Alexandra Martiniuk is a Professor of Epidemiology at the University of Sydney, an Adjunct Professor at the University of Toronto and an Honorary Senior Research Fellow at the George Institute for Global Health in AustraliaPicture of Alexandra Martiniuk

“It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness….” (Dickens, 1859).

It has certainly been the winter of despair.

We are 4 sisters. An epidemiologist, an ED doc, a GP and a teacher. Between us we have 14 children.

As kids we grew up in Victoria and Ottawa. After university I moved to Sydney, Australia, while Anastasia hunkered down in Edmonton, Shauna stayed in Toronto after medical school and Kristianna set up a practice in Oakville.

At time of writing on January 28, 2021, there are 57,743 active cases of COVID-19 in Canada with 4,000 hospitalized. Cases in Australia number 106 – all overseas arrivals, 21 of whom are in hospital and the rest in guarded hotel quarantine. Since the pandemic began, Canada has seen 19,564 deaths from COVID and Australia 909.

ALEXANDRA: Today there was an easing of restrictions in Sydney as we come out of our “second wave” of 122 COVID cases in New South Wales. Our 4-week lockdown worked, and we are back to 0 ACTIVE cases. Genomic testing showed that the second wave was due to an American strain which must have escaped from hotel quarantine or been transmitted from airline staff, a diplomat or a movie star who previously had special permission to quarantine at home. After this small second wave, quarantine for all returning passengers now occurs in a guarded hotel for 14 days.

Australia Day was this week, marking the end of summer holidays. School starts tomorrow, face to face. This is a relief after we home-schooled for 7 months last year to protect our newborn baby (though schools only closed for 2 months). 2020 was a good year to focus on our newborn, but I felt dismay that as an epidemiologist I could not assist NSW Health in their COVID efforts.

I’m working from home currently which suits the breastfeeding schedule of the baby well. After work and day camp, we will head to the library where we’ll sign in using a QR Code (for contact tracers if needed) and will don masks. It’s been five years since we’ve seen family, but for now, we clutch the $15,000 plane tickets to Canada and Europe that we bought in May 2020 to visit our 80-year old grand-parents and siblings until… it is safe to travel.

KRISTIANNA: Today I headed out to run, while my husband set up to teach high school from the living room and our adult children jostled for space at the small table for their online university classes.

After the run, I went to the office where it is challenging to teach my McMaster University residents how to assess and treat patients in person, by phone and by video. Our practice is seeing patients suffering from worsening mental health symptoms, with more new presentations in youth. We are supporting many families who are rallying together to keep their medically complex, frail elderly parents at home because of fears of sending them to long-term care. These patients and their families need enormous support. We are also caring for our elderly patients who live in retirement homes and have contracted COVID.

After the office day and some dinner, I head out again to co-host a town hall with the Halton Medical Officer of Health regarding vaccine roll out. Ahh – then bed.

SHAUNA: My husband wakes at 5.30am to operate and see patients who need to be seen, pandemic or not. Today, I have a late shift in the ED.

High school is virtual. Kids wake at 08:44, roll over in bed and turn on the Zoom or BrightSpace class to begin at 08:45. The university-aged kid is still asleep. I am trying to give her a first-year university experience! No Grade 12 grad, no Prom, no residence, no university life. The kids have joined some afterschool clubs, like teaching first aid online, adding another virtual meeting to their day of screen time. Gone are the highlights of driving to hockey and soccer, school meetings, and high school parties. Now we just look to see what package has arrived at the door.

It’s January, and new bike lanes enable a socially distant commute. Volumes in the ED have fluctuated during this pandemic. Today, there is a line up for triage and a busy waiting room. Few spaces to see patients. An older woman arrives from home. Vital signs absent. Known SARS-CoV-2 positive. We run a code. I am on airway and intubation. She doesn’t make it.

I run across the street at shift’s end so I don’t miss getting my second COVID vaccine. I feel a wave of relief with that needle in my arm. There will be more codes to run in shifts to come.

ANASTASIA: In Edmonton it’s -20°C today. My husband and I and our three children (10 months to 8 years old), each grab a new cloth mask from the bag near the door before heading out. Putting the mask on at home is much better than freezing our hands fixing the masks on outside school. We are happy wearing our masks – how warm they are!

Each class enters from a different door. Their teacher greets the children, spraying their hands with sanitizer.

Our gyms are closed, so our new treadmill sits prominently in our living room. I run while my baby naps. But I do miss the social aspect of the gym. Then it is time for half-day kindergarten pickup. With my husband now working at home, there is no need to wake the baby mid-nap for school pickup.

Beside the school there is a park, skating rink and tobogganing hill. Everyone is becoming a very good skater! This is everyone’s social time, parents included. There is a lot of hand sanitizing. Some people wear masks, and some don’t. We have discovered that masks get very wet when playing outside in the winter, so I am not sure how useful they are.

After dinner, because there is no evening soccer practice, there are lots of board games, card games, soccer in the basement and playing with the baby. There is no need for babysitters and no need to put gas in the car.

COVID-19 has been the best of times. We’ve had more time with our spouses and our children, less commuting and less running from event to event. We love attending a seminar while taking a walk outside, having our adult university students returning home to complete their online studies and chess games over zoom between cousins in Canada and Australia. COVID has strangely brought us closer together despite being far apart.

COVID-19 has also been the worst of times. We worry about everyone’s health and safety, some of us have financial difficulties due to lost jobs, the teenagers are missing their important social development and we missed celebrating Dad’s 80th birthday together. Our health has gotten worse as some pharmaceuticals have critical national shortages and we are reluctant to seek medical care for fear of catching COVID. Our Mom loves babies but has yet to meet her last two grandchildren born in 2020.

It was the age of wisdom. Australia acted quickly and decisively to curb the spread of SARS-CoV-2, shutting borders (inter-state and international), instigating mandatory 14-day hotel quarantine, ensuring high testing rates in the community and announcing full lockdowns early before COVID went exponential. Globally, vaccine development has been astounding and Canada has already started rolling out vaccines (Australia begins late February). Two of us have already received our vaccinations .

It was the age of foolishness. The underfunded, ‘modernised’, Canadian public health system had poor contact tracing abilities. Canadians continued to fly to winter in the USA in 2020 and 2021, bringing home the virus that ravaged their communities; travelers from the UK, South Africa and elsewhere introduced variants of concern. At the beginning of the pandemic, there was a lack of PPE globally (Kristianna receiving sewn gowns from her patients), reticence to state that COVID is airborne, COVID infection parties, and herd immunity dreams in some countries and social circles, leading to large numbers of infections and greater opportunities for the virus to mutate. It was certainly, and at times continues to be, the age of foolishness.

It has certainly been the winter of despair.