. Leave it for 10 minutes. The other one is the timing. I want to go through the topic of hand-washing. Best techniques.

Dr. Sharkawy: Yeah, excellent question and I really can’t overstate this enough, a few things to remember is number one: Make sure that you are washing your hands properly, which means that you want to use warm or lukewarm water. Don’t use hot water, hot water can actually damage your skin, provide cracks in the skin and increase your risk of skin infection and it’s going to make it worse for your skin hygiene overall. So please use warm water or lukewarm water. Apply the soap. Make sure you’re covering all of your skin surfaces, both on top of your hands and palms and 20 seconds is a minimum. So some people say sing “Happy Birthday,” but it has to be 20 seconds, if you’re doing it for less than that, you’re not doing it well enough, get under your fingernails that you can in between the web spaces of your fingers and when you’re done, if you’re in a public place, take a napkin and close the faucet with a napkin to close it with your hands or your at home, hopefully you’ve wiped off the faucet and your handles already.

17. With everyone from the U.S. president to basically everybody online coming up with ideas and potential treatment options, I’m wondering what leeway Canadian doctors have? Do they have the freedom to try whatever they think work in treating their patients with extreme cases of COVID-19?

Dr. Sharkawy: The great thing about what’s happening right now is that there’s been a tremendous collaborative effort that’s gone on throughout the world between scientists and researchers trying to expedite clinical trials of various therapies that are being used. Most of them are therapies that are actually already being used for other conditions, autoimmune diseases, for example, like lupus and rheumatoid arthritis.

Unfortunately, it takes time to really get statistical power behind these studies and a robustness behind them to make sure that we’re not just going by the seat of our pants, anecdotally.

There are certainly a number of things that are being explored, but rest assured that in Canada we’ve got world-class researchers, we’ve got world-class doctors and nurses and healthcare staff who are actively looking at this. And we won’t be left out if something comes through as a breakthrough protocol for managing this disease.

LaFlamme: Unfortunately, a lot of people think Google is gospel and they’re reading online. This a several others wrote in about wondering about an alcohol vapor inhalation, something that was suggested on. Can you comment on that?

Dr. Sharkawy: This is dangerous and this is why it’s very important to make sure that whatever you’re reading or hearing is from a credible source. There’s been talk about drinking copious amounts of very hot liquids and again, this idea of inhaling hot vapors.

It’s dangerous to rely on these techniques. They may cause actual harm, especially when you’re talking about alcohol vapors. Make sure that you’re getting your information from a credible source. Right now, there are protocols under way that are being explored and studied to get your knowledge and your information from the World Health Organization, from the CDC, from your physicians. Don’t go to the internet, please.

LaFlamme: Every medical officer of health in every province in this country and every city has on their Web site all of the information, including our own CTV News.ca website for questions like that. So really, that’s so important. Consider your source where you’re reading this from, but I want to ask about this vaccine for pneumonia. It can’t prevent COVID-19, but we have viewers writing in and wondering if it can prevent someone from developing pneumonia after they’ve contracted at CIVD-19.

Dr. Sharkawy: Absolutely. It’s an excellent question and it speaks to the importance of different vaccines, having different benefits. So remember, we’re often exposed to a multitude of different infections in a given season and that might be bacterial pneumonia, it might be influenza, and if you have one, you may be more susceptible to the other. So it’s important to recognize, particularly in people who are immune compromised, people who are elderly, if you get COVID-19, you may be less likely to succumb to a secondary bacterial pneumonia. If you have had your pneumonia vaccine. So I would certainly advocate for those at risk over the age of 50, smokers, chronic lung disease, heart disease, diabetes. Speak to your doctor, know if you’re eligible for this vaccine and get it.

LaFlamme: What about those people have been so laissez-faire about the flu shot every September, October? Here’s a message in here for them also.

Dr. Sharkawy: Well, I hope this is an excellent reminder for people that these viruses are deadly and I think the scale and extent of this infection worldwide has grabbed our attention, but the reality is the flu has been around for hundreds of years. We have the Spanish flu in 1918 that claimed 50 million lives.

So we’re hopeful that we don’t want to run into the same bad lessons from history by taking things too lightly. It’s important to make sure that the flu vaccine is administered widely across communities and by the same token, we’re talking about distancing, sparing others. When you get your flu vaccine, it protects others around you who are more vulnerable to it. You will shed less virus, you’re less likely to give it to someone who is on dialysis, to a cancer patient sitting in a waiting room next to you in a movie theater, etc. So it’s all of our responsibility. Please, please get your flu shot.

