We’re breaking down what you need to know about the pandemic by answering your questions. You can send us your questions via email at COVID@cbc.ca and we’ll answer as many as we can. We’ll publish a selection of answers every weekday on our website and we’re also putting some of your questions to the experts on the air during The National and News Network. So far, we’ve received more than 40,000 emails from all corners of the country.
What are the long-term effects of a COVID-19 infection? Can your lungs be damaged permanently from the disease?
Researchers say COVID-19 is so dangerous because it invades our respiratory cells and triggers an immune system response that targets those infected cells, destroys lung tissue and ultimately clogs our airways, cutting off our oxygen supply.
The Campbell family wrote to us asking if COVID-19 can lead to long-term damage to a person’s body — specifically, their lungs.
“The answer is likely yes,” said Dr. Samir Gupta, a respirologist at St. Michael’s Hospital in Toronto.
The level of damage will depend on the severity of the infection and how it progresses in each person.
“For people with mild infections, we are unlikely to see any long-term consequences,” Gupta said. “The concern is in people who will develop pneumonia with this infection, and particularly those who will end up on a ventilator in the ICU.”
The problem, Gupta said, is that there is “very little” information on COVID so far — so doctors are basing their knowledge on similar infections.
“This infection does seem to cause a lot of scarring in the lungs, and if we extrapolate from what we know of other infections that can also lead to pneumonia and ventilator use, [COVID-19] is likely to cause some permanent loss in lung function and some permanent decline in functional capacity, with symptoms like permanent shortness of breath.”
In severe cases, sometimes the treatment can also cause damage.
When someone has severe pneumonia, for example, their lungs aren’t able to do their job of getting oxygen in and carbon dioxide waste out. In such cases, a mechanical ventilator may be used to perform these functions until the patient recovers.
Dr. Lynora Saxinger, an infectious disease specialist at the University of Alberta, said ventilators themselves can damage the lungs.
“If someone has been critically ill with acute respiratory distress syndrome (ARDS), on a ventilator, regardless of the cause, there are a number of issues,” she said.
Saxinger said lung function decline, loss of muscle mass and even post-traumatic stress disorder are possible.
“Some people end up with long-term decreased stamina … even five years out.”
In short, doctors don’t yet know if the recovery from COVID-19 is different from any other severe lung infections, but it appears that mild and moderate cases can recover well.
Researchers are also looking at how the kidneys and the heart may be at particular risk due to a heightened immune system response.
Is it safe to have an operation while COVID-19 is being treated in the same hospital?
Most provinces in Canada have already begun their reopening stages. Part of that includes resuming surgeries, and Mark G. is wondering if it would be safe to have an operation done in a hospital that is simultaneously treating COVID-19.
We spoke to some emergency department (ER) doctors who said, for the most part, patients shouldn’t worry.
Right now, there are still some emergency surgeries taking place despite most hospitals treating COVID-19 patients, explained Dr. Alan Drummond, an ER physician in Perth, Ont.
“Emergency surgeries and cancer or cardiovascular surgeries that can’t be delayed have been ongoing,” he said. “These are being done under very strict protective guidelines to minimize the risk of transmission. So if you absolutely need surgery, there should be no concern.”
“Hospital wards have been restructured to place COVID-19[-positive] patients at a safe distance from non-COVID patients,” said Drummond.
Dr. Brian Goldman, ER doctor and host of the CBC podcast The Dose, said it’s “unusual for patients to get infected” with the virus while in the hospital.
“Hospital [staff] are well trained and equipped to handle patients infected with the coronavirus,” he said.
Even with hospitals that have experienced “outbreaks,” patients should understand these are not on the same scale as long-term care homes, for example.
“An outbreak may be as few as two to three people infected,” said Goldman. “It does not mean that there is widespread transmission of the virus in the hospital.”
Some provinces, including B.C., have designated COVID-primary sites with specific units treating COVID-19 patients.
“This means all COVID[-19] patients are cared for within these sites in their designated units,” a spokesperson for B.C.’s Ministry of Health said.
Goldman thinks it’s a good idea.
“In order to accelerate the treatment of patients waiting for delayed surgeries due to COVID, it might make sense to have COVID-only and non-COVID hospitals to simplify the need for infection control.”
Ontario released its comprehensive framework last week to help hospitals assess their readiness for resuming scheduled surgeries and procedures. But a spokesperson for the minister of health, Christine Elliott, said this framework “does not contemplate COVID-19-only hospitals.”
Do I need to isolate when I get back from the hospital?
This question comes from Gohar F., who recently went to the ER and was wondering if she is required to isolate when she returns home.
The two ER doctors we asked agreed there’s no reason to isolate when you return from the hospital; however, there are a few exceptions.
Goldman said you won’t need to isolate unless your visit to the hospital included coming into close contact with a patient who has a known or suspected case of COVID-19, or you were “contacted by Public Health because they are tracing contact of a person known to be infected with COVID-19.”
You’d also need to self-isolate if your visit to the hospital was for the purpose of being tested for the virus, Goldman said.
If you have been swabbed and are awaiting results, Drummond said you should isolate until you know whether you are positive or not.
“Thankfully, the turnaround time for diagnostic tests has improved dramatically since the pandemic started,” he said.
When it comes to patient safety in the hospital, staff are being extra cautious, wearing all the proper personal protective equipment and implementing strict isolation measures for COVID-19 patients.
Doctors say you shouldn’t let fear of COVID-19 keep you from going to the ER if you have real concerns.
We’re also answering your questions every night on The National. Last night your questions included: What kind of non-medical masks should people wear? Watch below:
Tuesday we answered questions about cleaning services and blowing bubbles.
Keep your questions coming by emailing us at COVID@cbc.ca.