I’m a rural family physician in Raymond, Alberta, Canada. I work at the Raymond Medical Clinic and the Raymond Health Centre.

This is just a page of useful (I hope) information for locals on the current COVID-19 pandemic. I will try to update it regularly. Always trust official government or Alberta Health Services channels more than me, especially if their information is more recent than this.

Public AHS info on CORVO-19 is available at: https://www.albertahealthservices.ca/topics/Page16944.aspx.

How many cases in Alberta:

29 of 19h00 13 March 2020.

How many south of Calgary?

0 as of 22:04, 12 March 2020.

How many in Raymond?

0 as of 22:04, 12 March 2020.

What if I think I have coronovirus (COVID-19)?

Do you have symptoms? Only something like 0.1% of patients who test positive have no symptoms. So if you don’t feel unwell, you don’t need to worry. (We couldn’t do anything anyway.)

Symptoms include ANY or all of:

• fever;
• cough;
• shortness of breath;
• extreme fatigue;

if you also:

• travelled outside of Canada;
• had close contact with confirmed COVID-19 case;
• had close contact with someone else with an acute respiratory illness that has travelled outside of Canada in the last 14 days;

These are based on the AHS screening criteria as of 12 March 2020, 22:10.

If you meet these criteria, you should be screened.

The best way to do this is to call 811. Please be patient with that service–they are overwhelmed. They can advise you as to where to go for screening, or they may come to your house.

If you cannot reach 811, you can be screened at the Raymond Medical Clinic during office hours (9am to 5 pm).

How do I get screened at the Raymond Clinic if I’m a patient?

1. Come to the clinic parking lot. Park your car.

2. DO NOT enter the clinic. Call us on your cell phone (403) 752-3337. Tell us you are there.

3. Someone in protective gear will swab you for COVID-19, and will also assess your vital signs (heart rate, respiratory rate, and blood oxygen saturation).

4. If you need to be assessed by a physician, we have a triage/quarantine area available to protect other patients and health care staff.

5. Please be smart about this. Those without symptoms do not need to be screened. We don’t want to exhaust testing supplies, lab resources, or health care staff by doing unnecessary testing in the “worried well.”

What should I not do?

DO NOT come to an ER or medical clinic for screening. The only reason to come to ER with COVID-19 should be if you have trouble breathing, or are otherwise in distress. There is no treatment for COVID-19. There is no medication we can give you to make you feel better sooner. (If that changes, we’ll spread the word.) The only reason to come to ER is if you might need admission. And the only reason you would be admitted is if you were in respiratory failure or unable to breathe properly.

So, if you think you may need hospitalization, call 911. The paramedics will assess you and judge whether you should be transported to ER.

Otherwise, you’ll be whisked out as quickly as possible. (It may even happen that you don’t get in the front door at ER, depending on how screening procedures work out.)

Really not the ER?

Really.

Please try to avoid using ER for anything except genuine emergencies. (This is always good advice, but it applies doubly now.)

The biggest danger of COVID-19 is having our health-care resources stretched too thin. All of this is going to take more staff time, since we’re going to have to mess around with donning and removing personal protective equipment. That is going to make ER slower, and increase wait times. All the regular health problems that people have are going to continue unabated through all this.

Coughs, colds, sore throats, or chronic problems should be followed up in a family doc’s office, unless you are in acute distress (e.g., can’t breathe, choking, etc.)

What if I need a note for work?

No employer should be demanding a work note during an outbreak like this. Leave us a message at the clinic if you are getting push-back from an employer. DO NOT come to the clinic or ER for a work note. This is for two reasons:

1. we don’t need the risk of infection if you come in;
2. dealing with a work note situation is a poor use of our time when we’re already going to be taxed and overstretched. Time I spend writing your note is time I’m not with someone I might be able to help.

What about prescriptions?

The doctors at Raymond Clinic will do our best to fill telephone prescriptions. It is easiest if you have your pharmacy fax us. Regulations may require us to meet with you for some renewals (e.g., narcotics). This isn’t a good long-term plan for good medical care (i.e., don’t get used to never seeing us!) but at the moment in most cases it will be the best choice. If we tell you to come in, rest assured we have a very good reason.

Snow’s Pharmacy (Todd Snow) in Raymond has indicated that you can text them a picture of your medicine bottle, and they will contact us to get it refilled, and will deliver it to you.

I’ve yet to speak to Raymond Pharmacy (Wayne Smith), but I’m sure they would do similarly, as I know they too deliver meds.

Remember that text and e-mail cannot be considered secure methods of information exchange. (Faxes are secure.) So, if you are sensitive about a prescription image being sent in a way that others might potentially access, don’t use text or e-mail. Use phone or fax if you fear your future political career may be adversely affected by your Rogaine prescription images getting out on Twitter.

Is COVID-19 a human-made disease?

There’s no evidence of this. The virus is substantially similar to other viruses such as SARS and MERS, but happily less lethal.

This is an RNA virus–RNA viruses mutate more quickly than DNA viruses, since they have less error-checking in their genetic material.

Is the Facebook post about a Japanese doctor and keeping one’s mouth/throat moist reliable?

No. It is false. Please don’t spread it.

Will Sipping Water Every 15 Minutes Prevent a Coronavirus Infection?

Anything else?

Please respect government and AHS recommendations about restricting gatherings as they are issued. The risk to you may be low; the risk to others may be high. Current recommendations read:

It was also announced today that, effective immediately, Alberta Health is asking that all large gatherings or international events in the province with more than 250 attendees be cancelled. This includes large sporting events, conferences and community events. It does not extend to places of worship, grocery stores, airports or shopping centres.

Any event that has more than 50 attendees and expects to have international participants, or involves critical infrastructure staff, seniors, or other high-risk populations should also be cancelled……

Events that do not meet these criteria can proceed, but risk mitigation must be in place, such as sanitizer stations and distancing between attendees. Please err on the side of caution for in-person gatherings at this time.

Note that even smaller gatherings should be able to avoid being close to people. Most spread is by droplet and airborne virus. Sitting side by side in a theatre, for example, is probably A Bad Idea. And in a small town like ours, its hard to picture any gathering of significance that couldn’t include seniors or “critical infrastructure staff.”

Just to pick an example, if I’m at a gathering where someone turns out to have COVID-19, even if I’m not sick, I have to self-isolate for 14 days. That takes me out of medical commission, and puts a greater burden on colleagues. The younger physicians are going to be taking the lead on these issues, since there are health risks to older practitioners.

Conclusion

We have a good team in Raymond, and are prepared. Don’t panic, just be smart, and think about how your actions will affect everyone. If you have questions, we’re there to help out.

And, wash your hands!