Full Comment - An ICU Doctor explains mistakes we've made (and still make) with COVID

00:00:00.000 Welcome to the latest episode of Full Comet. Our guest today is an ICU doctor who has had

00:00:09.860 a front row seat for what's really been going on at ground zero during this pandemic, and

00:00:14.220 we have a lot to talk about. Is the healthcare system in Canada still in crisis? What did

00:00:19.120 we get wrong? What are we getting wrong still? And did we really need all of these restrictions

00:00:23.640 on our lives, some of which are still in place? One of the best voices in Canada to answer

00:00:28.500 these questions is Dr. Kwadro Kamaratang. He's a critical care physician who has been treating

00:00:32.940 COVID patients at hospitals in Ottawa, where he is also an assistant professor at the University

00:00:37.420 of Ottawa and host of the Solving Healthcare podcast. Dr. K, hello, welcome. Wow, Anthony,

00:00:43.940 you make me feel special. You are special. We're really glad to have you on here. Thanks so much

00:00:48.460 for joining us. Thanks for having me. And I really want to get your insight because you have views

00:00:52.800 on restrictions, you have advice to offer Canadians on really how to think about this time right now,

00:00:57.840 how to proceed. And you've also got on the ground experience, pretty much, you know, from day one

00:01:03.200 of this pandemic starting in the hospitals in our country. And I'll definitely want to go back and

00:01:07.660 get your thoughts on some things that were happening earlier in previous waves. But to just sort of jump

00:01:12.660 into the moment right now, here we are, it's pretty much summer commencing in Canada. What's the current

00:01:18.260 situation right now? I mean, are we right to be optimistic? What do you see is the urgent issues right

00:01:25.220 now? Yeah, I mean, I got to be honest with you, Anthony, like there is a lot of reasons for

00:01:29.780 optimism. Like I, I have, as you alluded to, been part of this pandemic through all waves. And the

00:01:37.540 third one obviously hit us the hardest. And it was pretty intense. Like we were seeing that locally in

00:01:47.240 Ottawa numbers that we haven't seen before, we were seeing a significant amount of transfers from the

00:01:52.220 GTA. We did see younger patients come through, which was, you know, to, to many of us was, was

00:02:00.100 shocking and, and, and unfortunate. But all that has gone better, you know, like our numbers in the

00:02:08.620 community have gone better. COVID admissions have come down significantly. Our ICU numbers in terms of

00:02:15.820 like, like the absolute numbers of patients in the ICU remain relatively high locally for this time of

00:02:23.360 year, but the percentage of COVID patients is significantly lower compared to, you know, even

00:02:30.960 just a couple of weeks ago. And so like, there is absolute reasons for optimism. We're seeing more and

00:02:37.860 more Canadians getting vaccinated and even double vaccinated. So from our perspective, or my perspective,

00:02:45.760 I should say things are looking up. One of my biggest kind of concerns with, with communications

00:02:50.940 and information during COVID right now, we increasingly live in a soundbite age and a sort

00:02:55.120 of tweet age. And a lot of the information that, that we were getting that people were processing was,

00:03:00.820 was pretty sort of capsule information. Whereas I know you have a very full picture, very nuanced

00:03:05.820 picture. And I want to get you to break down a bit more, please, for us, the idea of younger people

00:03:10.560 being admitted to the ICUs, because a lot of people took that. We just hear young people getting

00:03:15.580 into hospital. We'd see that on the ticker board. And a lot of people got nervous and said, man,

00:03:18.740 this new variant, it's, you know, it's knocking down people in their twenties and their prime and

00:03:22.540 so forth. Well, hold on, you know, what, what was really going on? Who were these? Can you break

00:03:25.900 down for us what the, what the profile was of the person, what it means, you know, to be younger?

00:03:31.520 Because for a while, first wave, we're talking people in their eighties and nineties. What was it

00:03:36.180 looking like as the waves continued?

00:03:37.620 Yeah, that's a very good point, Anthony, because once again, this wave, the third wave,

00:03:44.840 we were seeing younger demographic, as you mentioned earlier in the pandemic, we were seeing

00:03:50.320 typically older patients in their sixties, seventies, eighties. And this time around,

00:03:57.640 they were vaccinated. So some of our vulnerable population, unfortunately, were a bit younger,

00:04:02.520 but the, the key demographics that we saw throughout the pandemic, regardless of age was

00:04:10.060 obesity, type two diabetes, high blood pressure, other also known as metabolic syndrome was clearly

00:04:18.460 a risk factor. Like when we saw patients that were in their, you know, I saw some that were in their

00:04:24.200 twenties and thirties, but unfortunately, obesity was a predominant part of their profile.

