COVID-19

COVID-19

Coronavirus disease 2019 is a respiratory illness that can spread from person to person. The virus was first identified in Wuhan, China but has since then spread worldwide. On March 12th, 2020, the World Health Organization declared a global pandemic. Over 60 countries have confirmed cases of the virus which is rapidly spreading. As of July 2020, the count of COVID-19 cases in Canada was 106,805.

The coronavirus virus spreads very easily through close contact with people within about 6 feet from droplets when an infected person coughs or sneezes. It is also possible to get the coronavirus from touching infected surfaces or objects, and then touching your mouth, eyes or nose. 

Coronavirus causes mild to severe respiratory illness which can vary from person to person also varying with different age groups. Some of the more commonly reported symptoms include:

  • New or worsening cough
  • Fever – temperature equal to or over 38°C
  • Shortness of breath or difficulty breathing
  • Feeling feverish
  • Chills
  • Fatigue or weakness
  • Muscle or body aches
  • New loss or smell or taste
  • Headache
  • Gastrointestinal symptoms (abdominal pain, diarrhea, vomiting)
  • Feeling very unwell

Children have been more commonly reported to have abdominal symptoms, and skin changes or rashes.

The severe complications for some patients include pneumonia in both lungs, multi-organ failure and in some cases death. These severe symptoms are widely described in older people, the immunosuppressed and those with long-term conditions such as diabetes, cancer and chronic lung disease. These symptoms could occur in pregnant women so should be identified and treated promptly. 

Symptoms may take up to 14 days to appear after exposure to COVID-19.

Recent evidence indicates that the virus can be transmitted to others from someone who is infected but not showing symptoms. This includes people who:

  • Have not yet developed symptoms (pre-symptomatic)
  • Never develop symptoms (asymptomatic)

While experts know that these kinds of transmissions are happening among those in close contact or in close physical settings, it is not known to what extent. This means it is extremely important to follow preventative measures.

  • Wear a mask in public places where social distancing cannot be practiced consistently or inside buildings such as stores, public transportation, shopping areas.
  • Wear a mask to your midwifery clinic appointments and during any visits with your health care practitioners.
  • Maintain a 2 metre physical distance from anyone who does not live in your household or social bubble.
  • Avoid close contact with people who are sick
  • Limit non-essential travel
  • Stay home as much as possible to avoid exposure
  • Avoid touching your eyes, mouth and nose with unwashed hands
  • Wash your hands often for at least 20 seconds with soap and water. Use an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are unavailable.
  • Sneeze or cough into a tissue or the bend of your arm
  • Avoid greetings that involve physical contact such as hand shakes or hugging
  • Clean and disinfect frequently touched surfaces and objects such as toys, toilets, phones, tablets, electronics, door handles, bedside tables, television remotes.

Medical Masks or Homemade face coverings –

When worn properly, a person wearing a non-medical mask or face covering can reduce the spread of his or her own infectious respiratory droplets.

Non-medical face masks or face coverings should:

  • allow for easy breathing
  • fit securely to the head with ties or ear loop.
  • maintain their shape after washing and drying
  • be changed as soon as possible if damp or dirty
  • be comfortable and not require frequent adjustment
  • be made of at least 2 layers of tightly woven material fabric (such as cotton or linen)
  • be large enough to completely and comfortably cover the nose and mouth without gaping

Some masks also include a pocket to accommodate a paper towel or disposable coffee filter, for increased benefit.

Non-medical masks or face coverings should:

  • not be shared with others
  • not impair vision or interfere with tasks
  • not be placed on children under the age of 2 years
  • not be made of plastic or other non-breathable materials
  • not be secured with tape or other inappropriate materials
  • not be made exclusively of materials that easily fall apart, such as tissues
  • not be placed on anyone unable to remove them without assistance or anyone who has trouble breathing

Limitations:

Homemade masks are not medical devices and are not regulated like medical masks and respirators:

  • they have not been tested to recognized standards
  • the fabrics are not the same as used in surgical masks or respirators
  • the edges are not designed to form a seal around the nose and mouth

These types of masks may not be effective in blocking virus particles that may be transmitted by coughing, sneezing or certain medical procedures. They do not provide complete protection from virus particles because of a potential loose fit and the materials used.