18. Is research for finding the vaccine to the coronavirus currently happening in Canada? If so, how are they trying to solve the problem?

Dr. Sharkawy: Yeah, no question. While we’re very excited and we’re heartened to see that there’s been this tremendous collaboration between people here in Canada and around the world, I can’t overemphasize the fact that a vaccine is not our solution here.

A vaccine is something we’re looking for in the future. If and when COVID-19 becomes a regular virus, we have to contend with on a seasonal basis. This takes months of development when we talk about purifying the extract from the vaccine to actually formulate it in terms of animal testing, in terms of testing on healthy volunteers and then safety assessment beyond that. So we’re looking at several months at the very least, we can’t afford to look that far ahead. Right now, we have to focus on stemming the tide of this infection right now in our own homes, in our own communities. So hand-washing, physical distancing, making sure we take care of all vulnerable segments of the community. That’s much more important. Please don’t look at the vaccine as a way out of this.

19. Can our pet dog or cat contract COVID-19 from someone who tested positive, or from someone who is asymptomatic? If so, can that same pet spread it to someone who does not have the virus?

Dr. Sharkawy: The good thing is that it does not appear that pets seem to be affected by COVID-19 very frequently at all. There are certainly case reports of cats and dogs who have been infected by this, but they are extremely rare and fortunately, there is absolutely no documented evidence to date of a transmission from an infected pet to a human.

So this is not something that we need to be necessarily very concerned about. I would say take care of your pet the same way you ordinarily would by maintaining regular visits to the vet, taking regular grooming and hygiene, but go ahead.

LaFlamme: But those that clinics, I can’t say for sure, but I’m not sure that they’re grooming salons are probably not open. It’s probably not a good idea right now to take your dog to a groomer, but if someone’s walking along six feet away, they’ve got those extendable leashes and the dog comes over to you or your dog. No problem.

Dr. Sharkawy: That’s fine.

LaFlamme: OK, that’s good to know.

Dr. Sharkawy: Man’s best friend.

LaFlamme: That’s true, and woman’s I might add, as a dog owner myself, but there are there extra steps that Canadians should be taking on those all important daily walks, whether it’s with their dog or just on their own?

Dr. Sharkawy: That’s an excellent question again. We have to remember, this is a marathon. It’s not a sprint. We are going to need exercise. We are going to need fresh air and as scary as this is. It’s not a nuclear fallout. You are able to get out of your home and to smell some fresh air, but you have to be very cautious and intelligent about how you’re doing this. So you don’t want to walk in groups at all if it can be avoided. If you’re going to talk to your neighbour, do it from across the street. That’s OK. You’re walking to exercise, not to socialize, to borrow that fantastic line from Premier McNeil from Nova Scotia yesterday. So it’s important to get fresh air, but remember, it’s not a social activity.

LaFlamme: Who should not walk right now, who should not walk?

Dr. Sharkawy: Anyone who is under the recommendation of self-isolation should not be out for a walk.

LaFlamme: So somebody who’s come in from their holiday in the states or wherever and they are under a 14 day self-isolation, they on their own cannot walk their dog on the street.

Dr. Sharkawy: They really shouldn’t. They really shouldn’t and they should be isolated to their own home environment. We just want to minimize any potential opportunity for someone who may be at a higher risk of having been infected coming across somebody else. It’s a big ask, but remember, it’s temporary. So two weeks is something we can get through. Hopefully most of us still have shelter. Hopefully most of us still have light and power. Some of us are not quite as fortunate. So I think we need to take that into perspective here.

LaFlamme: The fear is that the virus is airborne.

Dr. Sharkawy: The virus is not really airborne in most circumstances. So the virus is only airborne during high-risk situations, which mostly happens during medical procedures with vigorous coughing, etc., where you’re going to get secretions that fill the air. The virus, we are pretty confident, is the droplets spread, which means that it can’t really percolate and spread more than about six feet before it lands somewhere else, either on you hopefully not or on a surface of some kind.

20. Now that the spring is here, do we have be worried about spreading the COVID virus through mosquitos or other bugs that feed off our blood?

