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The avoidable underlying problem of many chronic diseases

Infographic credit: BreatheWellBeing.in

What if you could lower your risk of a slew chronic diseases, like heart disease, diabetes, cancer, inflammatory diseases, and perhaps even Alzheomer’s, just by making some changes to your diet and lifestyle… giving yourself extra healthy years to enjoy life? Would you do it? Would it be worth the effort? New research suggests reversing “insulin resistance”, through improvements in diet and adding some exercise, could prevent many diseases from developing and possibly reverse some at early stages. And if you make these changes one little step at a time, they can be easy to do!

What is insulin resistance?

You may be familiar with the term “Insulin resistance” … it’s understood to be the first step in the development of diabetes and, more recently, it’s been strongly suggested as the underlying problem driving many other chronic conditions too. Insulin is a hormone needed to enable sugar/glucose (as well as other nutrients) to get into our bodies’ cells. Being resistant to insulin means that, although the insulin-producing beta cells in your pancreas are able to produce the hormone, your cells are not responding as they should. Your pancreas is able to produce extra insulin for a long while to compensate (resulting in higher-than-normal blood insulin, while blood sugar remains normal) but, eventually, it can’t keep up and your blood sugar will begin to rise. At this point regular blood testing will pick up the problem and you will be diagnosed with pre-diabetes or diabetes (depending on how high your sugar level is). However, the insulin resistance has likely been in progress for years by the time this happens. (Note that “developing insulin sensitivity” is essentially the same thing as “reducing insulin resistance”.)

But insulin resistance (or a lack of insulin sensitivity) also drives cholesterol problems, weight gain (especially around the waist), bloating, fatigue, food cravings, mood swings, irritability, needing to urinate at night, and feeling hungry/unsatisfied after eating. Other symptoms include non-alcoholic fatty liver disease (from all the extra sugar being stored there as fat), inflammation, sleep apnea, slow metabolism, loss of muscle mass, acne, low testosterone, poor focus, and increased response of the sympathetic “fight or flight” system to stress. Increased insulin also raises your blood uric acid, the substance that can cause gout or kidney stones when it becomes too high to stay dissolved in the blood. These are all symptoms that you may be developing a problem with responding to insulin. Quite a list, right?

How do you test for Insulin Resistance?

Unfortunately, although there is a simply way to detect insulin resistance, few doctors do this. The result is, by the time it’s diagnosed, you may already have problems with high cholesterol, high blood pressure, excess weight gain around the middle. Along with the diabetes diagnosis, this collection of abnormalities is known as “metabolic syndrome” and it puts you at risk for heart disease and stroke, as well as other chronic diseases. And, although it all could have been corrected by a few diet and lifestyle changes years before, you’ll likely be prescribed several medications to treat the cholesterol, blood pressure, and diabetes, and will be told to exercise to lose weight (and you’ll probably have a hard time getting the weight off!)

But to detect insulin resistance long before this happens, your doctor simply has to order a fasting blood insulin test along with the fasting blood glucose they are probably already doing. There is a simple calculator available online, called the HOMA-IR calculator, that you can easily find using Google. HOMA-IR stands for Homeostatic Model Assessment for Insulin Resistance, and it looks at the relationship between fasting glucose and fasting insulin. You just plug in the 2 numbers and it gives you the result, along with an interpretation of what the result means. It was so easy, I have difficulty understanding why my doctor wasn’t doing it, especially given the damage that high insulin can cause over time. She actually wasn’t sure whether our provincial Medicare would pay for the test but was willing to try (unlike my hubby’s doctor, who stated it wasn’t covered and refused to order the test.) I guess she’d never asked for the test to be done before, but I was pleased she was willing to try.

PS, the test was covered, and I was surprised by my result… and motivated to change! Insulin resistance explains the kidney stones I’ve had in the past couple of years, as well as the gradual weight gain that I’ve struggled to avoid, and had difficulty to correct in spite of using a strict keto diet for the past 8 months. I dove into researching how to correct insulin resistance, of course, and found plenty of safe, fairly easy-to-do changes I could make. So, I thought I’d share what I learned with you!

