ER physician drills down for possible second wave
Dr. Matthew Carere, 36
• Emergency-room doctor • Married, two children, ages 5 and 3
Emergency-room physician Matt Carere has been inspired by the rapid response to COVID-19 in Victoria, where simulations and preparations continue for a possible second wave.
At Royal Jubilee and Victoria General, he says, no stone has been left unturned.
“It’s crazy what’s happening here. Physical walls are being built on a daily basis. We’ve cordoned off areas. We’re inserting negative-pressure rooms. We’re changing the entire geography of hospitals, just to be ready for this.”
Carere says how rapidly the hospitals adapted made the pandemic feel real very quickly.
“When people are critically ill now and they’re coming into the emergency and if we don’t know their COVID status, we’re pretty much treating them as if they are likely to have COVID,” says Carere.
“It just adds one more layer, one more decision to an already very stressful situation.”
Previously, for example, an asthmatic child would be given medicine that would be humidified, but that procedure would aerosolize the virus, turning droplets into a far-reaching mist, “so we can’t ask a nurse to start that in the middle of the emergency room.”
Now, staff must don full personal protective equipment and put the child in a negative-pressure room. It’s the same for cardiac or kidney patients — the logistics are challenging.
Simulation drills could include an infant with breathing problems, a six-year-old with a seizure, patients with major traumas — all positive for COVID-19. “We’re preparing for all those eventualities.”
In the beginning, doctors were looking for coughs and fevers, then runny noses, headaches and muscle aches.
“Then it was vomiting and diarrhea,” Carere says. “You put those things together and basically anyone that comes into the emergency department has one of those things.”
Calming and connecting with ER patients is also tougher in a gown and mask. “Certainly with our pediatric patients, when they come in, you pull your mask down really quick and say: ‘this is my face’ to normalize the experience.
With reduced traffic in the emergency department as a result of the pandemic, he says, the level of care for sick patients is “quite excellent. Now we’re seeing heart attacks very fast. We see traumas right away.”
Carere says people who work in critical and emergent care tend to be risk-tolerant, but COVID-19 has caused everyone to change their ways. Many physicians shower at work so as not to bring contaminants home. “One doctor installed a shower outside of his house.”
Carere says he’s indebted to Vancouver Islanders for staying home and decreasing the patient volume.
“We have a low caseload on the Island, but if we had the pre-COVID volume in our hospital going on while we were trying to change everything and get ready, it just wouldn’t be possible. We wouldn’t be ready.”