COVID-19 is on the move in Nova Scotia.

Halifax is experiencing the first signs of community spread. Merriam Webster tells us that community spread is: “The spread of a contagious disease to individuals in a particular geographic location who have no known contact with other infected individuals or who have not recently traveled to an area where the disease has any documented cases.”

Doctor Strang, Nova Scotia’s chief medical officer, tells us that the 4-week lockdown that is underway in Halifax is necessary if the spread of COVID-19 is to be limited. People who have no symptoms are being encouraged to get tested for the virus so that more infections that are out there can be identified.   

CTV news released this report as local cases climbed up to 22.

Doctor Milburn, who works in the Regional Hospital’s emergency room and as a family doctor, is quoted as saying he supports only individual physical distancing and mask-wearing as measures to limit the spread of the virus: “He says following health measures like wearing a mask and physical distancing are recommendations he's onboard with, but implementing more restrictions, he says can do more harm than good.”

Huh.

How can a 4-week shutdown, for example, do more harm than good when community spread is an established risk?

Well, Doctor Milburn’s logic seems to flow like this:

• “The number one co-risk factor for COVID is basically obesity, diabetes, poor fitness…”
• People who go to the gym, play hockey, swim, and are “living life” are more likely not to be fat, not to have type-2 diabetes and not to have “poor fitness.”
• Shutting down gym and pools - “it's bad for their mental health, it's bad for their physical health and overall it may increase the risk of people dying from COVID.

I would like to make these points:

• We can all agree that physical exercise is important to our health, but it is quite a leap to suggest that a 4-week shutdown like the one in Halifax, or other measures beyond physical distancing and mask wearing, might increase the risk of people dying from COVID-19. Doctor Strang encourages those under lockdown to be physically active outside, understanding that this lockdown will be a tough thing for people.

• It is also odd that Doctor Milburn boils down the co-risk factors of COVID-19 to “is basically obesity, diabetes, poor fitness” when the Centers for Disease Control and preventions lists these co-risk factors: Cancer; Chronic kidney disease; Asthma, if it’s moderate to severe; Chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis; Having damaged or scarred lung tissue such as interstitial lung disease (including idiopathic pulmonary fibrosis); Cystic fibrosis, with or without lung or other solid organ transplant; Pulmonary hypertension (high blood pressure in the lungs); Dementia or other neurological conditions; Diabetes (type 1 or type 2), Down syndrome; Heart conditions (such as heart failure, coronary artery disease, cardiomyopathies or hypertension); HIV infection; Liver disease; Overweight and obesity; Pregnancy; Sickle cell disease or thalassemia; Smoking, current or former; Solid organ or blood stem cell transplant; and Stroke or cerebrovascular disease, which affects blood flow to the brain.

• Doctor Milburn says that he will “continue to follow the science behind the pandemic.”

• But the scientific consensus is that lockdowns are sometimes necessary: “Lockdowns stink, but they work,” said Dr. Isaac Bogoch, an infectious diseases expert and member of Ontario’s Vaccination Task Force.

I am grateful to all of the doctors like Doctor Milburn who practice on Cape Breton Island. I think they have difficult jobs, and are overworked because there are not enough of them. I do think that it would useful if Doctor Milburn would clarify his remarks around COVID-19 as many people look to our local doctors for information about the pandemic.