How to improve insulin sensitivity

First, of course, is exercise. Any exercise will help, but studies suggest that adding resistance training (i.e. weights) is an important addition to fight insulin resistance, and exercise later in the day has a greater effect than that early in the morning. But even small increases in exercise, like taking the stairs instead of an elevator) can help (I say as I sit at my desk… I’ll be sure to go for a walk when I finish!)

Intermittent fasting, which involves reducing the hours during the day when you eat, can help too. Doctors recommend fasting for 16 hours a day, which simply means keeping your food intake within an 8-hour window each day. They usually recommend shifting gradually to this pattern of eating, for example, reducing to 12 hours at first then compressing your food intake by an hour at a time. It can also be done by keeping total food intake less than 600 calories on 2 non-consecutive days each week, but that sounds rather unpleasant to me! (Don’t think I could do that…)

Decrease inflammation by fasting (as above) and ensuring you are getting enough vitamin D. Here in Canada, the sun isn’t strong enough from October to April, so we need to supplement or spend the winter somewhere warm and sunny! When the sun shines on our skin, it converts cholesterol into vitamin D, creating thousands of units a day, depending on several factors, like the amount of skin exposed, sunscreen use, and the amount of natural pigment in the skin. When supplementing, you’d want to take at least 1000 units of the vitamin, and up to 2000 iu a day is considered very safe. Here’s a link to a blog I wrote in 2018 about Vitamin D if you’d like to know more…

Newer research into gut microbiome (your gut’s natural bacteria/yeast/virus contents) suggests it may have an influence on inflammation as well. Addressing any digestive problems you may have is a good start to being healthier overall.

If you’re often stressed-out, decrease your stress response (and therefore stress hormones, like cortisol) by using stress-reduction techniques such as yoga, tai chi, or meditation. Listening to or playing music, and making art can also lower stress. Note that stress hormones raise your blood sugar to provide energy for dealing with the stressful event.

Work to improve your sleep, if you don’t sleep well at night. A good night’s sleep can lower your stress hormones. PS you won’t be eating if you’re asleep (so it helps support intermittent fasting!)

Eat more veggies and fiber. These foods support healthy gut bacteria that will produce a substance called butyrate, known to help improve insulin sensitivity. Fiber also slows the rate of absorption of sugar and other carbohydrates, preventing spikes in blood sugar that stimulate lots of insulin production. If you have digestive problems, you might consider taking a probiotic capsule (and/or eating more probiotic fermented foods) to improve your gut flora, the blend of good bacteria in your intestines. Nuts and seeds are very high in fiber and make good snacks, if you’re looking for something to substitute for sweet treats!

Add some herbs to your food. Garlic, ginger, turmeric, and cinnamon can help improve insulin sensitivity and reverse the trend toward insulin resistance. Green tea, and the minerals Chromium and magnesium are also understood to help. Berberine and resveratrol (the good stuff in red wine) may also be of benefit, but have less evidence.

Eat lower glycemic index foods. Glycemic index (GI) is a measure of how quickly the glucose from carbohydrate foods, like sugar and flour, get into the blood stream. The more processed a food is, generally the more quickly it is digested and absorbed, spiking blood sugar quickly and requiring more insulin to handle the sugar. For example, brown rice has a lower GI than the more processed white rice. However, once both are processed into flour, the difference disappears and both become higher glycemic foods.

Avoid added sugar. I probably don’t need to say this, but sugar itself (especially in rapidly absorbed forms, like sugar-sweetened drinks) is a big contributor to insulin resistance. It quickly floods the blood stream with sugar that the pancreas then needs to produce extra insulin to clear away.

Omega-3 fats, contained in fish, nuts and seeds (and their oils), eggs (especially omega-3 enriched) and some vegetables (like spinach and brussels sprouts) can also help reduce insulin resistance.

