IN IT TOGETHER: This is a first in a series of stories profiling members of the Niagara Health team and the work they are doing as part of our response to the COVID-19 pandemic. Meet Dr. Karim Ali, Director, Division of Infectious Diseases & Antimicrobial Stewardship Program and Lead Physician for Emergency Preparedness.
Dr. Karim Ali remembers well the email he received from the International Society of Infectious Diseases on Dec. 30, informing him and other Infectious Diseases experts around the world that there was an unusual cluster of pneumonia cases in Wuhan, China.
The email was among the early reports of the novel coronavirus that was rapidly spreading through the Chinese city.
Dr. Ali joined Niagara Health in 2012. As our Director, Division of Infectious Diseases & Antimicrobial Stewardship Program and Lead Physician for Emergency Preparedness, he was part of the NH team that started planning in January for the arrival of COVID-19 in Niagara. Early on, he monitored the situation around the world, providing updates to the organization, and he was instrumental in developing a process to safely test patients for COVID-19 at Niagara Health Emergency Departments.
As an infectious diseases physician, Dr. Ali has additional medical training – a Fellowship in Infectious Diseases – specializing in the diagnosis, control and treatment of infections. His role has evolved into becoming the pandemic/emergency preparedness physician lead for Niagara Health.
Describe your role at Niagara Health in the pandemic?
As the pandemic/emergency preparedness lead, I advise the organization and use my medical expertise in infectious diseases to help make decisions. I work with key stakeholders like medical directors, the manager of Infection Prevention and Control and with physicians and other front-line staff to help make timely decisions about testing, working with Public Health authorities, and supportive care options for patients with COVID-19.
What is most striking to you about the COVID-19 pandemic?
For me it’s the fact that a pandemic means every person is susceptible to getting the virus. Nobody has any immunity to this. In my mind, that’s why it is so important to continue to maintain best practices in infection control and for everyone to listen to the advice of health experts, including practicing physical distancing, staying home and cleaning your hands often to stop the spread of the virus.
Based on your experience, how does this compare to the influenza virus or the SARS outbreak?
What’s concerning is that the COVID-19 is much more infectious compared with the influenza virus and SARS. This is a novel virus, a brand-new virus. We all have some immunity at times to different influenza viruses that carry on. With this novel virus, everybody is susceptible. And the community transmission is more prevalent than with SARS, and that’s why it’s so important to follow the advice of health experts to stop the spread.
Who is more vulnerable to suffer most with the virus?
The elderly and people with underlying medical problems tend to have worse outcomes. They don’t have the capacity to fight this off because they have a weakened immune system. For people who have no medical problems and who are otherwise healthy and young, the virus does not tend to cause as many problems. For more than 80 per cent of people who get the virus, this is a flu-like illness and they can recover at home.
What are the conditions of patients being admitted to hospital?
What we’re seeing is patients who are dehydrated, have pneumonia and low oxygen levels. I work with the team to advise on what is the best way to care for them based on these symptoms and the severity of their condition.
What’s your role in providing advice on patient care?
I’m part of a provincial group of medical experts that is examining and reviewing evidence about different treatment options for patients with COVID-19. As it stands now, there are no proven targeted therapies against COVID-19. There are multiple antibiotics and multiple different compounds that are being studied to see if they are effective. We now provide supportive care to patients with the virus. When someone is admitted to hospital, we make sure their oxygen levels are good. If they require a critical level of care, like a ventilator to help them breathe, they are taken to our Intensive Care Unit. If there is a secondary bacterial pneumonia, we treat that. We make sure they are hydrated and that their symptoms are under control. We are treating the symptoms and providing supportive care as opposed to targeted anti-viral therapy.
Describe the work of the NH team during the pandemic?
It has brought out the best in people, the willingness to help and to have each other’s backs. The teamwork is incredible and people have pulled together and are willing to help 24/7. Our team is providing excellent supportive care to patients and it has been inspiring to see patients recover and be discharged from the hospital. That is a testament to the great supportive care being provided by the team on our COVID-dedicated unit, Intensive Care Unit and Emergency Department.
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