COVID-19: An E.R. Doctor's Perspective, with Sukh Dhiman, M.D.

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We interviewed Sukh Dhiman, M.D., E.R. Doctor at Surrey Memorial Hospital via Zoom last week. Dr. Dhiman shared with us his perspective on how COVID-19 has - and how it will continue to affect - B.C. in the weeks and months to come. He also shared his recommendations with regard to social distancing and the use of medical and non-medical masks. Here is the full interview: 




Transcription of the Interview:

Sherry Chen: [00:00:10] Ok, so today I have Dr. Sukh Dhiman here from Surrey Memorial Hospital. He is an E.R. surgeon at Surrey Memorial. Surrey Memorial is a newer hospital, so they got a really good good equipment and also more space. So they've kind of been the centre of infection and disease control during all this Covid-19 stuff. So Sukh, I just wanted to give you the floor and maybe talk a little bit about yourself and what you've been doing.


Sukh Dhiman: [00:00:51]  So there are emergency position so we are on the front line. So we are kind of like the canary in the coal mine. So we saw this  starting individually and as a group, starting in Wuhan, and the risk of this pandemic spreading and spreading all over and coming to affect us as well.So it's been an interesting process to see it and experience it and be part of it and like the risk that entails as well. I work at Surrey memorial in the emergency department and like you said, we have a we're lucky. We've got a we've had a newer emergency department and a new tower. And we're also the biocontainment unit for the Province.. We've got excellent resources to deal with this pandemic. And I'm really lucky to work with a great group of emergency physicians and colleagues. So we've been lucky, we've been able to be prepared. And I think we've been ahead of the curve to be able to deal with this.


Sherry Chen: [00:02:05] So how do you think? Well, obviously, as you said, we're ahead of the curve. How do you think we compare to other provinces as well in Canada?


Sukh Dhiman: [00:02:19] Well, it's interesting. I mean, where are our numbers are similar to Alberta.. We haven't tested as many cases as Alberta has. But our numbers are quite similar, I think, with we've just gotten lucky. I don't know quite why. Maybe it's because we're not as densely populated. Maybe that’s a factor. Maybe its population compliance. But I think in Canada, we've got lucky. And I think B.C. in particular, because we have a lot of traffic from international travel China. I personally know some parents from Wuhan at our kids and her kids school. So I think we've just gotten lucky.


Sherry Chen: [00:03:16] Yeah. Do you think social distancing has really helped as well? Like everyone's been very compliant. 


Sukh Dhiman: [00:03:24] That have been a big factor, the population's been quite complete, very compliant with that. So I think that the biggest factor that has helped to curb the spread of Covid.


Sherry Chen: [00:03:39] And I've had a lot of people kind of ask about, you know, I've heard lots of conflicting stories on whether you develop immunity once you get Covid. Can you speak a little bit about what  your thoughts are on that?


Sukh Dhiman: [00:03:56] Yes, we do develop immunity. Once you get it. In fact, there is also you can do something called convalescent serum where you can take like serum from people that have had it and recovered. And this will give  if you inject it into yourself, like through a process, you can get a temporary passive immunity. So this is the. So, yes, you do. You do get immunity. The question is how long? And like as with like we don't know what's going to happen with this type of Coronavirus, whether it's going to be a seasonal occurrence, or that it mutates and changes. So we we're not. Yes. You have it for the moment. Whether it's there in two years time or if there's another Coronavirus outbreak, that's that's a different question.


Sherry Chen: [00:05:01] I think so as well. So I know it's not a matter it's it's not a matter of how long this will go on for. But how do you think things are going to be moving forward? You know, how do you think life will slowly return to some sort of semblance of normal?


Sukh Dhiman: [00:05:19] In the emerge, what we're seeing, like we're not seeing yet many cases coming in. So I definitely think we've peaked. Our cases coming into emergency.. There's not as many and I know in the ICU there, they've been turning over and discharging more patients. So that's actually a very, very good sign that it's actually on the decline here. So all the measures that have been taken, they work quite well. What's going to happen going forward, I think, is... One of the things that the government needs to do, and I think they're doing, they're going to do that here very shortly, is open up the testing criteria... much more liberally in that way. Any possible anybody with any signs of illness can get tested and get a quick turnaround test and be isolated. And that allows like the restrictions to start. So I think they're still going to be social distancing. Like large gatherings are still not the case. I don't see that happening. But small businesses opening up, I think that's going to be a big, big factor. And I think we're going to have a new norm with masks. Like mask they do work out, social distancing does work. Boy, they've got going to be a factor that's going to change here as well.


Sherry Chen: [00:06:55] So you think masks will definitely be mandatory moving forward?


Sukh Dhiman: [00:07:01] I don't know if it's mandatory, but ... he responsibility is on the individual. I think it that masks do work in a situation like this. I think they have a role to play?


Sherry Chen: [00:07:23] Sure. Do you think there is? Because a lot of people are talking about the different kinds of masks. There's ones that they say don't work as well. Is there a difference between, you know, medical non medical masks or is it just good to have something that kind of filters out?


Sukh Dhiman: [00:07:40] I think it's more the mask is more to protect other people against droplets from yourself. And also it does work the other way around. So, I mean, we don't need it. I rarely use the A ninety five mask at work except for in situations where I need to be in contact with like an unknown patient that is in a restaurant or doing an active resuscitation. Otherwise we use surgical masks under the simple masks. That cover in the front of the face. So I think something like that is right. If not the in ninety five mask, but it does, it does a reasonable job and it doesn't have to be a medical grade surgical mask.