Apple cider vinegar is also believed to improve insulin resistance. I found an easy-to-make recipe for a drink that’s essentially water with apple cider vinegar, lemon juice, and cinnamon added:

• Apple cider vinegar 15 ml (1 tbsp)
• Lemon juice 15 ml (1 tbsp) or juice of 1/2 lemon
• Cinnamon 2.5 ml (1/2 tsp)
• Sweetener to taste
• Water 250 ml (1 cup)

This formula, of course, can be tailored to your liking. It can be made with cold water or you can use warm water to make a sort of tea. They recommend sipping it through a straw to prevent contact of the acidic liquid with the teeth (which has the potential to erode tooth enamel) but, that being said, colas are more acidic than diluted apple cider vinegar, and sugar itself promotes loss of tooth enamel! (See references below for a link to a video on this!) If you find the mixture too sour tasting, try adding more sweetener (I use erythritol/Swerve) or reducing the amounts of vinegar or lemon juice. The idea is to give you another source of insulin-helping food and amounts of the ingredients are not crucial.

Type 3 Diabetes

And, lastly, insulin resistance may have a connection with Alzheimer’s Disease. Some researchers are even calling it Type 3 Diabetes, where resistance to insulin occurs in the brain, preventing it from clearing away the tangles and plaques associated with Alzheimer’s, and causing death of brain nerve cells. Although researchers say more research is needed, evidence is mounting. Risk of Alzheimer’s is noted to be higher in those with diabetes and insulin resistance.

So, there are many reasons to reduce your sugar intake (essentially the Keto diet!) and to check for (and treat!) insulin resistance before it becomes obvious through development of diabetes or other chronic diseases it puts you at risk for! Diabetes, obesity, heart disease, and other preventable conditions associated with insulin resistance are becoming epidemic, putting our health and our healthcare systems at risk in the future. Are you ready to make the changes needed to prevent this? Talk to your doctor about it at your next visit!

References:

14 Natural Ways to Improve Your Insulin Sensitivity – Healthline

Type 2 diabetes: Exercise later in the day may cut insulin resistance – Medical News Today

The 9 Benefits of Apple Cider Vinegar – Dr. Berg’s Blog

12 Foods That Are Very High in Omega-3 – Healthline

Type 3 Diabetes and It’s Role Implications in Alzheimer’s Disease – International Journal of Molecular Science (National Library of Medicine)

The Gut Microbiota and Inflammation: An Overview — National Library of Medicine

The #1 Worst Drink That Dissolves Your Teeth — Dr. Eric Berg

Since October is Breast Cancer Awareness Month, I thought I’d dedicate a blog to this terrible disease that affects 1 in 8 women in North America, not to mention the impact it has on their families and those they love.

So here are some myths about breast cancer, and what the experts say about them…

Myth #1

A breast injury can cause breast cancer. Although a breast injury can sometimes cause changes in the breast tissue that might mimic the look of a cancer in a mammogram, it cannot cause cancer. But just to be sure, your doctor may want to do a needle biopsy, removing a small amount of breast tissue with a needle and syringe to examine in a lab, if an area looks different than usual due to a previous injury.

Myth #2

Underwire bras increase the risk of breast cancer. The wires do not cause cancer, but they can irritate the skin under the breasts, causing it to break down. Irritated skin is less resistant to bacteria and fungi which could cause an infection or abscess in the breast. Also non-wired bras are more comfy!!

Myth #3

IVF increases the risk of breast cancer. In vitro fertilization (IVF) involves the use of estrogen-like drugs to stimulate the ovaries to produce eggs. This led some experts to wonder whether the treatment could increase the risk of hormone-sensitive cancer cells developing, or at least speed the growth of any of this type of cancerous cells that might be forming. Although no studies have specifically been done to confirm this doesn’t happen, one trial compared the cancer risk of women who had had IVF with those who had not, and found no difference.

Myth #4

I won’t develop breast cancer because no-one in my family has had it. Most women who are diagnosed with breast cancer have no family history—only 5-10% of breast cancers are caused by a genetic mutation that was inherited. In fact, many diagnosed women have no known risk factors at all. Obviously, we’re missing something… (perhaps an environmental connection?) More research into the causes, please!!

