LET'S LEARN FROM COVID-19 AS MEASLES STARTS TO REAPPEAR
The disease is making an inexcusable comeback, says Dr. Nili Kaplan-myrth.
We have lost our innocence, our naïve belief that people will do what is necessary to take care of each other. It is far too easy for people to forget the refrigerated trucks lined up outside of hospitals, the body bags in long-term care. Dr. Nili Kaplan-myrth
Reading headlines this week about possible measles outbreaks post-march break, I think back to more than four years ago, mid-april 2019. As a family physician, I sent a letter then to patients in my clinic to warn them that there were cases of measles identified in Ottawa.
In my letter in 2019, I offered to provide boosters for those who were eligible, or to give a first dose to those who had previously declined the vaccine. We began to shuffle our schedule to ensure that our patients who refused the measles vaccine would be seen at the end of the day. Measles is highly contagious: It remains in the air for two hours after a person leaves the room.
Most medical colleagues of my generation have never seen patients with measles because until recently we've done such a good job of preventing a highly contagious and serious disease, aware that the dangers of measles could include encephalitis (swelling of the brain) and longterm (possibly permanent) damage to a child's immune system.
That year was a gentler time. The conversations about measles were respectful: Nobody was angry, there were no threats or harassment waiting for us on our clinic phone or in our mailbox in the mornings. It was also a time before rampant disinformation. Yes, there was already misinformation about vaccines on social media — a consequence of Andrew Wakefield's spurious article about measles and autism in the 1990s, thoroughly debunked — but looking back, it felt like the calm before the storm of anti-science rhetoric, before a war on public health.
Then COVID-19 swept the globe. In March 2020, before people fully understood that the pandemic would significantly change our lives for years — or forever, for those who died and their loved ones, and for those with LONG-COVID — there was a sentiment that we were “in this together” and people called health-care workers “heroes.”
As the virus flourished, so too did disinformation campaigns, anti-vaccine rhetoric, sectarianism and politics aligned with anti-science populism. We know too well how this played out in the convoy occupation of Ottawa. Many of us in health care and other fields who stepped up for the community were villainized. COVID -19 dramatically altered our lives and our personal safety, not just our health. My clinic will never again have an unlocked door. We can graph the death toll and global infections, but it is more difficult to talk about the demoralization, the personal and professional effects of the pandemic.
What have we learned over the last four years as Canadians, as a global population, and as a medical community?
It should not have taken as long as it did for the global medical community to acknowledge that COVID-19 was airborne, that masks and ventilation were more important than washing surfaces and standing two metres apart. We have lost ground in health communication, our ability to get out important, scientifically robust information. Disinformation and resistance to public health puts us all at significantly higher risk with the spread of each disease. We have lost our innocence, our naïve belief that people will do what is necessary to take care of each other. It is far too easy for people to forget the refrigerated trucks lined up outside of hospitals, the body bags in long-term care. As a society, we sadly continue to ignore disability, and so we relegate the population with LONG-COVID to the shadows. We seem puzzled by high levels of workplace absences, wonder why students and educators repeatedly infected with COVID-19 are struggling with recurrent and prolonged illnesses.
Which brings us back to 2024. Now measles is making an inexcusable comeback.
What can we do? Yet again, we have all the tools, we know the importance of vaccines, and we know that masking and ventilation, testing, reporting and isolation are important to reduce the spread of airborne viruses, including measles, influenza, RSV and COVID-19. Those of us who work in health care have a responsibility to update infection control practices.
Our office will maintain a mask requirement, use HEPA filters, and monitor air quality permanently, for the safety of patients and staff.
We know what is yet to come. Let's be proactive.
Dr. Nili Kaplan-myrth, MD, PHD, is an anthropologist and family physician who writes about health policy and politics. She is also an Ottawa-carleton District School Board trustee. Her fourth book was released by University of Toronto Press this month: Breaking Canadians: Health Care, Advocacy, and the Toll of COVID-19.