Doctors, nurses and other health-care professionals across the country are trying to prepare for what comes next in the battle against the coronavirus,
Stress level rising for health-care staff who know pandemic deluge is coming
Not all heroes wear capes, as the saying goes. But even as they are being hailed as heroes, that label does not rest easily with some front-line health workers waiting for the worst of the COVID -19 pandemic to hit.
“Many of us don’t feel like the heroes people say we are. We don’t want to be in this situation. We want to stay home and hide inside, safe, just like the public. But we have mortgages and bills to pay and our families to support,” wrote an Eastern Ontario critical-care nurse who communicated with the Citizen on the condition of anonymity.
As the wave of the novel coronavirus pandemic has slammed its way around the world, Canadian front-line health workers have been watching and preparing. And worrying.
As cases, and deaths, begin to mount across Canada, many are coping with real anxiety, even anger, mingled with determination to meet the challenge — probably the most difficult of their careers. Fears that they will not be properly protected, because of growing shortages of protective equipment, have ratcheted up those worries as hospitals begin rationing masks.
“At this point, I would say a lot of us have progressed from feeling tense or anxious about the situation to just plain fearful. We are scared,” wrote the nurse.
Behind the scenes, nurses, doctors and other front-line medical staff are having anxious conversations with colleagues and loved ones.
What will the peak look like? How will the health-care system cope? Are they prepared? Will they be properly protected? Will they pass the coronavirus to loved ones and patients? Some nurses are discussing whether they will continue to work if they aren’t properly protected.
As they ask these questions, they watch health professionals in Italy and elsewhere coping with collapsing health systems, and hear reports of deaths of health professionals.
Some doctors, including in Ottawa, have sent their children to live with relatives to protect them from possible contamination. Many now assume they will become infected at some point. Dozens across the country already have.
For some, the waiting is the hardest part.
“It feels a bit surreal, to be honest,” says Alan Drummond an emergency physician at Perth hospital. “It is hard to know what is going to come.”
It is being called pre-traumatic stress disorder — the psychological and emotional trauma caused while anticipating the worst — and it is real, says Dr. Mamta Gautam, an Ottawa psychiatrist who specializes in physician wellness.
“We know there are going to be difficult decisions ahead. These are the kinds of things people are talking about.”
Gautam began holding free daily online group peer support sessions for physicians this week. The meetings allow front-line physicians to talk about anxieties and coping strategies during the pandemic. Gautam said she has been surprised by the response. Five hundred people have asked for the link to the daily meetings and up to 40 physicians a day are joining the sessions.
Gautam points out that fear and anxiety are normal human feelings. It is important that frontline health workers express those concerns and support each other, especially now.
“The more we can allow it, it gives us the ability to have those feelings then move forward and do the best work we can.”
Caroline Gérin-Lajoie, executive vice-president of physician health and wellness at the Canadian Medical Association, is also hearing from physicians anxious about what is to come.
“There is no roadmap for this,” she says.
For front-line workers, including Drummond, and Dr. Nadia Alam, the immediate past-president of the Ontario Medical Association who works as an anesthetist in Georgetown, waiting for the unknown is tough.
“When we hear what our colleagues are facing in New York City or Italy, the message is that it is not going to be a gradual ebb and flow, but that they will suddenly show up on your doorstep and you will be flooded,” Drummond said.
That will be true of smaller hospitals that don’t have critical-care beds as well as the big, urban centres.
“Most of us are taking that understandable anxiety and channelling it into positive action. But the waiting is on the minds of our staff, notably our nursing staff.”
Anxiety is palpable, especially among nurses, said Drummond, because they have been getting unclear and changing messages about personal protective equipment from health-care leaders. Now masks and other equipment are being limited.
“You can see it playing on the minds of our nurses now.”
Drummond said he has had some worried conversations with his wife about what could be coming and the risk to him, especially as a front-line emergency physician in his 60s.
“She would like me to find another line of work right now, but I just can’t. I understand the level of concern and anxiety, but this is the way it has to be. This is the job I have signed up to do.”
He and others talk about the battle against COVID -19 as a war effort that will be fought on the front lines of the health system.
“Bad things happen to nice people and you have to deal with it. I can’t change what is going to happen, but we are just going to have to get up in the morning, put on our gear and do the best we can. If we get overwhelmed, we get overwhelmed. All we can do is our best.”
Alam is also watching for what is coming.
“We know that this is just the tip of the iceberg that is coming toward us. A lot of us are bracing for the impact. There is a lot of anxiety because we don’t really know what this is going to look like.”
Like Drummond, Alam believes it will be almost easier when the waiting for the worst is over.
“Physicians are generally people of action. Once the action comes, we roll up our sleeves and get to it, even if it is overwhelming. But the waiting and the anticipation, coupled with the horror stories that we are hearing, we really don’t know how to deal with it.”
Meanwhile, Alam, who is a mother of four, is already working hard to protect her family. She has not seen her parents, who are elderly and immunocompromised, in weeks.
And when she arrives home from work, her four-year-old daughter shrieks and runs toward her only to be intercepted and held back by her husband. Alam does not hug her children until she has changed and showered and put her clothes in the wash.
Meanwhile, the Canadian Medical Association is offering peer support and advice to anxious frontline physicians. It includes advice about learning how to be flexible and to prepare to “sit with a bit of discomfort” for awhile during the pandemic, to prepare for a marathon and to pace themselves, and to practise kindness to others.
The CMA also encourages physicians to regularly check on how they are feeling and to do something that helps them to keep up their spirits and recharge.
“What is hard is the unpredictability and the uncertainty. We just don’t know what pattern the wave is going to take,” Gérin-Lajoie said. epayne@postmedia.com