Myth #5

Stress can cause breast cancer. While too much stress can certainly affect our health, there is evidence to show there is no association between stress and breast cancer. On the other hand, breast cancer most certainly causes stress! We can all benefit from learning effective ways of dealing with the stresses of modern life…

Myth #6

A healthy lifestyle eliminates breast cancer risk. A healthy lifestyle can reduce the risk of breast cancer, but it can’t eliminate it. Refer back to Myth #4… we need more research into the causes of breast cancer!

Myth #7

Breast cancer only occurs in older women. It is true that most cancers occur in older women. Age is a known risk factor—one we can’t do anything about. Screening mammograms are recommended only after age 50 in most countries, and after 40 in the US, as they are less accurate in younger women with more dense breast tissue. But about 5% of cancers are diagnosed in women under 40 years, typically in those with a strong family history of the cancer. It is recommended to watch for any unusual breast changes, like lumps, puckering of the skin or a nipple pulling inward (inverted nipple) and to see your doctor right away if any of these occur.

Myth #8

All breast lumps are cancerous. Actually, most new breast lumps are not cancer. A cyst (a pocket of liquid surrounded by a membrane) feels like a lump, and these are fairly common. However, always see your doctor right away for an evaluation if you notice a new lump or any other unusual breast change.

Myth #9

An abortion increases the risk of breast cancer. An abortion interrupts the normal hormone cycle of pregnancy (and pregnancy before age 30 is believed to reduce breast cancer risk), causing some to wonder whether it could increase the risk of a hormone dependent breast cancer. However, a large observational study in Denmark and several other smaller studies found no link between abortion and breast cancer.

Myth #10

Nipple piercings increase breast cancer risk. Piercings do not increase cancer risk, but they can lead to increased risk of infection, abscess, nerve damage, scars, cysts and difficulty breastfeeding (due to blocked ducts from scar tissue).

Myth #11

Sugar causes breast cancer. Refined sugar in excessive amounts is bad for our general health, but there is no evidence it directly causes breast cancer. I have read reports of research looking at very low sugar/high fat diets (an extreme form of the keto diet) to slow the growth of cancer cells in general, but the studies are not yet conclusive. Studies specifically looking at sugar and breast cancer have had “mixed and inconclusive” results, according to experts.

Myth #12

Men do not get breast cancer. Yes, they do! One in every 100 cases of breast cancer occurs in men. Men also should stay alert to any changes in the breast area, particularly as it can spread more quickly in males since they do not have as much breast tissue to contain it. As well, men are not screened for this cancer and tend to have less support when they are diagnosed with it.

Myth #13

Mammograms and biopsies can cause breast cancer to spread. The thinking here is that the squeezing and poking of a potential cancer could cause the cells to seed in another part of the breast. Some women also worry that the radiation of the mammogram could cause a cancer to begin. However, very low doses of radiation are used in current mammograms, and these are considered safe (although the operator, being there daily, needs to protective themselves from work-related exposure). No evidence has been found that these tests cause cancers to spread and they give valuable diagnostic and early-detection information that save many lives.

Myth #14

No lump means no cancer. Cancers that have formed “palpable” lumps (ones that can be felt with the fingers) have often been there, growing, for several years. The advantage of screening mammograms is that they can often detect a cancer before it is large enough to be palpable, greatly increasing the chance of a complete cure.

Myth #15

Anti-perspirants cause breast cancer. This myth started because many breast cancers occur in the upper outer area of the breast, the area closer to the armpit. However, very little if any of the ingredients in anti-perspirants are absorbed and there is no evidence that they would cause cancer if they were absorbed. At least one large well-conducted that compared breast cancer survivors with healthy women found no evidence of a problem with anti-perspirants or deodorants. The tiny grains of minerals left on the skin by antiperspirants do, however, show up on a mammogram, causing confusion for the radiologist interpreting the image. This is why they always insist that these products not be used on the day you are having a scan.