Some commercially available masks have exhalation valves that make the mask more breathable for the person wearing it, but these valves also allow infectious respiratory droplets to spread outside the mask.

Masks with exhalation valves are not recommended, because they don’t protect others from COVID-19 and don’t limit the spread of the virus.

Medical masks, including surgical, medical procedure face masks and respirators (like N95 masks), must be kept for health care workers and others providing direct care to COVID-19 patients.

*Information available in several languages

Pregnant clients do not appear to be at more risk of susceptibility than the general population. Expert opinion is that the fetus is unlikely to be exposed during pregnancy or congenital effects of the virus on fetal development. There is also currently no data suggesting an increased risk of miscarriage or early pregnancy loss. 

We advise pregnant clients avoid traveling during the coronavirus pandemic. You can check the Government of Canada’s website for the latest travel advisories. 

If you have recently traveled outside of Canada, please reschedule your midwife appointment until you have been symptom free for 14 days after your arrival into Canada. If you are 37 weeks or more, please contact our office phone line and ask to speak with your midwife. Your midwife will be able to do a phone triage assessment and/or set up a home visit if necessary. Please note, we will not be providing letters to travel outside of Canada during the pandemic until we have been instructed it is safe to do so.

If you have traveled to Hubei province, China, Iran or Italy in the last 14 days, you must limit your contact with others for 14 days, starting the day you began your journey to Canada. This means self-isolation at home. If you develop any symptoms, contact your midwife by pager for advise on the next steps.

If you or your family member(s) have symptoms of coronavirus, you should contact the Health Unit at 519-663-5317 and ask to speak to the Infectious Disease Control team to facilitate assessment and testing. 

Most people who contract COVID-19 will recover; however, some people are at higher risk of complications. If you think you may have COVID-19, or if you have been in contact with someone who has COVID-19, you should get tested.

Knowing if you are infected is important for protecting:

  • yourself
  • your family
  • people you encounter

Testing for the presence of the virus is the only way we can confirm if someone currently has COVID-19. Testing helps reduce the spread of the virus. When people are confirmed to have COVID-19, they can be isolated at home, or if needed, in a hospital.

Testing tells us:

  • who has the infection
  • where in our communities the virus is spreading
  • how much the virus may be circulating in our communities

Testing is a key tool to:

  • detect and isolate people who have COVID-19
  • follow up with close contacts
  • help us to better understand this virus
  • inform the public health actions we take
  • stop the spread of the virus and prevent outbreaks

Update March 16th 2020 – Oakridge Arena now has a drive-through assessment centre. It is located at 825 Valetta Street in London open 7 days a week 11am – 7pm. It is a screening program for anyone with COVID-19 concerns. You will not receive testing for the virus at the centre.

You should NOT visit the Emergency department, your midwife clinic or your family doctor. If you are experiencing a medical emergency, you should dial 911 and page your midwife.

There is no specific treatment for coronavirus. You should self-isolate at home indoors and avoid contact with others for 14 days or until advised otherwise. Click here for what to do if you are sick.

Advise for people who are self-isolating – click here for further information.

Advise for people who are self-isolating and live in the same house – click here for further information.

Currently in Canada, there are 3 ways of testing for COVID-19. 

  1. Molecular PCR – MOST COMMON – PERFORMED AT LHSC HOSPITAL
    • uses swabs to collect samples from the nose or throat which are sent to a laboratory for testing
    • results are ready in 1-3 days
  2. Point-of-care test
    • involves a rapid test done at the time and place of care, such as a hospital or doctor’s office
    • uses swabs to collect samples from the nose or throat which are then tested on-site
    • results are ready in 30-60 minutes
    • Since point-of-care technology can only test a limited number of samples in a single machine, it’s used in places where it’s needed most, including: rural, remote and isolated communities and specific high-risk settings where it’s important to have fast results without having to send samples to a laboratory.
  3. Antibody testing (serology)
    • Health care providers may have access to blood tests, called serological tests, which are used to see who may have already had the virus. These detect the presence of antibodies produced by your immune system in response to an infection. A positive serological test means that someone has been exposed to the virus in the past, but cannot reliably indicate how long ago that exposure occurred. As a result, they are not used to diagnose a case of COVID-19 in early stages of infection, since they don’t detect the virus itself.
    • Serological tests can help us: estimate how many people have had COVID-19, determine which public health measures need to be in place, better understand how much the virus has been circulating in the community.

