There has been a massive backlog in medical appointments and surgeries in Quebec’s healthcare system due to the slowdown in activities in hospitals last spring, at the height of the COVID-19 pandemic, and rotating lockdowns can only exacerbate this situation. According to a report by the Canadian Press last updated Sept. 15, 2020, there are 92,000 people awaiting surgery. The Quebec government is saying it will take at least several months to overcome the long waiting lists for surgery. To be sure, the first wave of the pandemic required a marshaling of medical resources to treat a surge of patients in the ICU. Retired specialists were called back to help fight COVID-19 even as family physicians couldn’t see their patients because of the lockdown. Doctors, nurses, and healthcare professionals were gradually returning to work during deconfinement, but after Labour Day news began to surface of the second wave of coronavirus cases and another possible shutdown and – voilà! – we’re back almost where we started.
What’s the take-away? On the downside, this already means fewer in-person medical appointments and procedures. The overriding focus on preventing the spread of coronavirus dictates limiting the number of persons in healthcare settings. This means that many, often elderly patients who need someone to accompany them to the hospital or clinic have to go it alone or forego their appointments. The shuttering of restaurants for seated service hasn’t helped matters either. Restaurants are a lynchpin of economic and social life, not simply establishments that sell meals and refreshments for take-out and delivery. They are places where people can rest up and use the restrooms on their journeys to and from work, school, shopping, and appointments. As long as restaurant dining rooms remain closed, many people just won’t go to their medical appointments. Delayed, and canceled appointments will have to be rescheduled once again.
On the upside, doctors are connecting with their patients in other ways, via telemedicine and telephone consultations. Telemedicine is useful when an in-person consultation isn’t possible and a telephone call from the doc is better than nothing. However, patients need to be digitally savvy for telemedicine to even be an option and it doesn’t replace a doctor’s assessment of a person’s condition based on close examination of their body and observation of their demeanor. Beyond these pragmatic considerations, some patients won’t feel reassured unless they have really met with their doctor in-person. Private medical services are picking up some of the slack in the public sector but at a cost and for those who can afford it.
Diane Doonan was instrumental in setting up the LaSalle D&D 50+ Centre for baby boomers and seniors and is currently the organization’s vice-president. She’s a hands-on VP, typically volunteering 3 days a week to help members in whatever way she can. “Groups in the non-profit sector are having to think outside the box,” she says. “We’re seeing loneliness, fear of COVID coming up more than anything.” The technological emphasis on COVID management strategies isn’t exactly senior-friendly. The centre is eligible to receive grants to buy computers but they are of little value because many of the clients don’t have the technical skills to use them while the centre can’t reopen yet for the staff to give lessons. “Those seniors who have a computer have a window on the world,” Doonan says. “Fifty-nine percent of our members don’t have computers,” she says but that’s only part of the problem. “People living on low, fixed incomes can’t fit a WiFi hook-up into their budget.”
It’s not all doom and gloom. “We look at the obstacles and try to find a way around them,” Doonan says. The centre hosts 3 group chats per week for seniors who only have landlines. “It’s similar to a conference call and the groups vary from 7-15 members.” The chats are facilitated via a Google Meet program supported by (Montreal) Catholic Action and also feature guest speakers. Canadian actress Jayne Heitmeyer spoke to the group about her life as an actress, giving them a behind-the-scenes look (so-to-speak) at her life on set. “She is absolutely gorgeous! You’d never guess she is 59,” Doonan blurts out. Other guests have included Ann Soden the founder of elder law who spoke to a group about elder abuse and a representative from the SPVM LaSalle Police station who gave a talk about telephone fraud in COVID-19.
Seniors aren’t the only group challenged by public health policies designed to protect from COVID-19. In all the hand-wringing over whether or not to keep the schools open, Quebec came up with a hybrid model for high school students: one day in class, the other doing distance learning. However, the impacts of stringent regulations on the mental health of young peoplehave been largely overlooked. After initially saying that students wouldn’t have to wear a mask in the classroom or at recess, on Monday, Education Minister Jean-Francois Roberge announced that high school students would have to wear a mask all day everywhere on school property, including in class. By some reports, this will also apply outdoors in the schoolyard. The police have been instructed to maintain a visible presence around schools, signifying their role as enforcers of this latest sweeping measure. Moreover, all intramural sports have been canceled until further notice.
The Association of Quebec Pediatricians has written a letter to the province’s premier questioning the new health measures announced for high schools. The pediatricians said wearing masks all the time and temporarily banning sports will do nothing to reduce COVID-19 transmission within that age group. “One of our worries is by creating these measures with the spirit of flattening the curve which we all agree to, I just worry that it’s the wrong metric,” said Dr.Sasha Dubrovsky, a pediatrician at the Montreal Children’s Hospital and Associate Professor at McGill University. “So keeping kids in schools and in sports is important. Adding screen time to children every other day only feeds into the addiction to screens that our society is facing and contributes to increased anxiety, increased mental health (issues).”
How all these dynamics will play out in the current quasi-lockdown remains to be seen. More than six months into the pandemic, and with far fewer deaths and hospitalizations than in the first wave, it is time to balance the scales of healthcare and resume some degree of social normalcy. Replacing in-person medical consultations with telemedicine while substituting virtual communication for real contact will further marginalize many seniors who aren’t tech-savvy. This can only increase isolation among seniors and have a detrimental effect on their health and well-being.
Treating high-school students in the 12-17 years age bracket as if they were super-spreaders of coronavirus based on an uptick of cases among young people 18 years and up – college kids old enough to go to bars linked to outbreaks – will leave vulnerable young teenagers feeling targeted and stigmatized. A high-stress back-to-school environment won’t work for anyone and is bound to feed the cycle of mistrust, depression, and acting out. Education isn’t only about learning which can just as easily be accomplished online. It is also about meaningful social interactions, but this doesn’t appear to be part of the program in COVID-19. Young people may be a lot more tech-savvy than their elders, but kids need to unwind and have fun too in real-time in the real world and on their own terms.