Dr. Sharkawy: At this point in time, we’ve never had any experience with any coronavirus, whether it’s novel or not being transmitted through mosquitoes. So we need not worry about COVID-19 specifically related to that. However, it’s important to note that mosquitoes can certainly bring a whole host of other conditions with them, including other viruses and right here in Canada, probably the most important one to be aware of in the summer and early fall is West Nile virus. So we don’t want to take mosquitoes lightly. If you are out, try and wear long sleeves when possible, if you’re at a picnic or you’re somewhere else, you know, insect repellent is important. Avoid areas of stagnant water where mosquitoes breed. They certainly can bring other problems with them, but COVID-19 is not one of them.

LaFlamme: You just made me think of such an interesting point. We have on some level conditioned ourselves against West Nile and that came through Canada and Lyme disease. Some of the measures that we took then in just hiking through the woods or something like that. We will need to implement again this summer, because I guess one of the issues is whether or not this is seasonal. We received a lot of questions from people saying, “We see the beautiful weather in British Columbia” and you wonder, is that a good thing to keep numbers down or it does weather not matter?

Dr. Sharkawy: We don’t know. There’s certainly some idea that with warmer weather, the virus will not really want to sustain itself or it won’t thrive. That’s highly speculative at this point in time, so we don’t want to count on that. I think we need to count on our own individual healthy habits and that’s going to be far, far more important than waiting for warmer weather to bring this down.

LaFlamme: When will we know more about this cycle?

Dr. Sharkawy: Excellent question. I wish I had the answer to that, too. I think we’ll have a better idea at some point over the next few weeks when we see the full impact of the containment strategies we’re using of our individual physical distancing strategies, of our self-isolation strategies, etc. We’re not going to know for at least a few weeks.

LaFlamme: We saw the situation in Italy ratchet up to now, its parks. I mean, you see whole the city of Milan, not one person walking around in that city. So I guess the question is, are we learning from what they’re doing? It’s taken them a few weeks to get to this extreme lockdown situation.

Dr. Sharkawy: I certainly hope we’re learning and again, I remember the important thing is that we really shouldn’t be waiting for our governments to impose a strategy for us to contain this virus. We should be looking in the mirror.

Every single one of us can do something on our own in terms of our habits, in terms of physical distancing, to make sure that we don’t contribute to this spread any further so that we can stem this tide as quickly as possible. If everybody does what they’re supposed to do and really buys into this and takes it seriously and embraces this as an opportunity rather than a curse or a sacrifice, we can look forward to actual picnics and actual barbecues in the summer, not virtual ones.

Bonus Question: When will things get back to normal?

Dr. Sharkawy: The honest answer is we don’t know, but I think what we need to do now is adopt a new normal and I know that that’s been mentioned before, but it’s hard to digest. We need to try and remember that if we adopt some of these strategies and healthy habits in our lives, we’ll do things in a beneficial way to get on to a normal lifestyle again soon. I’m really confident that if we do that, we will see this through at some point over the next few months. If we don’t, unfortunately, this can become much more problematic. Let’s have faith in each other. Let’s recognize that we’re individually accountable to each other. Let’s recognize that we have good principles. As Canadians, we can embrace this change and embrace it positively and do something we can all be proud of.

LaFlamme: Canada has been so focused on mental health for so many years now and trying to remove the stigma and all that. Now we have an entire country of people forced into self-isolation for the betterment of the community right now. So give us some coping skills before we leave on trying to stay strong of mind, you know, whether it’s learning harmonica or learning a language or what.

Dr. Sharkawy: Yeah, I think, again, everybody needs to look at this as an opportunity. This has been called a reset for the earth, that there’s less of a stamp of pollution being put out, that there’s less noise pollution. Families are actually talking more rather than just texting each other. These are all opportunities that we have now that we shouldn’t let pass and at the same time, we’re learning great habits about health hygiene and preventing lethal infections from spreading to those more vulnerable around us. Let’s not lose sight of that. This is an opportunity that we can use. We will get through it. We have to have faith in each other, but that faith has to start from within.

LaFlamme: Obviously, when you’re cooped up in your house. Things can get a little angry when there’s kids around. So it’s not the talking they might be worried about. It’s the screaming. So how do you try to keep the tempers down at a time like that?

Dr. Sharkawy: It’s hard. I think we all have to exercise an enormous amount of patience. I’ve had to deal with it myself. Be patient with each other, cut each other’s slack. We’re all in this together. We all need each other’s help.

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