All tests must be performed by a health care professional. At-home sample collection test kits or home test kits have not been authorized for sale. 

Watch how health care professionals test for COVID-19.

 

Test accuracy can vary during the course of your illness. For example, depending on when a test is conducted, it could result in false negative results if there’s not enough virus in your body at the time of the test. False positive results are also possible. Health care professionals make their diagnosis decisions based on a number of factors, including test results.

  • A positive test means that you have COVID-19 and must follow public health measures.
  • A negative test can indicate that a person is not infected, but it doesn’t always mean you’re COVID-19-free. If you’re tested too soon after exposure, the virus may not be detected because the person is still incubating the virus and it is not detectable at the time of the test and will ultimately become infectious.
  • Sometimes tests are inconclusive. In this case, your health care provider may re-test you.

If you are in labour or require a hospital assessment urgently for your pregnancy, and are self-isolating, your midwife will meet you in the car park of the hospital to provide a mask for you to wear until you can be admitted to our specialist isolation rooms for assessment. If you require an ambulance transfer, you should inform the dispatcher that you are self-isolating for coronavirus.

Your midwives will wear special masks, gowns and gloves to prevent the transmission of coronavirus. You must not remove your mask until you are in the isolation room. Visitors will not be allowed and therefore, two birthing partners will be able to be present with absolutely NO switching.

Currently the recommendation from the Royal College of Gynaecologists UK suggests continuous fetal monitoring is implemented to ensure your baby’s wellbeing due to the increased risk of fetal compromise, although this guidance may change as more evidence becomes available.

It is reassuring that in six Chinese cases tested, breastmilk was negative for COVID-19; however, given the small number of cases, this evidence should be interpreted with caution. Your midwife will discuss precautions to take while breastfeeding.

Information adapted from: Centers for Disease Control and Prevention website, Middlesex Public Health Unit, World Health Organization, and Royal College of Obstetricians and Gynaecologists in U.K. Last modified March 2020.

If you are in crisis or immediate danger please contact your midwife or dial 911.

If you are experiencing gender-based violence, you can access a crisis line or request a video appointment from your midwife where you can use the signal for help.

You may also access support workers, social workers, psychologists and other professionals for confidential chat sessions or phone calls by texting WELLNESS to:

  • 686868 for youth
  • 741741 for adults

The COVID-19 pandemic has resulted in many changes. You might feel like you’re no longer in control of things. It is normal to feel sad, stressed, confused, scared or worried. People react in different ways. Some common feelings include:

  • a sense of being socially excluded or judged
  • concern about your children’s education and well-being
  • fear of getting sick with COVID-19 or of making others sick
  • worry about losing your job, not being able to work or finances
  • fear of being apart from loved ones due to isolation or physical distancing
  • helplessness, boredom, loneliness and depression due to isolation or physical distancing
  • Stay informed but take breaks from social media and the news.
  • Practise physical distancing, but stay socially connected to friends and family through:
    • email
    • phone calls
    • video chats
    • social media
  • Practise mindfulness by:
    • stretching
    • meditating
    • taking deep breaths
  • Try to:
  • Follow safe food handling and cooking practices to keep you and your family safe by killing the virus and lowering your risk of infection.
  • Think about how to use any unexpected flexibility in your daily routine.
  • Focus on the positive aspects of your life and things you can control.
  • Be kind and compassionate to yourself and others.
 
Information adapted from: Government of Canada website, Centers for Disease Control and Prevention website, Middlesex Public Health Unit, World Health Organization, and Royal College of Obstetricians and Gynaecologists in U.K.