00:04:31.600 And so it, it, you know, in some ways, this was once again, my bias, I always thought Anthony,

00:04:39.340 this was the, it was good to bring this up because maybe it would empower a lot of people to ask

00:04:46.140 themselves, like, should we be doing more to think about prevention and getting healthy in terms of

00:04:51.100 what we eat and staying active. But, you know, we, there was a lot of things to tackle, I guess.

00:04:57.580 And a lot of this wasn't, I'd argue that this wasn't even really brought up at all within

00:05:04.960 mainstream media. And I'm not even sure in Twitter world, how much this was brought up,

00:05:09.760 but it was just so apparent from early on in the pandemic that this was a huge contributor to people

00:05:17.080 getting sick from COVID. And luckily because they were younger, they were, most of the patients would

00:05:21.900 pull through, which was, was great. We also saw a bit of a rise in pregnant cases, which was a full 1.00

00:05:28.740 disclosure. We want some of the most anxiety provoking scenarios as a ICU doc, but you know,

00:05:35.900 in my, in my limited exposure to these patients, they, they, they got through.

00:05:42.580 You make a, you make a really interesting point when you're talking about why didn't we talk about

00:05:46.580 health factors and so forth. And I know you've been an advocate of that for quite some time.

00:05:50.460 And I can't help, but feel that early on in the pandemic, we said, we want to make sure everyone

00:05:54.940 takes this seriously. We want to do things out of an abundance of caution. I get that. So we started

00:05:59.820 basically saying, look, anyone can get coronavirus. Anyone can get, get it seriously. Anyone can die of

00:06:06.160 it. So everybody needs to follow all these rules. Everybody needs to follow the lockdowns. And I get

00:06:10.620 that idea of making people take it seriously, but I worry sometimes that didn't allow for the very

00:06:15.500 conversations you're talking about here. When you, when you're saying, you know, we got to talk about

00:06:19.220 healthy living. This is not, you know, I would do a lot of writing on comorbidity data and people

00:06:23.220 would be like, well, Anthony, what's your point? You're trying to suggest that, uh, you know,

00:06:26.440 these people don't matter or so forth. And no, no, no, it's almost kind of the opposite that there

00:06:30.540 are, there is a, a group, there are specific indicators in people that suggest, well, they really

00:06:36.140 matter. And we really need to talk about that. Yeah. And the thing why it's so important to

00:06:42.040 capture the data is, is exactly what you say. So you could do something about it. So whether

00:06:46.420 it's your vaccine strategy, whether it's once again, promoting healthy living, because one of

00:06:52.180 the things as a nice you doc that I found shocking, and this was kind of some of the content that we

00:06:56.700 covered on our podcast was that some of these conditions you could reverse relatively quickly

00:07:02.260 based on what, how you choose to eat, whether that's fasting, low carb, ketogenic approaches to,

00:07:07.920 to health. Um, like there's ways that you could really reverse disease relatively quickly. And

00:07:15.200 to me, this, I was new, new to that. I wasn't aware that, you know, this was an option for so

00:07:20.200 many. So when I, when I caught wind of these opportunities, I was like, wow, how could we not

00:07:25.680 be preaching this to the world right now when this is a huge driver in the pandemic? And, and you kind

00:07:33.080 of alluding to this too, like not everybody has the same risk factors. Like, you know, I'm, I'm in

00:07:38.260 my, you know, in my forties, I'm, uh, relatively healthy and I, I'm, I don't have the same risk of,

00:07:45.040 of, of dying from COVID as, you know, even someone my age, but you know, that has obesity or high blood

00:07:52.480 pressure. And I think this is something that, you know, is should, in my opinion, it should have been

00:07:59.120 part of the discussion because a lot of our messaging just induced fear and it induced some

00:08:06.360 anxiety, undo anxiety. Um, and I mean, to me, that has sequela. Like you could see it, like

00:08:12.660 even to this day, when you walk by somebody outside on the street and they feel like they got to cross

00:08:18.320 the street to, cause they want to reduce their risk of getting COVID. And I'm like, I'm sorry,

00:08:22.860 you can't, you're not going to get COVID this way, but walking past me on the street, it's just,

00:08:26.900 I don't know. I think to me, it always came down to like, let's focus on the real problems,

00:08:32.700 the real areas of concern and not dilute the public with so much information and so much fear-based

00:08:39.080 info, um, to distract us. But you know, that's just my humble opinion, Anthony.

00:08:45.720 Well, speaking about, you know, real problems moving forward, cause now, thankfully we,

00:08:49.260 it seems like a lot of things are in the rear view mirror. Are you worried about,

00:08:52.480 about long-term concerns that are, that are indirectly related to coronavirus? I know we

00:08:58.160 talked about, uh, we, we've heard reports on deferred breast cancer screenings to give just

00:09:02.800 one example, or, or to your point, the potential psychological damage that some people are going

00:09:06.940 to feel, you know, are they going to continue to have anxiety in the grocery store and so forth?