Myth #16

Carrying a phone in your bra can cause cancer. While most experts will say there is no evidence that cell phones cause any type of cancer, a few have reported case studies of unusual cancers that began in the same location where the woman carried her phone for several hours every day. Not proof of a cause, but one doctor was suspicious enough to publish a report after seeing several similar cases (which I linked to in my Sept 17th blog on environmental links to cancer). It might be a good idea to carry your phone in a purse or proper phone case, both to protect it and possibly also you! Cell phone manufacturers do recommend avoiding exposure of the phone to sweat, as the liquid could cause damage to the phone (as happened to my daughter, who no longer tucks hers into the waistband of her workout pants!)

So, there you go… less to worry about, right? I think the key in avoiding many diseases, including cancer, is to strive for as healthy a lifestyle as possible: eat well, exercise, limit alcohol to recommended amounts, and avoid exposure to nasty chemicals. And, since it’s Breast Cancer Awareness month, maybe make a little donation that might help researchers find the causes and cures for this disease that affects too many women…

References:

Medical Myths: 15 breast cancer misconceptions—Medical News Today

Antiperspirant Safety: Should You Sweat It?—WebMD

Some patients have always fallen through the cracks of our medical system, with unnecessary delays in diagnosis. We’re all human… a significant symptom can be ignored or misinterpreted, or we can put off investigating the cause of a nagging problem that could suggest a serious condition. But during the COVID pandemic, the cracks in the system have become wider. With fewer in-person appointments, cancelled screening clinics and hesitation to seek treatment because of worry about virus exposure, experts are warning that diseases are likely being diagnosed later when they’re harder to treat.

They worry that because early-detection procedures like PAP tests, mammograms and the PSA test for prostate cancer are being postponed, we may see cases where the diseases these tests screen for are more advanced at diagnosis. This can sometimes mean more expensive treatment and worse outcomes because diseases are more likely to have spread when diagnosed. Just like a house fire, cancers and infections are best treated sooner before they have a chance to advance and spread.

It will take time for statistics to show how much of this is happening and to what extent the problem of decreased health screening is affecting our health and our chances of surviving health problems that are detected further along in the course of the disease. But, anecdotally at least, I’m seeing that this is happening.

Of course, for privacy reasons, I don’t want to describe the cases I’ve learned about amongst family and friends, but I can tell you my story. You may have noticed that I took a break from blogging this summer… but it wasn’t because I was having too much fun to write. The truth is, I haven’t been feeling well for the past several weeks. And I still don’t know the cause.

So, from my point of view, here are some of the “cracks” that it’s easy to fall through…

Crack #1: one thing at a time

In mid-May I noticed some abdominal discomfort—nothing too terrible. Then a week later a sudden severe pain sent me to Emergency… Crack #1 to avoid: try not to have 2 things going on at once (not that we really have that choice…). If you do, be sure to explain that there seem to be two unrelated things going on. Turned out I had a kidney stone (perhaps obvious from the level of pain…) but since they couldn’t see the stone on a CT scan it was diagnosed as a kidney infection. I spent the next 2 weeks on an antibiotic that made no difference. A later scan showed several smaller stones, confirming what I had suspected must be the cause at the time because the pain was so severe.

But in spite of visits with 4 doctors and a nurse practitioner, along with a series of tests, there’s still something else going on that hasn’t been diagnosed yet. At least I’ve progressed from phone appointments to in-person ones as my symptoms have gradually worsened.

Crack#2: describe symptoms clearly

I can see that the system is backed up, with longer delays than usual in getting appointments and results of tests. Crack #2: make sure the person on the phone understands your symptoms and how severe they are. Avoid the “Fine, thank you” automatic response when a health professional asks how you’re feeling—be truthful and accurate. Let them know how the symptoms are affecting your daily life.

Crack #3: know your receptionist

One important lesson I’ve learned is that the receptionist is the gatekeeper of the doctor’s time. While it may seem weird to be describing details of an illness over the phone to someone who isn’t a health professional, she is the person who decides how soon you need to be seen. So, heed Crack #3 and treat the receptionist like the important person that they are… describe what’s going on politely and carefully along with any frustration or desperation that you may be experiencing! And thank them profusely for helping you to be seen in a timely manner—it’s probably due to their actions. Usually, they’re the ones who manage the doctor’s schedule and often are the ones with the connections to the receptionists in the specialists’ offices.