Sherry Chen: [00:08:35] Ok. Yeah. Do you think there would be more supply. Because I mean obviously there's a lot of people who can't get masks or any of these supplies. Do you think the government will be doing something to help with that? Moving forward as well?


Sukh Dhiman: [00:08:51] I think a lot of it is like there's not like a lot of this doesn't need to be medical grade masks. So there's stuff that you can even you can fashion out so you can just make it by offer or by all parties Like I mean, there's not it's not like an end ninety five, which is a very elaborate process to create this or manufacture this mask like this is simple. Kind of just a barrier, for you and for the other person or anybody else. I think any kind of gathering like if you're going shopping, you should probably have a mask. From  that point on, it's probably a good idea.


Sherry Chen: [00:09:47] Ok. And what do you think about. I mean, there's a lot of people obviously there's conflicting things that people are saying that, you know, only the older people are susceptible to this. But I heard as well that there are younger people that could get this, could get Covid as well.


Sukh Dhiman: [00:10:06] Yes, so everyone is susceptible. Just the severity of illness. Your risk is higher. I'm getting severe illness as you get older. Doesn't mean that some young people aren't going to get very, very sick. There's going to be like 20 year olds that get very sick, that go into the intensive care unit. It's just your chances are more. The younger you are, there are fewer health conditions you have. It's kind of a we don't know why some people get really sick with it, . All right. So some people are going to get very, very sick with it. We don't know why.


Sherry Chen: [00:10:49] Ok, let's just kind of how their body reacts to it.


Sukh Dhiman: [00:10:54] We're not sure why. Like, we don't know why.


Sherry Chen: [00:10:59] Ok. And then do you think I mean, obviously some people are afraid to go to the hospitals now as well with other conditions. What are your thoughts on on that?


Sukh Dhiman: [00:11:11] Yeah, that's actually very like. That's a big topic. A big concern because people with chronic medical conditions are really needing to go or avoiding it, delaying it. Again, we're seeing delayed presentations of illnesses. There's bad outcomes that are happening because people are not presenting or because you're scared of coming to the hospital. So I don't see at this point this is not a concern. We have a complete separation of cases coming into the hospital. They're in a completely separate area and right up front. We're separating any possibility of patients that have a viral illness like this. We do completely separate area. So it's actually very safe to come to the hospital to present. So you don't want to delay coming for a management of  a condition because you're worried about that. That's actually more harmful to you for sure.


Sherry Chen: [00:12:26] Do you think so? Dr. Bonnie Henry has been really on top of it with all the updates. She said that maybe, you know, in the next couple of weeks they might be easing some restrictions. What are your thoughts on what that could mean?


Sukh Dhiman: [00:12:42] Yeah, I think that's very possible that could happen because our cases, like from what I can see, we're not having as many cases coming in. So I think the big thing is that testing capacity has to be there. Like, if you're gonna do that, we need to have like you would need to be able to run a lot of tests. So I think that we can if there were testing capacity there and then we could do that because then as we ease restrictions, there is gonna be some spreads. We're gonna be able to really quickly test and isolate and contain. If you can do that rapid testing and large scale testing, then you can start easing restrictions or easing restrictions like I did when we talked about small businesses being I think like like we accountings can start gathering yet again. I think Dad said that's that's a big thing. I don't know about schools reopening, but maybe like like grade twelve students, or grade 11 students like like you can get,with social distancing together that can start happening. But I think the big thing here, like small businesses are getting up and running again, because this is going to have a huge economic impact for sure.


Sherry Chen: [00:14:05] So I guess we touched on a few of these things as well. So do you have any kind of advice, you know, for how you should go about your daily life after as we kind of ease restrictions and kind of start getting back into normal life? Because, a lot of people are talking about about there possibly could be a second wave of this in the fall.


Sukh Dhiman: [00:14:29] Yeah. Is there's a possibility. I think, number one, if there's any sign of any illness, like I think people are a lot more aware.  Before, when I would go to work with a cold, but now there's no possibility. Of that and I can get better really stay home and I'm  getting the testing criteria open up, getting tested. That's a big thing wearing a mask, like if you're gonna be in a gathering outside, like a shopping mall or  shopping, I think it's probably a good idea. Handwashing is really important. I think these are like these are small things that make a huge difference going forward. I think like if you want to be like extra like prepared or vigilant, like one of the things like having a thermometer in the House is probably a good idea. The other thing is having like you can get a portable oxygen sensor on your finger, like it's something you get from eBay for about twenty five to like seventy dollars like that tells you your oxygen saturation. That might be a good idea to invest in that going forward just to have it in the House. One of the things that happens with this is that with coronaviruses you start ill, your oxygen saturation starts to go down. That's when you're seeing the first signs. Oh, this is probably not just a cold.


Sherry Chen: [00:16:02] Ok. Is there anything else you think is important to mention?


Sukh Dhiman: [00:16:07] NI think this is is it has been a I don't think that I think those are the big points. We've been very lucky here in B.C., It's nowhere near what it's like in other places. We have we have been we're lucky  that  our social system that's held up. We're very fortunate for sure. But are there a lot of it luck as well. So we we've been really fortunate. Yes. Yeah.


[00:16:50] And yeah, again, thank you so much. As one of the frontline workers combating this COVID 19, I know it's not easy. And I know you've been working some long hours. So thank you so much.


Sukh Dhiman: [00:17:03] Thanks Sherry, Thanks a lot!