00:09:11.080 May that manifest itself physically and so on. Do you have concerns about, about the months and I

00:09:16.020 don't know, maybe years ahead with that stuff? Unfortunately, I have massive concerns about

00:09:20.580 this and I'll start with our kids. Like the fact that they're not in school, the fact that the,

00:09:26.660 you know, their physical health, their, their mental health is being directly impacted. Like

00:09:33.140 my wife's a psychologist. We're good friends with a child psychologist and the, the demands that are

00:09:38.420 on families and kids right now is immense, you know? And when we look at even the inpatient

00:09:44.900 admissions for mental health disorder for kids, it's like my concern, Anthony, is that not only are

00:09:52.000 these short-term concerns, but for some of these kids, it's going to be lifelong and it's generational.

00:09:57.220 And, and this is to me, one of the saddest parts of our COVID response. And at the beginning,

00:10:03.660 when we didn't know much, that's one thing, but at knowing this level of, of, of how much we know

00:10:11.300 now about COVID it's, it's, it's to me, it's a travesty when you think of the domestic or the,

00:10:17.460 not only domestic abuse, but the child abuse that is going unseen right now at so many levels.

00:10:23.780 We, they're, they're, they're consequences to our, our, our actions. And then you mentioned also like

00:10:29.540 the delayed cancer screening. That's unfortunately, we're going to see the consequences of that delayed

00:10:36.180 surgeries. I can't tell you how many people I've seen presenting late as they were waiting for an

00:10:42.580 operation, uh, and either unfortunately pass or have complications from, you know, having that delay.

00:10:50.500 We've seen people presenting late to hospital because of fear of coming into hospital. This one to me is

00:10:57.200 on us. Like we really, from a public messaging should have been from the, from the get-go. If you're

00:11:02.920 having symptoms that you feel need to be addressed acutely, please come into hospital. We'll do our

00:11:09.640 best to keep you safe and, and, and we'll treat you for, for the conditions you need because the

00:11:15.720 amount of late strokes, the late, uh, the late heart attacks that I've seen, the late infections

00:11:22.680 has been really unfortunate and, and too many to that, uh, too many to, to count, unfortunately.

00:11:30.760 Why is this not being discussed more? I mean, this is what's so frustrating doctor. I mean,

00:11:34.840 there's, there's a lot of conversations on the news about obviously the concerns about different

00:11:39.080 waves, ICU capacity and, and the horrible things that, uh, that our old folks endured in long-term

00:11:44.440 care facilities. I get all of that. I'm not sympathetic to it. I know, I know two people

00:11:47.960 who've lost their parents or lost a parent to coronavirus. It's very real. It's very much a

00:11:52.600 problem, but then you had people who, who wouldn't, they'd go on the airwaves and they were,

00:11:56.840 they were very credentialed people and they wouldn't acknowledge these harms. And I know

00:12:00.840 you've been a powerful voice calling for a more balanced approach. Why have we not had,

00:12:04.760 well, forget a balanced approach. Why have we not had a more balanced conversation?

00:12:09.080 Well, I mean, Anthony, at the beginning, it was taboo to be honest with you. Like it was all about,

00:12:14.520 you know, everyone stay home, do your part. That's all we, that's all we could do. And

00:12:21.160 I got to tell you, I was motivated because of what we were seeing it. What we're already seeing

00:12:27.560 early, for example, was the late presentations coming into hospital. That was, that was probably

00:12:31.880 my first signal of like, uh, like we should be talking about some of these consequences and not

00:12:37.560 only because, you know, just sitting, you know, maybe we shouldn't be going, we should be altering

00:12:43.960 our restrictions, but also that maybe we could be doing something about it to address it, whether that's

00:12:49.080 messaging, whether that's active, uh, you know, uh, just being more active and addressing these things.

00:12:56.280 But man, at the beginning, it was taboo to talk about some of the consequences, but yeah, I think

00:13:02.920 as an ICU doc who, you know, our role, if we're doing our jobs, well, is to always look at things

00:13:10.680 holistically. Like you can't just look at one organ. You can't just say, Hey, let's make sure that the

00:13:16.440 kidneys are doing well. And that's all we're going to focus on. You need to think of the,

00:13:20.360 you need to think of the heart. You need to think of the lungs. You need to think of the liver. Like

00:13:24.760 you have to think of all things in unison to, and then come up with a solution that kind of balances

00:13:29.640 things. And so as more and more information comes through and you realize, whoa, you know,

00:13:35.240 there's another side to this coin. It's these harms. We need to factor that in to our equation.

