Exclusive Special Feature: Interview with Dr Constantine Dan Mallin, Ontario family physician in practice since 1976 and President of Canadian Macedonian Health Professional Association..

I spoke with Dr. Constantine Dan Mallin to hear his opinion about the COVID-19 global pandemic.

SAN: Are you currently working with patients or giving them advice and prescriptions over the phone?
Most family doctors are doing business over the phone or through an online government program to link doctors and patients in a secure fashion. People can use video to show rashes for example. I have had patients show me their sore throats by electronic means. It is not as good as in person but most matters can be resolved that way.
I am seeing one or two patients in the office a day, but it is a very slow process. People wait in their cars until we call them. We only let one person in, at a time. With our personal protective equipment in short supply we have to keep visits to a minimum and because we have to disinfect the room after they leave it becomes a slow process.
Non-essential medical services like elective surgeries are being postponed.
Many of us are taking shifts working at the local COVID-19 drive-through screening clinic. Everyone we see has symptoms. Last week, I think most of it was not COVID-19 but these past few days I believe we are seeing more people with COVID-19. We can only test a minority of people who come because our supplies are limited. We stress self-isolation with everyone.
I have sent a few people to the Emergency Department but I do not think they were ill enough to be admitted.

SAN: What is your advice on how to reduce the spread of COVID-19? Is confinement the only way?
Confinement of people with symptoms for a minimum of 14 days and social distancing for everyone else is the only method we have for controlling spread. Avoiding unnecessary trips, washing your hands properly and often, using alcohol gels with at least 60% alcohol on your hands, avoiding touching your face, disinfecting surfaces with alcohol, hydrogen peroxide or dilute bleach products will help prevent spread. Masks are good but not fool proof. Gloves may be helpful but you must use these with caution and not let their use lull you into a false sense of security.

SAN: What is the capacity of Ontario hospitals at this time?
I am in the country (Orangeville and Grand Valley) so I do not have direct knowledge of what is going on in the city. We have a couple of people admitted locally but no one on a ventilator, as far as I know, but that can change easily. My understanding is that Toronto is not overwhelmed, but things may become more challenging as the numbers increase and put a strain on our limited resources. We are not there yet and hopefully Public Health measures will flatten the curve and allow us to deal with this without turning into another Italy or Spain.

SAN: Is there any treatment or medication that has been helping?
There is no known proven treatment or drug prophylaxis for COVID-19, so I am not prescribing anything for viral-like illness. We can treat other problems as usual.

SAN: What is your advice for people who are at health risk?
People with compromised immune systems, older people, people with cardio-respiratory issues, and others are at higher risk and especially need to minimize their contact with the outside world. If you are not sure, ask your doctor.

SAN: What message you would give to families with children and young people, who are staying at home at this time in order to stay safe and calm?
Things are in such a state of flux, that anything said today, can be old by tomorrow
The advice you can get online from Public Health is sound and useful. The World Health Organization (WHO) has a very useful page on masks and prevention.
There is a lot of advice online from reputable sources on how to cope with the stress of this epidemic.
There is also information on how to talk with your children about COVID-19

SAN: Does this situation remind you of anything that you experienced during your career as a doctor?
In over 40 years of practice I have not experienced anything like this. The H1N1 of 2009 made a lot of people sick but it did not overwhelm hospitals like in New York or Italy. And we had a vaccine for it. The SARS epidemic was very deadly but very limited.
We may be living our lives very differently for a while until we find an effective treatment or find and implement a successful vaccination program but that may take a year or so. Our world has changed so quickly. Most people have been very cooperative with self-isolation and physical distancing measures. We will learn to cope I am sure.

Links to coronavirus information: ontario.ca/coronavirus & canada.ca/coronavirus