Crack #4: communicate well

Crack #4 is about lack of communication. If you go to an after-hours clinic or emergency department, your doctor may or may not know about it afterward. Even if the Nurse Practitioner in your Family Doctor’s office sees you and documents her observations on your chart, your doctor may not see it until your next visit with them. Your family doctor should be the central hub of your healthcare and seeing them regularly, especially when you have a health issue, helps keep your care from various sites coordinated. Make sure they are well informed and aware of any care you receive outside their office. At least now we have electronic health records in most areas, so information about various treatments in different locations is accessible to everyone who is treating you and needs it. They just need to know it’s there and to look.

Crack#5: avoid vacations!

And Crack #5 is: don’t get sick during vacation (as if we have a choice!). Many doctors are not able to find locums to cover the office when they take vacation, leaving patients to rely on after-hours clinics and emergency departments. Even our local blood collection/lab sample drop off clinic, usually lined up daily to overcapacity, just closed up for a week to take a holiday. For many like me, we were left wondering where to go and this resulted in yet another extra week’s delay for me and many others in getting test results needed to help find a diagnosis.

My story…

So, where am I now? I just learned this week that my latest test, the one that should finally provide a diagnosis and the test I’ve waited 2 months to get, has a 2 to 3 month wait for results. I can’t believe it. I’m unbelievably frustrated that any lab could take 2 months to process a sample and that, as the receptionist told me, it could take an additional month in this age of electronic communication to send me a letter by snail mail with an appointment to hear the results. I think I cried on the phone in frustration. I’m hoping my newest favourite receptionist may be able to work some magic and expedite this process somewhat for me, the way the receptionist in my family doctor’s office was able to get me into the specialist more quickly. The words “possible carcinoma” on a June 30th test should have resulted in quick action but here I am, 2 months later, still waiting for a diagnosis. Whatever it is, I just want to know. It’s more than a little stressful and certainly not the norm in any medical system, including ours. Might be time to send an email to my local politician…

The bottom line

I guess, the bottom line is that we all need to be proactive about our health. Even in these days of the continuing pandemic, we still should insist that routine care and screening tests are completed in a timely manner. Vaccines and well-fitting masks are tools we have to make sure we stay safe from the virus while we do this. If you have unusual unexplained symptoms, insist that they be diagnosed. Keep asking for investigations until the problem is resolved. Remember that your family doctor is usually the most important healthcare professional to work with you and to coordinate and oversee your care.

So, if you’ve missed any screening tests in the past year and a half, now is the time to book an appointment. Just like a house fire, it makes a big difference if you catch it early. If something seems to be wrong with your health, check it out right away and keep pushing until you get an answer… that’s what I’m doing, even though it seems to be taking much longer than it should.

At last, we are seeing the light at the end of the COVID tunnel… It’s exciting to think of getting back to normal – especially seeing family we miss so much – but we still want to open our communities up safely. Experts warn that we still need to be careful to avoid a fourth wave. This week New York announced that fully vaccinated people no longer need to wear masks and that they likely have more risk of being run over in the parking lot than contracting COVID-19 in a grocery store when fully immunized. Images of unmasked people returning to sidewalk cafes generated some excitement for many of us.

In Canada, with our alternative strategy to delay the second shot, the scenario might be a little different. We likely need to flip to “normalcy” more gradually. Everyone who wants it will have partial immunity (the first shot) by the end of June or sooner — a decent 80% or more for most — and that will start making a difference while we line up for our “top up” (family lingo for a second drink…).

While many of us are looking for solid guidance with experts telling us what is safe to do and when, it’s somewhat of a game of numbers… and “guesstimates” of how protected we are in different situations.