00:13:41.720 That's the thing that killed me, Anthony, was when you roll out these models of, of,

00:13:46.520 you know, the impact of COVID-19 in my world, when we do research, like I do a lot of cost analysis,

00:13:53.720 it's always cost benefit. It's harm and benefit. You know, like you got to look at both sides of the

00:13:58.440 coin and we weren't at all discussing the second, the other side of the coin. We're saying, yeah,

00:14:04.360 these are the projections for ICU admissions, for mortality, for cases, but what were the impacts

00:14:09.880 that are restrictions going to have on long-term, whether that's the economy, whether it's our

00:14:14.200 kids education, whether it's cancer rates, where are those projections? You have to put that into

00:14:21.080 the equation to decide what is the best action. Otherwise you're going blind.

00:14:25.480 And they didn't do it. I asked Dr. Barbara, Dr. Barbara Yaffe, the associate chief medical

00:14:30.120 officer of health for the province at a press conference. I asked her live, has the department

00:14:33.800 of health in Ontario done a cost benefit analysis? And she gave this kind of laugh. I don't think

00:14:38.360 it was a laughing at the question. I think it was a nervous laugh where she was like,

00:14:41.640 pretty much no, yes, those things matter, I guess, but no, we haven't done it. And to your point,

00:14:46.840 you say in your line of work, you're doing cost benefit analysis. There's businesses where they

00:14:51.320 make the smallest, most inconsequential decision. They do the cost benefit analysis. It's beyond me

00:14:56.280 that one of the biggest decisions we've, we've made in like our lives, shutting down society,

00:15:02.760 people have just kind of shrugged it off. They've been like, oh, okay, fine. You know,

00:15:05.320 if you flip a coin, if it makes sense. Yeah. It was just, I don't know. The whole thing was kind of,

00:15:15.160 it was a bit scary in some ways. Like the way we were just, just like, to me, like the key thing,

00:15:24.120 Anthony too, was always like using the data that's in front of us to make our decisions as well. Like,

00:15:28.600 like, you know, don't try and, uh, politicize this. Let's look at our data and then come,

00:15:37.080 come up with the most logical actions. Like one of the things in Ontario that was baffling was

00:15:42.440 we knew that, like, if you look at the, the, the hotspots, like the truly hotspots,

00:15:48.360 like Ontario was hotspot. Like that was the issue, man. You go to Peel, you go to Scarborough,

00:15:54.200 like that place was on fire. Right. And if you think, you take an outside perspective and say,

00:15:59.560 like, why don't we just address a fire? Right. Let's really focus on our energy,

00:16:03.880 our resources on where this, where this, uh, this, uh, the hotspots are, because if we can control

00:16:10.920 that, man, we can really control the, the, the concerns in Ontario. And one other thing too,

00:16:18.440 that I think also gets lost in the discussion before I forget was when we look at health,

00:16:24.600 public health, it's not just COVID. It's always, it's health is multi tier. It's multifaceted.

00:16:31.880 It is COVID. Yes. But mental illness overdoses, uh, as we talked about strokes, am I other aspects

00:16:39.320 of health and it baffled me that how, how we did not address or acknowledge some of these things.

00:16:47.400 Like when we looked at even BC, their reports of opioid overdoses were, you know, the highest

00:16:53.640 they've seen in years. And what were you going to do about it? Or why aren't we discussing these

00:16:58.280 things? You know, like look at the data and let's try and come up with solutions. But man,

00:17:04.040 it just, I don't know if it was just because this thing got too political or the decision makers,

00:17:10.280 I have no idea, but we really needed to be more data driven throughout this thing.

00:17:14.600 Well, let's talk about that for a bit, the politicization of it, both in the broader,

00:17:18.600 you know, political realm and in the healthcare and medical community realm,

00:17:22.120 you alluded to it a bit, the idea of, oh, you couldn't even talk about this or that and so forth.

00:17:26.120 One of the things I guess I've had a split experience here where, uh, speaking to so many,

00:17:30.360 uh, credentialed medical voices, such as yourself, I just have so much respect,

00:17:34.680 a newfound respect for what you guys are all doing and my hats off to all of you. But then at the same

00:17:39.480 time, I also see these really kind of petty, caustic attacks on social media and this cliquishness.

00:17:46.360 And I'm kind of like, oh, wow, this is also, there's a lot of like high school nonsense going

00:17:51.000 on as well. That is made, you know, there's, there's online bullying and so forth happening.

00:17:55.480 If you know, you don't get on board with my views, and then I'm going to file a complaint to this

00:18:00.280 medical regulator, or I'm going to try and get you kicked off this committee, or just this odd stuff

00:18:04.840 that I've been hearing about. And, and, you know, people in the medical community have

00:18:08.360 been reporting back to me on, I mean, what is going on?

