Dr. Sanjiv Gandhi speaks on COVID-19, public health, and preventive care

He emphasized education and clean air are key pandemic responses

Photo of a woman putting on respirator
PHOTO: Sora Shimazaki / Pexels

By: Michelle Young, Editor-in-Chief

“Scientifically and objectively, we’re really still in the midst of this pandemic,” said Dr. Sanjiv Gandhi in conversation with Protect our Province BC. “Emotionally, much of the population — I think to no fault of their own — is in a different place.” On February 3, the grassroots organization hosted an online seminar with Gandhi to discuss the current state of the pandemic and BC’s pandemic response. 

Gandhi, who specializes in pediatric heart and lung surgery, recently left the BC Children’s Hospital and joined the BC Greens as their deputy leader. In an interview with The Tyee, he cited his reasons for leaving the medical field as a toxic work environment and “the health authority’s positive narrative,” as a barrier to providing patients with proper care. He has been a vocal critic of BC’s current healthcare policies. 

“Some would say we need to move past COVID-19 and ‘learn to live with it,’ but I think this thinking really demonstrates a fundamental ignorance and lack of education,” Gandhi continued. “That’s unfortunately been an approach that’s been encouraged by a government that hasn’t been honest with British Columbians about the virus, how it spreads, and how to protect ourselves.” 

In regards to BC’s pandemic response, Gandhi said one of the biggest mistakes, “can be traced back to a failure to adapt to a changing science, which should have been used to educate the public properly.” This includes lagging information on COVID-19 transmission, incomplete mask guidance, and a lack of recognition of long COVID from public health. 

“Polls suggest that voters don’t particularly care about COVID-19 anymore, but it really needs to be science, not polls, that guides public health.” He cited the increasing death toll of COVID-19, noting more deaths have occurred from acute COVID-19 in 2022 in BC than previous years of the pandemic. Acute COVID-19 refers to the stage of infection that involves symptoms which would typically resolve on their own, rather than a chronic condition like long COVID. “Those numbers don’t include people who have suffered from other medical issues because of previous COVID-19 infections.” 

Gandhi explained the importance of preventative care and acknowledging COVID-19 as an airborne disease. “‘Preventative’ means not getting the disease in the first place. Wear a mask before you get sick.” He described “spraying a can of mace in a room,” as a way to understand the lingering nature of airborne disease. “It doesn’t leave immediately — you can walk into that room a few minutes later and your eyes are going to burn and your lungs are going to sting — and COVID-19 is just like mace.” 

He added our ability to control respiratory illnesses will be dependent on our ability to “improve air quality.” This includes measures such as CO2 monitors and air filtration devices. Gandhi said the airborne nature of COVID-19 is a “fact not up for debate, the inability of the government to state that categorically is, I think, politically based. Acknowledgement of that fact would make them culpable for their inaction on measures.”

Measures to prevent airborne disease are not only applicable to COVID-19, but will also prevent the transmission of future outbreaks. “We stop waterborne diseases with clean water, so stop airborne diseases with clean air — it’s not just about COVID-19 — it’s about the nature of airborne diseases.”

Gandhi also spoke on the false theory of immunity debt. This theory claims the early pandemic response is to blame for the recent influx of respiratory illnesses, because measures such as social distancing and using masks “understimulated” the immune system. However, it’s not a theory formally recognized by immunologists. “Never, ever, have we promoted illness to promote wellness.” 

In 2022, McGill reported that the idea of “immunity debt” largely stemmed from a single 2021 scientific paper, and has since been critiqued as lacking evidence. Global News also reported the paper as being misinterpreted. Other doctors noted immunity does not require constant exposure to viruses, as the immune system wouldn’t become less effective over time “on its own.” Gandhi added this theory “doesn’t recognize the vascular nature of this virus and falsely concentrates on the acute respiratory symptoms.” 

Evidence for potential long-term health complications due to former COVID-19 infections has been quickly accumulating, explained Gandhi. Studies show long COVID can produce “dozens of symptoms across multiple organ systems.” This can include cardiac impairment in the heart, cognitive impairment, blood clots, erectile dysfunction, and irregular menstruation — among many other symptoms. A study in Nature reported that “symptoms can last for years.” Gandhi added, “The potential ramifications of repeated COVID-19 infections — for everyone — young, old, those with pre-existing medical conditions, and those that were previously healthy are significant.” Studies show repeated COVID-19 infections increase the risk of death, organ failure, hospitalization, and long COVID

“We need specific clinics with experts knowledgeable about this disease,” he explained. “We have these clinics for disorders whose prevalence is far lower than long COVID.” 

He said while the current pandemic response encourages people to “assess their own risk,” the public hasn’t been sufficiently informed on how to do so or understand the risk associated with a COVID-19 infection. If the BC Greens were elected, Gandhi said the party would first focus on “proper education, rooted in science, geared to empowering people to make informed decisions,” in addition to clean air, which Gandhi emphasized as a part of preventative medicine. 

“Clean air is not hard. You measure air quality, and when air quality is not up to snuff, you put air filtration devices in. There’s a variety of them out there.” CO2 monitors can measure air quality by providing a sense of how well-ventilated a room is. In spaces where there is poor ventilation, CO2 levels will be higher, and signify a risk of potential infection to airborne disease. To improve air quality, measures like ventilation and filtration can be taken. Ventilation allows fresh air to circulate into a space, whereas filtration can “reduce airborne contaminants including viruses,” by filtering the air already within a space. Masks, ventilation, and filtration all help to reduce the risk of COVID-19 and other diseases by providing better air quality. 

Gandhi said those who are still concerned with COVID-19 are not “obsessed” with it. He added, “I’m not obsessed with COVID-19, what I am obsessed with is caring about the health of people.”