Considerations…

It makes sense to me that each geographical area should make recommendations for opening based on the local situation. And each of us will need to estimate our risk — and that of others — in each situation. As I see it, several factors need to be considered:

• Is there community spread of the virus in the area, especially cases that cannot be traced to the source?
• What percentage of the population has been vaccinated? One shot or both?
• Which activities involve less risk, and can be started sooner? Indoors or out? How many people? How well do you know them (whether they’re vaccinated, how much risk they’ve exposed themselves to, etc.)?
• On a personal level, what is your tolerance for risk? Do you have underlying health problems, a lowered immune response (due to medication or an autoimmune disease) or contact with family that is at higher risk?
• Although vaccines can prevent serious disease and hospitalization by 100%, none can completely prevent us from catching the virus (the best vaccines have around 95% protection). The risk of a mild/asymptomatic case of COVID and of passing the virus on to someone who has not been vaccinated or is at higher risk is thought to be very low but not shown to be zero, as yet.

Canadian experts are recommending that we delay re-opening until 75% of the population have received their first shot, and that we will still need to be cautious to reduce the chance of a fourth wave this summer. It’s a balance between trying to help the economy and saving lives, of course. But what is a life worth? As tragic as it is to see businesses close, it is worse to hear the numbers of lives still being lost.

There isn’t a play book for the ideal way to reopen our communities. We’ll only know in hindsight how cautious we need to be to avoid a resurgence of cases (and deaths). I guess we’ll have more information to base decisions on, if and when the next pandemic happens.

Decisions affect lives

In my province (New Brunswick, approximate population 800,000), communities were put in shutdown as soon as community spread was detected, and kept that way until every case could be traced and isolated. This has kept our loss of life to 43 people, as of yesterday… each one a tragic loss. In provinces that delayed closing for several weeks when they reach this point, the numbers were much worse. Ontario, for example, has had over 500,000 cases and 8,000 deaths in a population of close to 15 million. To compare the 2 provinces, that’s about 10 times the death rate per 100,000 population (5.4 in NB vs 53.3 in ON). The governments of several Canadian provinces are currently being criticized for delaying necessary shutdowns for several weeks longer than they should have. And delaying needed action to control a pandemic is turning out to harm the economy, not help it, as businesses closures are extended to gain control of the virus spread.

The future?

In the longer view, experts tell us that COVID-19 and its variants will very likely become a seasonal disease, much like the flu. There will always be those who are not vaccinated for various reasons, and it will be a long time until every country has good vaccination rates (if ever…). It’s not certain how high the vaccination rate needs to be to achieve herd immunity (the level of immunity that will prevent the disease from spreading through a community) but experts talk about 70 to 80% vaccination rates. With vaccine hesitancy (resistance to vaccination) as high as 40% in some countries, this suggests that outbreaks will continue to occur. And we know that, the more the virus spreads, the greater the chance that mutations, resistant to the vaccine, will be created.

Perhaps it will become like malaria, where you’ll want to check the disease rate in an area and whether it’s a resistant strain before you travel there. And maybe you’ll want to renew your immunity with a booster a few weeks before travel or take a drug with you to prevent or treat an infection if you are exposed, presuming portable forms are developed.

We’ll likely want to protect ourselves, at least during “COVID season”, by wearing masks on public transportation (especially planes) and perhaps also in public places, as they do in Asian countries that have experienced this level of risk from viral infections in the past. It may become “rude” not to wear a mask if you have sniffles or a cough, even if it’s “just a cold”. Given the non-existent flu season this year, we may want to use masks to protect against that virus during flu season too.

By the way, CTV News reports that Canada is on track to pass the US in percentage immunized (albeit with one shot rather than two, following the UK, India and other countries with limited supply of vaccine). Perhaps we should start up a friendly competition for “best immunization rate”… 😊

Anyway, these are my musings this week after reading the news. My hubby and I will be 4 weeks post-shot-#1 as you read this… hence my focus on how things are changing. But, after more than a year of taking precautions against exposure to this nasty virus, I’m wondering whether we will ever completely return to “normal”. Hopefully our new normal will be a better one and, having learned from this devastating pandemic, we’ll be more prepared in the future…

References:

Businesses welcome back customers as New York reopens – New York Times

Do we still need to wear a mask outdoors? CNN Health

Canada’s COVID-19 vaccination rate likely to surpass US this week – CTV News

#ReopeningAfterCOVID #ReopeningCommunities