00:18:11.160 I, I do not know, but it's, it's been childish. It's, um, like, like, I don't know if it's the

00:18:20.120 avenue, the fact that it's been Twitter sphere where people don't have, like people, it's hard

00:18:25.560 to have a nuanced discussion and, and look at the gray areas when you're, you know, you got that,

00:18:31.320 what is it, 140, no, it's more than 140 characters now, uh, 220 characters now. But, um, I just think

00:18:39.720 one of the things that we, I don't know if this is a societal thing, if it's within medicine, but we,

00:18:48.280 we started to tie our, our opinions to our identities, you know, like what's, what you've decided to be

00:18:56.680 pro, I'm just using random example, pro mask, you're pro mask, no matter what, you know, if you,

00:19:04.920 you were in a scenario where you think, Hey, maybe masks aren't necessarily,

00:19:09.640 aren't necessary in the circumstances, it was, it was almost like you've now said something about

00:19:14.520 your character. And I just think we just needed to stick with our values. Ultimately just stick

00:19:19.880 with the values. What do we want? We want what's best for our patients. We want what's best for society

00:19:25.160 and let's navigate and discuss some of these things because there was, because of that inability to,

00:19:31.960 especially at the beginning of pandemic to, to discuss some of these concerns, I think there's

00:19:35.720 negative consequences. Right. And I just think having an open dialogue, like this was what we

00:19:40.840 normally do in science is that you, you could debate something and you could change your mind,

00:19:47.080 you could stick with your guns, but it's, it's amicable, it's respectful. And at the end of the day,

00:19:52.440 we're shaking hands and saying like, okay, we, we've collectively come up with a solution that we

00:19:57.240 probably think is the best for everybody. But this just became war. Like I've never,

00:20:03.000 like I, you know, I, at the end of the day, I always say, you know, my values is always, you know,

00:20:08.840 do the right thing. You know, it's what we're trying to instill in our kids. And, and that was my

00:20:13.960 kind of anchor when there was like the onslaught of Twitter attacks for, you know, uh, I think you

00:20:21.400 were attacked for just standing up for kids for saying, I think we should reopen the schools and

00:20:24.840 so forth. And then people get really angry and you know, like, how can you attack a guy for standing

00:20:28.840 up for kids? But I guess they found a way. Exactly. I mean, this is the thing people would

00:20:34.600 just dig their heels, you know, and I, and to me, you know, when it come down to like a lot of my

00:20:41.480 colleagues, they're scared to speak up for sure. Like I would get, I've been actually in a lot of

00:20:46.680 ways. Um, um, it's been nice to see people reach out and say, thank you for your messages. And, and

00:20:54.040 thanks for being courageous. And in some ways I, you know, it's nice to hear, but in a lot of ways,

00:21:00.040 I feel like it's not, I'm not even being that courageous. It's just, you're doing the right

00:21:04.200 thing. Like who can not, like, how can you be upset at somebody for defending children? Right.

00:21:09.800 Like really, you're gonna, you're gonna really, uh, like reprimand somebody for speaking up for the

00:21:18.360 people that can't speak up for themselves. To your point, I guess it's an absolutism. Like you said,

00:21:22.760 I'm on team mask or I'm on school shutdowns and so forth. I always got so upset to see the,

00:21:28.200 like when I'd see those videos, there weren't many of them, but somebody decided I'm not wearing

00:21:32.200 a mask in the Loblaws today. And I don't know why they may be, cause they're a, you know,

00:21:35.800 maybe they're a conspiracy theorist. Maybe they had a medical problem. Maybe they forgot it. I

00:21:39.160 don't know. They just didn't wear the mask and there's 100 people in the Loblaws and this guy,

00:21:42.680 and of course they, everyone has to film him and they have to yell at him. And then the cops drag

00:21:46.280 him out and there's a fight. And I'm like, okay, one guy doesn't want to wear the mask. Okay.

00:21:49.320 Like I follow the rules. I wear the mask. If one guy doesn't want to wear the mask, who cares?

00:21:53.240 There's a thing the other week, this Jagmeet Singh discovered to be breaking COVID rules.

00:21:57.080 I was like, oh, what's this? I looked at the video and I guess he ran into a guy outdoors

00:22:00.440 that he knew and he was a person he hadn't seen in a while. And he gave him a quick hug. He gave

00:22:04.200 him like this bro hug kind of thing. And Jagmeet's vaccinated at that point. And oh,

00:22:07.560 I had to apologize. And I was like, where's our humanity? The guy gave a guy a quick hug outdoors

00:22:12.760 for just a second. Please don't make this into a national news story.

