As we are all abundantly aware, COVID-19, the novel coronavirus, has seized us worldwide. Although pandemics have been predicted for many years, we were largely ill-prepared for the arrival of COVID-19 and uncertain how widely it would spread.

There was little known about its type of transmission (droplet or aerosol), its ability to live on inanimate objects, its virulence or its lethality. We knew little about where it came from or how to mitigate its effects. We knew even less about potential societal impacts.

Nearly a year later, we now know more. We know that it is largely a respiratory virus with myriad non-specific clinical presentations that are shared by many respiratory viruses. We know it is predominantly spread by droplets, but we are increasingly concerned about potential aerosol spread.

Clearly, our knowledge of the virus continues to evolve. For instance, where there was initial uncertainty of the efficacy of mask-wearing, it is now clear that masks protect oneself and others.

We also know that the effects of the virus are disproportionately shared in the population. Age has clearly emerged as the greatest risk factor, with the largest number of deaths in the over-70 age group. Indeed, a high proportion of deaths have occurred in people over age 60.

We have seen this outcome in outbreaks in personal care homes across the country, including most recently in Manitoba, where a disproportionate number have occurred in personal care homes and where crowding, insufficient staffing and lack of personal protective equipment (PPE) have been identified as risk issues.

Throughout the world, racialized people, people of lower socio-economic groups and people with disabilities have been significantly impacted. In Canada and Manitoba, the increasing spread in Indigenous communities is a cause of great concern. Previous experiences with tuberculosis, respiratory viruses and H1N1 all point to the risk of spread and poor outcomes. The jurisdictional issues (federal/provincial) involved in providing care to Indigenous communities make interventions more difficult to implement. Collaboration is a necessity.

The impacts of racism outlined by Justice Murray Sinclair in the Truth and Reconciliation Commission of Canada report, including crowding, poor access to care and geographic isolation, will continue to worsen the effect of the virus on Indigenous communities. The Rady Faculty of Health Sciences’ Ongomiizwin – Indigenous Institute of Health and Healing has committed to help with mitigation through co-ordination of Rapid Response Teams’ deployment of health professionals and other supports in a collaborative effort with Chiefs, Indigenous communities and both levels of government to support COVID-19 surge capacity needs in First Nation communities.

Throughout today’s pandemic, governments worldwide have continued to attempt balance in their approaches: mitigating the effects of the virus while also mitigating the effects on the economy and individual livelihoods.

As numbers continue to climb in Manitoba, the province has likewise increased restrictions.  We are hopeful that the impacts of these interventions will be evident soon.

Balance is the key issue in all of our efforts. As deans in the Rady Faculty of Health Sciences educating the majority of our province’s future health-care professionals in dental hygiene, dentistry, medicine, nursing, pharmacy and occupational, physical and respiratory therapy, we balance risk to students with their need to progress in their clinical skills to allow them to advance in their programs and graduate in their professions so they can contribute to front-line health workforces.

Management of this pandemic will continue to require our collective concerted efforts. We must continue to depend on the expertise and wisdom of public health professionals as they provide advice to governments, with whom the ultimate decisions rest.

As the holidays approach and the first vaccine inoculations start taking place, we will be required to be patient as public health priorities for vaccination will be determined by need, and it will take several months before all Manitobans are able to be vaccinated. As well, we must continue to heed the advice of public health professionals in order to keep our families and communities safe in the coming months by adhering to the very basics: socially distance; interact only with members of your household or, for individuals living alone, one designate; wear a mask; and wash your hands.

This year’s holiday celebrations will be much smaller and look very different than in the past, but COVID-19 is not done with us. We must commit to its containment.

Wishing you all a safe holiday season and a joyous and healthy new year!

Dr. Brian Postl, Dean, Max Rady College of Medicine; Dean, Rady Faculty of Health Sciences & Vice-Provost (Health Sciences), University of Manitoba

Dr. Anastasia Kelekis-Cholakis, Dean, Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, UM

Dr. Netha Dyck, Dean, College of Nursing, Rady Faculty of Health Sciences, UM

Dr. Lalitha Raman-Wilms, Dean, College of Pharmacy, Rady Faculty of Health Sciences, UM

Dr. Reg Urbanowski, Dean, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, UM