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Pandemic prompts Q&A podcast

Dr. David Thomas is a family physician also serving as the current Chief of Staff for the Dr. Charles L. LeGrow Health Centre in Port aux Basques, which covers the Southwest coast region. Dr. Amy Pieroway is a family physician based in Corner Brook and Chair of the Long Range Family Practice Network.

By ROSALYN ROY

PORT AUX BASQUES – Sunday, Jan. 3 marked the 23rd edition of the West Coast NL COVID-19 podcast. Hosted by Dr. David Thomas and Dr. Amy Pieroway, the podcast started on April 19, with the support of Western Health and the Long Range Family Practice Network.

“We’re going to call this one Variances and Vaccines, because those are the questions that we’ve received tonight,” begins Thomas.

Taking questions is pretty much the entire point of hosting these podcasts. Thomas says the goal is to clear up a lot of the misinformation while avoiding any sensationalism that permeates some of the COVID-19 coverage, as well as to bring a local and regional perspective to the discussion.

Like global pandemics, podcasting is also a new challenge for Thomas, though the affable, gregarious doctor seems to be adjusting well on both fronts.

“I do enjoy it, yeah,” said Thomas via phone interview on Wednesday, Jan. 6.

Initially the podcast aired on a weekly basis, but that has been scaled back to the first Sunday of each month at 7:30 p.m. on Facebook. The doctors plan to keep podcasting as long as the communities they serve continue to tune in.

“As long as we keep getting questions and there’s new things coming out about COVID, absolutely, yeah, we’ll keep doing it,” said Thomas. “It’s (COVID) not going away anytime soon, unfortunately.”

Questions stemming from the most recent podcast naturally revolved around the new vaccines. In the beginning, people used to focus more on transmission, symptoms, testing and protocols.

“Every week before doing our podcast we’ll go through all of our questions and we assign them to certain areas, and we figure out which one of us can answer,” said Thomas.

If they don’t know the answer, they will readily admit it and conduct research to share afterwards.

“We’re just reading so much all the time and learning ourselves that we can generally answer the questions we get during the podcast,” notes Thomas, who admits it’s been a steep learning curve for even medical professionals at times.

The only one that’s sort of stumped them questioned the recommended usage of mask filter inserts. A recent question about whether or not the public can stop wearing masks once the vaccines roll out was easier to answer.

“No we can’t, not right away anyway,” Thomas explained. “We’ll have to get up to at least herd immunity and have control over the transmission of the virus before masks are even going to start to go away. I often wonder if masks might be a reality for the greater healthcare system for maybe forever. Who knows? But certainly within society it won’t go away until herd immunity starts to get achieved.”

He suspects that immunity won’t be achieved until close to the end of 2021 or possibly even into 2022, once 80 to 90 per cent of the population are no longer able to catch the virus, as not everyone can even receive the vaccine yet.

Some people with severe allergies have experienced a reaction, though Thomas notes they were treated successfully. Testing has only begun on trials for children and pregnant women, and questions remain about how long the vaccine will remain effective in those who are inoculated.

“It’s just too soon to say how long immunity lasts. They know it’s really effective in the beginning,” said Thomas. “Maybe it will last your entire life, but maybe not.”

Thomas received the first dose of the Pfizer-BioNTech vaccine on Friday, Jan. 8. Because this vaccine must be stored at ultra-low temperatures, that necessitated a trip into Corner Brook. In three weeks he will return for the second dose. Thomas says he has 100 percent confidence in the vaccine.

“We know Health Canada has a really high bar for efficacy and safety, and I’ve also looked at the data myself.”

Thomas was not the only medical professional from the area to be vaccinated. He also serves as Chief of Staff for LeGrow and shared that some of his staff also made the trip in on Friday.

As the pandemic began to sweep the globe, staff at LeGrow implemented new precautions to protect themselves and the patients they were caring for from COVID-19.

One of the first things they did was create a second emergency waiting room by using rooms in the outpatient department to treat patients for respiratory emergencies.

“We’ve taken extra steps to make sure that staff weren’t moving between units, particularly in the beginning,” said Thomas. “There was no cross between those seeing the sickest of patients and long-term care.”

That meant no doctors on the long-term care ward for roughly nine months. Instead a nurse practitioner served the ward and did not work in outpatient care.

Thomas did not step foot back into the long-term care ward until just before December, which he had last visited some time in March, even after the provincial government had eased protocols somewhat.

Others treating those with compromised immunity, such as cancer patients receiving chemotherapy, were not permitted to work in other departments either.

“We still choose to stay out of there if we can because we really don’t want to put anybody at risk in there,” he said. “If we’re seeing ER patients, we’re taking extra precautions to not enter wards where people would be more vulnerable.”

Thomas says that certain doctors were assigned to specific teams, and that the hospital is still focused on virtual care when possible.

“It is safer.”

Adjusting to the new normal has been hard on his staff at times. Changing in and out of full PPE (personal protective equipment) for 12 or more hours is not easy. Just having enough PPE available became “quite worrisome”.

“We never did run out, but there were times we were working quite low,” shares Thomas. “To change them out and do it properly, it does take a lot more time and effort. It slows you down greatly.”

Should a patient with COVID-19 present at the hospital, Thomas is confident the staff could ventilate and intubate them as needed. He notes that they would likely be transferred out soon, however, as they would require a full ICU package, which is not possible at LeGrow.

Thomas believes that although there have been no confirmed cases of COVID-19 in this region, it has more than likely experienced one.

“I do suspect that there’s been probably cases that we’ve had here, and I certainly know that there’s been cases that have passed through town, but I do feel that we’ve probably had cases on the Southwest Coast. It just hasn’t been confirmed with testing,” admits Thomas.

He says he can’t prove it and may well be wrong, but notes that Stephenville and Corner Brook have had cases, and that Port aux Basques serves as a provincial gateway thanks to the Marine Atlantic ferry service.

“It’s based on probability. With the amount of people that we have returning to the area who work away, and who have travelled away, chances are we’ve had them, but through isolation and not affecting other people, we haven’t had a positive test here that I know of.”

Like many medical professionals, Thomas has made personal sacrifices in order to do his job, even living in an area that has remained largely unscathed.

“In the beginning I had a room set up in the basement, so away from my family. We’ve become more normal, but I know a lot of my colleagues did the same. They may have been in the same house, but they moved away from their family,” shares Thomas.

In fact, a couple of his colleagues from within the region moved their families out of province.

“They actually moved their kids to New Brunswick. They both knew they’d be heavily involved in the COVID unit and the ICU, so they moved their kids away.”

Now that things are under better control in Newfoundland and Labrador, most families have returned to a semblance of normality, but Thomas says medical professionals still take all the necessary precautions they need to in order to keep their families safe.

“It’s tough on everyone. I haven’t gone home. I haven’t seen my family (from) away since all this started. I’d love to see them. I’d love to have a more normal social life, and I’d love to not have to take all the precautions that we do right now.”

Thomas believes it will be summer or even fall before the region gets inoculated. The AstraZeneca vaccine, unlike the Pfizer and Moderna vaccines, does not require cold storage and can be administered much like the annual flu shot.

To date AstraZeneca has only been approved in the U.K., but Thomas believes it will be approved quite soon by Health Canada.

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