00:22:16.120 Yeah. No, it's like, I feel like people are trying to do their best to like control what they can

00:22:24.520 control or something. Like I'm not, I mean, I don't want to play psychologist, but it's just,

00:22:29.400 it is funny how these reactions could really blow up. Like I've seen it on all forms of social media,

00:22:36.680 taking pictures of, Hey, this guy went into a church without a mask or, you know, all these

00:22:41.960 kinds of things. And I think, and maybe this is my palliative care side of things. It's like,

00:22:47.720 just come at it with a little bit of compassion. You know, maybe there's a good reason. Like,

00:22:52.280 you know, we assume somebody like is walking into a store and, and, or being outside, whatever,

00:22:59.080 and not wearing a mask. It's for a mal, like a negative reason, but maybe they have a condition.

00:23:07.080 Maybe they have a respiratory condition where they're having a tough time breathing. Maybe they

00:23:11.000 have a claustrophobia. Like just come up with some compassion and you don't need,

00:23:16.680 not everyone's going to follow the rules. Uh, not everyone's going to do what we think is right.

00:23:23.000 But, um, you know, we can't change everybody's mind. It's just collectively for most of us are

00:23:29.160 doing the right thing. That's going to make, that's going to, that's going to put a dent in this thing.

00:23:33.160 And this is why we, we have made dents. Well, why we've made some progress, but yeah,

00:23:39.640 just coming at it with a bit of a lens of compassion and just saying like,

00:23:43.000 why is this person doing this? Maybe it's out of fear. Maybe it's out of, um, insecurity,

00:23:48.280 anxiety, like, but just let's be nice to each other for once.

00:23:53.720 Doctor, when it comes to what's happening right now, this summer, I know a lot of

00:23:56.280 Canadians just want to forget about COVID. They've had their vaccines and they just want to party on

00:24:00.440 a patio or what have you. What are the things that you would like to see addressed right now?

00:24:05.320 Because I know there are still some concerns. Yeah. For me, it's just, once again, let's use

00:24:10.680 the data that we have available to decide what can, what we can reopen, what we could do safely

00:24:17.720 and approach it that way, put the politics aside and let's, let's, let's be objective.

00:24:23.480 You know, and some of the things that I know where we all know, like being outside really safe,

00:24:28.040 right? Like I still have yet to see somebody in hospital related to an outdoor exposure.

00:24:34.440 Right. I, I haven't, I haven't seen it. I haven't had a clear example in the medical

00:24:39.160 literature. I'm sure it's happened. I'm not to say it's impossible. I'm just saying like,

00:24:43.320 this is how rare we're talking. And so, you know, and, and we, and when it comes to COVID, I'm,

00:24:50.520 I'm one of harm reduction mentality. Like let's do our best to still live life,

00:24:55.320 but reduce our risk of getting sick. So, you know, when it comes to reopening, let's,

00:25:00.920 let's do the stuff that's safe. Patios, outdoor spaces, um, you know, continue to get as many

00:25:07.160 people vaccinated because the vaccines work. I like, I think this is another one, Anthony,

00:25:12.600 where the messaging is, was like atrocious, right? Like when you hear the, you know, this vaccine,

00:25:18.360 68, 68% effective, uh, against mild disease. But when you look at the data from the

00:25:25.240 trials, literally only one patient out of 130,000 was hospitalized. That's the kind of effectiveness

00:25:31.640 we're talking about. This should be celebrated. This should be screamed to the world. And we should

00:25:36.360 be like telling people how miraculous this stuff is as opposed to like, Oh, well, I want to,

00:25:43.320 maybe I'm going to go choose Moderna over, uh, this one because it's, uh, get to gain that extra 3%.

00:25:48.920 Like, no, like really focus on the win here. You're not going to be hospitalized or you're much

00:25:54.200 less likely to be hospitalized because you chose to get vaccinated. Um, the other things I'm looking

00:26:00.200 for is like, there's no excuses. I'm sorry for schools not to open like realistically at this

00:26:06.200 point with the data we have available with the harms that we've seen. I just, Oh, this is, it kills

00:26:12.520 me inside thinking, uh, that's even a possibility for September. Um, but yeah, I think, yeah, let's

00:26:19.720 use the data available. Let's like, look at other centers to like, look at Israel. Let's look at UK.

00:26:25.240 Let's look at, uh, BC. You know what I'm saying? Look at Quebec that have, that have, uh, you know,

00:26:32.200 that have opened up that have kept schools or in light of BC kept schools open and look at where

00:26:38.920 they are now, you know, we're just to put some like, uh, we're mid close to mid June and their

00:26:45.240 cases are still going down and they're opening up their economy. So like, let's use the data in

00:26:51.320 front of us to help guide us. But you know, uh, put the politics aside. Well, what do you think

00:26:56.200 about the U S I mean, I feel like in many respects they've put the politics aside because they're way

00:27:00.200 more open than Canada, but kind of whether you're talking about, you know, Republican governor of Florida

00:27:04.760 versus, uh, left leaning, uh, democratic Chicago mayor, uh, in Chicago, Lori Lightfoot. I mean,

