Canadians often see hockey as a metaphor for life. Hockey's cliche-littered locker room may offer some wisdom as we collectively deal with the COVID-19 pandemic in Canada. Let's take a few of hockey's time-worn aphorisms and apply them to our situation.
In Canada's COVID-19 outbreak we are in the first period and it's 2-0 for the SARS-CoV-2 virus. Team Canada faces an opponent that is big, strong and fast, and engenders fear. To ensure the game ends in favour of Team Canada, the first step is overcoming fear by building a sense of team.
1. There is no "I" in team
We will defeat COVID-19 as a team. As a cardiologist and head of medicine at Queen's University, I am acutely aware of the importance of every member of the health-care team. But the team that's required to defeat COVID-19 is even larger than that, and includes the whole community. It's going to take all of us to get this done.
2. The best defence is a good offence
We are using social distancing and the cancellation of events, mass gatherings and even elective health-care services to ensure we don't all get sick at the same time.
This flattening of the epidemic's curve (see below) is designed to slow the spread of a virus, against which we have no natural immunity, so that the numbers of infected people will be distributed over a longer period.
This makes the care of those who become sick much more manageable. This is a good defensive strategy, and until we get an effective vaccine, it is the best defence we have.
3. Move to where the puck will be
There's a famous quote from Wayne Gretzky, of Edmonton Oilers fame, about not skating to where the puck is, but to where it is going to be. This advice can be applied to COVID-19. The question is not where we are now. You can see where the outbreak is today, and how it has progressed, using this online tool. The question is where we are going. What will the epidemic look like in the third period? How can we shape it to ensure we are victorious?
Skating to where the puck will be requires a dynamic partnership between health care and public health. Think of public health agencies as hockey scouts who track the epidemic and apply lessons learned from other provinces and countries. These scouting reports are helpful because they tell us the natural history of the pandemic and predict the spread of COVID-19, helping us deploy resources wisely.
We can take some comfort in knowing that we are prepared and that fewer than five per cent of cases will be life-threatening. For most (80 per cent) infected people, including almost all who are young and healthy, this will be a self-limited infection, managed by staying home and recovering with symptomatic care, good nutrition, fluids and over-the-counter medications.
In Ontario, we have planned for out-patient and in-patient screening for the virus. It has been a slow ramp up, however, due to a national shortage of the swabs required to acquire the specimens for the COVID-19 test.
I am encouraged by victories that have occurred internationally. After three very difficult months, things have stabilized in China; indeed cases peaked in February. Some countries, such as South Korea and Germany, are managing to avoid high mortality rates. We can learn from them.
4. Play your position
There is not a position on the team that trumps the others in terms of importance. Our victory will reflect the efforts of front-line nurses, doctors and trainees, and those in our lab and pharmacy, as well as support services, from housekeeping to our information technology team.
As a calm, well-informed member of the public you, too, are part of Team Canada. There will not be a three-star selection when we beat COVID-19; you will all be stars!
5. Thank your team members
A typical hockey interview given by the star player after a game almost always follows a standard, self-deprecating script: "I'd like to thank the coach. My goalie was amazing. The wingers were passing the puck tape to tape, and our fans were great!" It's never self-congratulatory.
Listen to former Chicago Black Hawks star Marion Hossa give credit to everyone else - his teammates, and even the opposition.
In the hospital and beyond, a virtual pat on the back to a colleague or team member is always appreciated and goes a huge way to reassure them. Small acts of kindness to support each other are always appreciated. The bolstering effect of praise and acknowledgement is particularly felt as health-care workers struggle with daycare and school closures and worry about aging parents, all while caring for patients.
Here at Queen's University, our medical students are offering a tangible example of support to our physicians during this difficult time. They are providing services such as child care, pickups, drop-offs, etc. You can probably envision how you can help a neighbour who must continue to work in an essential service field!
5. Keep your head up
In hockey, this admonition is a reminder to be aware of what is happening around you so you are not blindsided (run over by an opponent). In the COVID-19 pandemic we can keep our head up by paying attention to high quality, reliable information about your city, province and country.
There is lots of information that is dark and false on the internet, so follow the information feeds from trusted news outlets and reliable health agencies.
6. Envision success
Believing that you will succeed is a precondition for success, whether in hockey or medicine. In hockey you cannot let your mind go to that easily reached, dark place of defeat. When its 2-0 in the first period, all thoughts should be focused on turning the tide: stop further goals, score one goal, repeat as necessary!
In the case of COVID-19, we are doing much the same: slowing the spread through social distancing, hand hygiene and suspension of elective services, buttressed by ramping up COVID-19 testing in symptomatic people. I am envisioning success and a resumption of normal life!
7. Thank the fans
The impact of COVID-19 is being felt by students, families and people working in restaurants, retail outlets, utilities and more. We, your health-care professionals, stand with the people in our communities.
Doctors, we can "thank the fans" in this analogy, not only through the health care we provide but also by listening to and allaying their concerns, providing accurate information and providing role models for calm response.
Permit me a few final aphorisms.
* Keep your stick on the ice (be prepared).
* Skate to the paint (stay engaged with your friends and co-workers).
* And finally, together we will put the puck in the net.
Author: Stephen Archer - Professor, Head of Department of Medicine, Queen's University, Ontario