Health

Should you shame friends into cancelling their vacations? (And 17 other urgent questions)

Should you attend religious gatherings? Should children visit their grandparents? Should you go to a restaurant? An infectious disease specialist weighs in.

When the World Health Organization labelled the coronavirus a pandemic earlier this week, reaction from Canadians ranged from hoarding toilet paper to carrying on as normal—including embarking on March break vacations.

But Canada has already had its wake-up call, says infectious disease specialist Isaac Bogoch. “We have the Prime Minister in self-isolation because his wife is infected. We had the NHL suspend its season. And minor hockey in Canada suspended its activities as well,” explains the associate professor University of Toronto School of Medicine. “That’s the core of Canada—our head of government and hockey. I get that there’s a lot more to Canada than that, but if there is any indication that the coronavirus is here and it’s time to take it seriously, it’s that.”

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Bogoch emphasizes how “we must roll up our collective sleeves and do our bit as individuals, as communities, as organizations to ensure that we mitigate the damage caused by this virus—at the health level and the economic level.”

So what does that entail, exactly? Should kids still be hanging out with their grandparents? Should Canadians wear gloves at the gas pump? And should we shame our friends into cancelling vacation plans abroad? Bogoch answered some of these practical questions from Maclean’s, and more

Q: Should kids still go visit their grandparents?

A: There’s no right or wrong answer to that. You have to be very mindful of visiting grandparents and vulnerable populations, which could be elderly people or those with underlying medical conditions. These people are more susceptible to this infection and are more likely to have a challenging time with this virus. It’s very important now that, if people are visiting, make sure there are no signs or symptoms of infection at all. Some people will choose to not go visit in person if they’re feeling unwell, and that is a good choice. 

Having said that, we also have to balance this with how we are social creatures. We have wonderful families and we know that even if we’re practicing social distancing, it might be challenging because we do want to visit loved ones. That’s extremely important. We have to balance not cutting people off, but also ensuring people who go visit are healthy when they do.

Q: For those adults who visit their elderly parents weekly, should they stop doing that—even if they are all relatively healthy?

A: Sadly, there’s no right or wrong answer. These aren’t “yes” or “no” questions. If you’re healthy and have no symptoms, there shouldn’t be any reason not to visit family members. If you feel unwell, absolutely don’t go. It’s not a smart decision.

Q: Should we stop sending our kids to hockey practice or dance class—even if there are only going to be, let’s say, six other kids there?

A: Yes. Minor hockey has been cancelled and many organized activities that involve people getting together have been cancelled. The pendulum is swinging towards cancellation of all this.

If things aren’t cancelled now, it will be in the future. Quite frankly, it’s irresponsible for large group activities to be held—right at this moment in time.

Q: Even if there are only six kids?

A: Obviously, there’s nuance to this. But when we start to see the cancellation of schools, the cancellation of after-school programs, the cancellation of organized sports—it’s hard to dissect every situation as “what if there are three people there?” “What if there are 10 people?” We can’t micromanage every situation. People need to use common sense and appreciate what social distancing really means. We still need social interaction, and we need to talk to each other, but getting multiple people together under one roof is just not a good idea now.

Q: Based on that answer, I take it people should stop going to religious gatherings.

A: I think we’ll see fewer people attend those. It’s the same thing. Be mindful about these large social gatherings—even large religious gatherings. 

Many provincial governments have said they don’t want more than 250 people at organized events. I appreciate that some of these services might have less than 250 people, but this will come down to personal choice. We have to remember we’re not… [acting in an]  individually-minded, but rather in a community-minded way. Maybe the individuals who choose to attend these gatherings may be at much lower risk of having a severe outcome, but if you’re contributing to community transmission, we’re not doing this right. We have to be mindful of the community around us. 

Q: A few stores have stopped accepting cash, and will only accept debit or credit. Should we stop using cash?”

A: No.

Q: Is it safe for me to take my family to a restaurant?

A: Like anything else, there’s nuance to it. If this is going to be a very crowded restaurant, you should reconsider. But if you’re going to be spaced out appropriately and it’s not a very crowded place I think it may be okay. I have to be very careful with my words: it may be okay. 

I think we’ll learn throughout this process and discover what is and what isn’t acceptable. Clearly, what wouldn’t be acceptable is being crammed into a crowded restaurant. But a less crowded place where people are spaced apart is probably fine.

Q: Can I meet a friend at a coffee shop—or go for coffee alone?

A: Same rules apply. If it’s packed, the answer is to really reconsider. If people are spaced apart, it’s probably pretty reasonable. 

We know what the human toll of this is. It’s sad that there are vulnerable populations and elderly people who, sadly, some are going to get sick and people will pass away. The economic toll of this is going to be enormous as well. It’s not that small businesses will suffer—they’re already suffering. I really hope we can pull through together as Canadians. When this is all over, we must come back and really support the places that were really squeezed throughout this process.

Q: Should we cancel birthday parties?

A: Yes. People should start considering avoiding situations where there are a lot of people under one roof. 