00:27:11.160 they're, they're both like, you can take polar opposites of the political spectrum, different

00:27:14.920 sides of the country, and they're all kind of all much bigger on reopenings than everybody is here in

00:27:20.040 Canada. And I know there's a bit different case numbers, different vaccination numbers, but I feel

00:27:24.280 like it's also kind of a different just frame of mind and attitude towards it. Do you think Americans

00:27:29.640 have, have the right attitude or do you, do you prefer the Canadian one? Yeah, that's a tough,

00:27:34.840 that's a tough one. I I'll, I'll be honest with you. And I feel like I'm pretty liberal is, is that I

00:27:39.880 think I, I would have still been a quite, I would have been less aggressive in, in terms of the opening.

00:27:47.240 Like it sounds certainly at least the last time I looked at the data seems like their approach has

00:27:52.680 worked. Like I just watched the, the golden Knights game and stadium was packed, you know, and that's

00:27:59.320 indoor, not outdoor. Right. And they were still able to make this happen. And we're not hearing

00:28:03.800 about increasing cases, you know? So, you know, I think once, once again, being data focused, you

00:28:10.200 wonder how many, not only how they had a ton of vaccine vaccines, uh, uh, uh, sorry, their population

00:28:17.560 vaccinated early on, but there's a significant amount of, uh, natural immunity, I would suspect

00:28:23.800 in a lot of those areas. So how much that plays into things? I think if I'm answering your question

00:28:29.800 directly, I think it would be somewhere in the middle where, you know, really opening up early,

00:28:37.560 the things that we know are safe, like the outdoor, like, as I mentioned, the outdoor space, outdoor

00:28:42.760 environment. I think even if I were, you know, king of the world at some point, really actually being

00:28:50.840 proactive and saying, how can we stimulate the economy using that outdoor space? Like really,

00:28:56.200 you know, whether it's outdoor markets, uh, you know, I think this could have been an opportunity

00:29:01.000 to really just get, you know, not only foster the economy, but also like morale saying like,

00:29:05.400 Hey, locally, we're going to do this to try and support local business. Um, so once again, to answer

00:29:11.400 you directly, it'd probably be somewhere in the middle, but, um, you know, if I'm choosing a place

00:29:17.400 within Canada that you, we should be modeling at minimum is British Columbia.

00:29:22.360 Well, let me ask you what's become a controversial question. I feel like we should be able to talk

00:29:25.880 about it as a academic question, but I know it's controversial. You mentioned natural immunity,

00:29:29.800 us seeming to have more of it because they just, you know, had more reopenings and some

00:29:34.120 jurisdictions, I think we're just kind of like, didn't even want to acknowledge coronavirus.

00:29:37.800 I think North Dakota had an interesting experience, uh, with that. I know you talked about metabolic

00:29:42.360 issues that people in ICU had had and so forth, all things that I think are a bit more prevalent

00:29:46.040 in the U S so Canada, generally more healthier population. Could we have allowed young people 0.99

00:29:51.480 to pretty much live their lives similar to what Sweden did, uh, almost throughout the pandemic 0.97

00:29:57.640 here in Canada, there would have been a more sort of natural immunity floating around. Did we almost

00:30:03.000 deny people the opportunity to have a go at that?

00:30:05.640 Yeah. I mean, they're all important considerations. Like one thing I'll say for sure is that

00:30:11.800 I think the, the natural, like you'll see some stuff in the literature, like is natural immunity

00:30:17.640 enough. I haven't seen anything convincing to say that it's not enough. And you know, in terms of

00:30:23.160 protecting yourself, like, uh, I, I think it's, you know, diligent that we are vaccinating people that

00:30:29.320 have, uh, had, uh, the, the COVID before, but I do think there is something to be said about that in

00:30:38.440 regards to the kids. Yeah. I mean, I don't know, like certainly kids are less likely to be sick for

00:30:44.760 sure. Like that is, that, that is clear, uh, in the data, their trends, their ability to transmit

00:30:51.960 it to others, especially the young kids aren't, it's not the same as older adults for sure. So I,

00:30:57.560 you know, I don't know if the, uh, they needed to be, uh, you know, wide open as in Sweden. Cause I,

00:31:03.480 I mean, all it takes is the, you know, a kid to give it to the vulnerable. They can still give it

00:31:09.880 to people that were vulnerable, like whether that's by age or metabolic health, but certainly,

00:31:15.560 um, this is one of the reasons why I thought, you know, that I think that schools have been safe.

