“Before you know what kindness really is
you must lose things,
feel the future dissolve in a moment
like salt in a weakened broth.
What you held in your hand,
what you counted and carefully saved,
all this must go so you know
how desolate the landscape can be
between the regions of kindness.” -Naomi Shihab Nye
All that matters is basic human kindness.
Infectious diseases exploit social inequality, prejudice and malaise. They exploit fear and hate.
Community is the antiserum. Do not be misguided, the fundamental solutions to HIV/AIDS, tuberculosis, polio, smallpox, and now SARS-CoV-2, have been neither medical nor technocratic. They are social. Solutions build off epidemiological tools we have had since Dr. John Snow’s 1854 cholera mapping. Nursing care, evidence-based hygiene and contact precautions as we learn of the particular disease’s character. Physical distancing when the illness prevalence requires.
Politicians and media will tout novel treatments for COVID-19, vaccines and fancy hospitals. Such offerings play for a narrative of triumph over tragedy, the victor and champion mythology sowed for prospective electoral cycles. They succeed because of the social underpinnings.
Local trumps global. But we must think global and act local.
Food security is our foundation. LUSH and the Comox Valley Farmer’s Market show us how. Food systems are essential services. We can use food to grow community and break social isolation, even when we need to maintain physical distance.
Creativity fuels resiliency.
Relationships build community.
Mid-March it all changed. Life and work would never be the same for me. It was my first Monday back from vacation, scheduled to have 40 of my patients through the doors. Routine physical exams, medication renewals, PAP screenings. Many of these in-person visits were suddenly not indicated – the potential risk of exposure to this unknown new illness outweighed potential benefit. At least for now. All the bricks of normalcy and routine were coming down.
I felt confusion. This first week of different. Even my usual post-work solace of the Saturday morning Comox Valley Farmer’s Market felt fraught with guilt – should I go? It stayed open – something that at first struck me as inappropriate, until I realized the considerable physical distancing changes and cautions taken to try to continue to strengthen the food security of the Comox Valley, in spite of COVID-19.
Seemingly overnight in mid-March, the Comox Valley medical community mobilized – “Slack,” the organizational and social media app, exploded to connect our medical planning and response. Remarkable individuals stepped up, mostly doctors under 50 in their first pandemic, co-ordinating our ICU, emergency, surgical, obstetrics and community responses. There were historical precedents, but no blueprint.
In primary healthcare, we have shifted to a new normal of Telehealth – building off the relationships that family doctors strive to create. There have been challenges and steep learning curves. Meanwhile, living off a boat, my dream of doctoring under sail became an unexpected COVID-19 gift, as Telehealth and electronic prescribing replace dinosaur fax technology. Leadership locally within the Comox Valley Division of Family Practice, and beyond from Doctors of BC and the Canadian Medical Association, has facilitated these steps – trying to ensure patients don’t feel abandoned. And from one wave to another, we shift again, to a new continuum of virtual and in-person care.
As Ed Yong incisively wrote in The Atlantic, “the COVID-19 pandemic is most like a very rapid version of climate change—global in its scope, erratic in its unfolding, and unequal in its distribution […] Our choices are to remake society or let it be remade, to smooth the patchworks old and new or let them fray even further.”
With compassionate leadership, community buy-in and creative solutions in the Comox Valley we have taken important steps through this crisis to strengthen our health and social fabric, taking this crisis as a potential opportunity to come together, even when we must remain apart, remembering the inspired words of Dr. Bonnie Henry, “Be kind, be calm, be safe.”
Dr. Alex Nataros,
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