I really want to record an answer and say: “use your common sense: avoid large gatherings of people.” The grocery store, the volleyball practice. It’s all the same answer: avoid large gatherings. Hockey is cancelled. School is cancelled. Conferences are cancelled. I hope people get the point.

Q: Speaking of large gatherings, is it safe to go to the grocery store—especially with these huge lineups?

A: We need to eat. We need to fulfill our basic needs of food, clothing, shelter, health care. There are certainly options where people can order groceries online and there are other options where people can go to the store—and maybe not go when it’s packed.

I don’t typically think of a grocery store as a mass gathering. They’re not really that packed. Once in a while there’s a line or something but it’s not like you’re shoulder to shoulder in there. Maybe, rarely. I don’t see them as high-risk places.

If you go to a megastore on a weekend, that’s one thing, but I think we can space it out and go at off-peak hours to try and ensure we meet our basic needs.

Q: How does one balance social distancing with what can feel like social isolation?

A: I don’t think there’s a right answer to this. It’s obviously going to be very challenging. We’re going to learn a lot of lessons on how to meet our social needs, plus how to be responsible and conduct appropriate social distancing such that we don’t facilitate the transmission of COVID-19. I don’t think anyone will get it right and we’ll have times when we have times when we’re really craving social interaction—and we might have other times when we say maybe we didn’t make the best decision by going to that party. We’re not perfect. It will take some learning, individually and collectively, to figure out what the new normal is going to look like for the next few months.

Q: Should people bring disinfecting wipes and hand sanitizer with them everywhere they go?

A: I think it’s a good idea to have some form of hand sanitizer on your person. That’s a good reminder that people should be mindful of hand hygiene. It lowers any barriers for people to clean their hands. It can also lower an individual’s risk of getting this infection, especially if people are outside of their home all day.

Q: Should I wear gloves at the gas pump? Or on the bus?

A: No. Just make sure you have alcohol hand sanitizer or soap and water—and be mindful not to touch your face.

Q: Is it safe to bring home books from the library?

A: Absolutely. In fact, there’s emerging data on how long this virus can live on inanimate surfaces. It doesn’t live very long on things like cardboard. It can only live for minutes to hours on surfaces like cardboard, and it can live for hours to days on surfaces like plastic and metal—but that’s under perfect circumstances and chances are it won’t live very long. It depends on the surface, the temperature, on ultraviolet light. The virus sure can stick to surfaces, but surfaces like books at a library won’t stick very long. 

The library is a public place and people are going in and out all the time. There are other points of contact along the way, like opening the door. Be mindful of having impeccable hand hygiene regardless of where you are in public. But I wouldn’t be concerned about taking books out of the library and bringing them home. Not at all.

Q: Should I panic if I hear someone occasionally coughing in the office?

A: No one should panic about anything, but they should be mindful about it. Certainly we’re very sensitized now to anyone who is ill and out in public.

It’s not acceptable to be coughing out in public, even more so in the context of a pandemic that’s transmitted by respiratory droplets. This is completely socially unacceptable, now more than ever. It’s worth mentioning to people, if you are unwell, go home. It is unacceptable to put other people at risk. 

The onus isn’t just on the individual, though a lot of it is. The onus is also on organizations to enable people to work from home—and enable people to be at home sick if they feel unwell. Some organizations really need human capacity to keep things going and it’s hard to compensate when people are at home sick, but I think we have to be creative in finding ways to permit people to be home sick. Sadly, there are many people living paycheck to paycheck and there might be unfortunate pressure that drives them to come to work even when they’re sick. That is unacceptable. It is not acceptable to have any pressure on people to come to work if they feel unwell.

Q: If someone doesn’t think they have coronavirus, but since symptoms can be really mild, should they get tested just in case?

A: No. Don’t get tested just in case. If you’re sick, get tested. If you’re not sick, don’t get tested.

And if you don’t know if you’re sick or not, isolate yourself, sit on it for a few hours at home and think about it. 

I get that people are anxious and this may magnify the way that some symptoms are perceived. If you’re objectively unwell, get tested. But if you feel generally well and don’t have signs or symptoms of an infection, don’t get tested.

Q: What happens if you have to go into quarantine, but you live with people over the age 65?

A: The Canadian Public Health Agency has excellent guidelines online on how to do this. Essentially, they say to do the best you can. If someone is truly symptomatic, they can wear a mask in the house. If there are multiple bathrooms in the house, allocate one washroom to the person being quarantined. If there is any opportunity to not overlap with other people in the house—a separate bedroom or a separate part of the house, that person could stay there. You can still avoid other people under the same roof. You don’t need a mansion to do that. Get appropriate cleaning supplies to clean high-contact areas.

Q: With March Break upon us, should people shame their friends or relatives into not going on that trip abroad?

A: Yes. Part of social distancing includes social pressure. We really are all in this together. It only works if we all play by the same rules.

We just had the Prime Minister make an announcement to the country telling us to avoid unnecessary travel out of the country. It’s not every day the Prime Minister gets on national television to parlay that message. Clearly this is important. I get that it will impact how we live. But there are meaningful policies. It’s not based on nothing. We should all roll up our sleeves and do that heavy lifting—and that might include cancelling a vacation.