00:31:21.800 And, and I think if anything, there was opportunities to keep our kids active. Like,

00:31:26.600 you know, once again, taking care of that outdoor, utilizing that outdoor space, whether that's,

00:31:31.800 um, you know, to sport, whether it's, whether it's through education, if we were really that

00:31:37.160 worried, because I think, you know, this is going to be unfortunately some generational impacts on

00:31:43.240 many. And so, uh, you know, I, I, we were talking a little bit before Anthony about just trying to

00:31:48.920 all do our part to advocate for our kids. Like we, we, we, we have a charitable, uh,

00:31:54.120 organization bridges over barriers that we're doing a fundraiser for that reason, like this summer to get

00:31:59.960 our kids active, like to be, you know, cause Ford came out saying, you know, we want our kids to

00:32:06.440 be able to go to summer camps and so forth. And, you know, once again, looking at the data,

00:32:11.480 how many of the kids can actually afford summer camps? And these are often the hardest hit spots

00:32:18.600 too, that throughout the pandemic. And so, yeah, we were all just trying to do our part to advocate

00:32:23.560 for them, making sure that they can have a chance to go to summer camp. And so we're doing a small

00:32:28.360 fundraiser there, but man, uh, the kids, they really were the forgotten ones in this pandemic.

00:32:35.560 Well, great to hear about that charity and good on you. That's a, that's a great endeavor. Uh,

00:32:40.040 before we go, I mean, you alluded to, you hope schools will be reopened in Ontario in September.

00:32:45.080 Other jurisdictions in Canada have had them open for much longer. And I gotta say, I'm, I'm a little

00:32:49.960 nervous and I hear this from others that, that people who are, who are committed to being overly,

00:32:55.640 excessively cautious, aren't going to give that up easily. Yes. Vaccination rates are increasing

00:33:00.920 and it looks like cases will just continue to crash across June, July and so forth. But,

00:33:05.560 you know, the seasonal component of this is many have acknowledged, this is an endemic illness.

00:33:09.240 Now it's, it's, it's here to stay. Hopefully, you know, fewer people get it and fewer people,

00:33:14.120 of course there have to be hospitalized with it, but we could see case numbers rise in September.

00:33:18.360 Um, and we could have the same attitude that, okay, we have to shut things down. We can't reopen

00:33:23.480 the schools in September. I mean, it seems like a crazy thing to say, but I, I think it's within

00:33:27.560 the realm of possibility and I'm, I'm nervous about that happening. A hundred percent. Just

00:33:32.680 look at the track record. You know what I mean? Like we're the only, aren't we the only

00:33:38.440 province right now or like jurisdiction in the, in North America that has their schools not open?

00:33:44.600 Yeah. Like, you know, you're in Kingston the other day, they had zero cases and you're having

00:33:50.920 your schools. Like, you know how I'm sorry, but that it's insane. Close the patios, zero cases.

00:33:57.560 Yeah. You can't have a beer outside in the wind.

00:33:59.720 It just does. This is what I'm saying. Like we gotta use the data, be smart. Um, cause all these

00:34:06.440 restrictions, they have consequences. And you know, as we mentioned, what's the flip side,

00:34:11.640 let's talk about that flip side. But in regards to schools, man, you could come up with 14 excuses

00:34:18.520 the government could come up with. Well, the new, the latest, uh, variant, you know, like, uh,

00:34:25.080 are we sure that we're, our vaccines are going to be susceptible to that? Uh, are the kids at,

00:34:30.200 by that time, I'm just a educated guess. There'll be more data on safety of vaccines for younger kids,

00:34:37.400 like younger than 12. Are they going to be asking for single or double vaccines there?

00:34:42.280 Um, should it be mandatory at schools? That's become controversial because I know a lot of

00:34:46.760 people say, look, we don't know, to your point, we don't know what's going on with kids in the

00:34:49.720 vaccine. So if they're not really dying of it, if they're not getting it seriously,

00:34:52.760 do not give them the vaccine. But I've already seen some people and even some teachers union reps say,

00:34:58.040 well, the students aren't vaccinated yet. So how can we go back to the classroom? I go,

00:35:01.160 uh, oh, those two things don't add up well.

00:35:02.840 Yeah. I mean, this is just my humble opinion. That should not be,

00:35:07.880 that should not be a factor.

00:35:09.240 A great place to leave it at a fascinating conversation. Dr. Kwajo Kamaratang. Thank you

00:35:14.200 so much for your time today. Full Comment is a post-media podcast. I'm Anthony Fury.

00:35:19.720 This episode was produced by Andre Peru with theme music by Bryce Hall. Kevin Libin is the executive

00:35:24.760 producer. You can subscribe to Full Comment on Apple Podcasts, Google, Spotify, or wherever you get your

00:35:29.880 podcasts. You can help us by giving us a rating or a review and by telling your friends about us.

00:35:34.840 Thanks for listening.

Full Comment - June 14, 2021

An ICU Doctor explains mistakes we've made (and still make) with COVID

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