MAKING SENSE OF THE CONFUSION
How to sort out which medical advice to follow during the COVID-19 pandemic
A former president of the United States of America once said, “Trust, but verify.”
The context in which words are used matter a great deal and, as a pediatrician observing the unfolding of the COVID-19 chaos, I must conclude that one word that best describes recent events is confusion. It has become very important to verify once we decide to trust.
When it comes to masks and what we have elected to enforce or impose, it gets really interesting. Three respected health organizations agree to disagree: The U.S. Centers for Disease Control and Prevention recommends that people wear face coverings in public at places where it is difficult to practise physical distancing; WHO does not. In Canada, the Public Health Agency of Canada decided to tell people that face coverings in public is optional. However, it says that face coverings/masks are required when people travel by air, but it is encouraged when travelling by rail or bus.
What I have noticed in my clinic is that some toddlers lose it when they see a mom or dad wearing a mask. The other day, I heard a huge kerfuffle in one of my exam rooms. I knocked on the door before I entered, as I always do just to be sure there is no wandering toddler behind the door, trying to escape from a parent.
What I saw was a wrestling match between a mom and her child. The child wanted to pull the mask off the mom’s face and this “wrestling game” lasted throughout a long consultation. There was no way that the determined toddler was going to relent.
Ironically, the night before, I discovered that in this world there are people who make a living by studying what happens when we sneeze or cough and if it matters that we do it in a moist or dry environment. One can actually see dynamic images online of droplets and substances escaping and travelling with various distances from nostrils or mouths (see jama.2020.4756)
I also received a detailed email from an engineering friend who has friends at MIT. In that email, I found numerous links about the studies done so far on viral shedding and turbulent gas clouds — following a sneeze or a cough (Some of the useful links which may help us trust our leaders, but also help us verify, can be found at: bmjopen-2020-e006577; s41591-020-0843-2; europa. eu.2020-03-26-masks and bmjopen-2015-e006577)
As much as we prefer to keep the COVID-19 chaos a topic for health professionals to sort out, it was inevitable it would become politicized. Many politicians admit they are not doctors, and that science drives their decisions. The problem with this is that when there is a glass filled to 50-per-cent capacity, one politician may tell us he sees it as half full while the other thinks it is half empty.
One of the behaviours of public health officials that has surprised me the most so far is that we are told to keep our distance, stay in a locked-down mode, consider the safety of others and not only our own, be patient while this perplexing virus is slowly defeated … and yet, very few talk about the role of nutrition.
People who are particularly predisposed are those with diabetes, high blood pressure and cardiovascular disease. It does not take a rocket scientist to notice these conditions share a common threat — poor nutrition marked by overconsumption of foods that are refined, processed, greasy, salty, too sweet and associated with pathetically low consumption of common sense foods.
Only nine per cent of North Americans consume the recommended daily intake of fresh produce and the vast majority of us fail to consume proper amounts of fibre which plays a significant role in creating an optimal gut microbiome and thus improving our immunity.
One of the most comprehensive resources on how nutrition plays a significant role can be found at www.nutritionfacts.org/ covid-19/
On May 27, Dr. Michael Greger will be conducting a free webinar at 2 p.m. ET on how to survive a pandemic. This dynamic U.S. physician, known for his blunt but honest style of communicating, has numerous resources for those interested in improving their nutritional status and reducing the risk of contracting or passing on COVID-19. At a time when many families are subjected to fraudulent solutions, I have found Dr. Greger’s meticulous use of scientific references very helpful in verifying what we know and what we do not know.
We do not know why children respond differently to this virus and, for now, some scientists believe it has to do with DNA sequencing; we do not know if this virus is linked with Kawasaki disease (a condition marked by inflammatory changes especially worrisome regarding the coronary vessels in children) and we do not know if the Swedish approach to this virus will prove to be a wise or unwise decision. But one day we will know, and I trust it will help us prepare better for the next inevitable pandemic. Dr. Nieman is a community pediatrician and the author of Moving Forward: The Power of Consistent Choices in Everyday Life.