‘We’re all really, really scared’
Front-line workers stretched ever thin as second wave gets fierce
The pandemic affects those who’ve fallen ill and those who love them, but it also burdens those who care for the stricken and see firsthand what happens in hospitals and care homes where people are sick and dying.
Every day, as health- care workers don their masks, gowns and other PPE equipment they wonder, too, if they will get sick and bring the virus home. And if they do get sick, who will take care of the patients?
As the number of COVID-19 cases passes the 344,000 in Canada, and deaths linked to the virus reach more than 11,600 in Canada, medical workers worry the health-care system will be overrun.
Nine months into the pandemic, burnout and illness are sidelining medical workers across the country. As provinces and territories wrestle with the second wave of COVID, some are worrying about a “third wave” — a coming crisis or shortage of health-care workers who are too exhausted, too burnt-out or have fallen ill with COVID themselves.
“In the next two weeks, that’s when we’re really going to start feeling that in our hospitals. We are very worried. We’re terrified,” said Dr. Shazma Mithani, an emergency room doctor in Edmonton. “It’s inevitable it’s going to happen and we just need to brace ourselves for it.”
She said restrictions announced by Premier Jason Kenney on Tuesday don’t go far enough, noting people are still allowed to gather indoors at large places of worship and in bars, casinos and restaurants.
She says the decisions don’t appear to be based on science, since contact tracing has broken down and up to 80 per cent of cases have no information about where they were contracted.
Physicians and nurses interviewed by the National Post say the high- water mark for the second wave has not yet been reached, but Covid-related occupancy in hospitals and ICUS across the country is rising.
In Alberta, the demands of the pandemic in combination with usual hospital traffic mean that multiple hospitals across the province are nearing capacity or well above 100 per cent capacity. As of Monday, 348 people were in hospital in Alberta with COVID, 66 in the ICU. The province announced it would create more designated COVID space in intensive-care units.
As of Tuesday, Ontario had 523 people in hospital, with 159 patients in ICU. In British Columbia, there were 284 people in hospital, and 61 in ICU.
“It becomes a daily struggle to find the right place to care for people and the right tools to apply your knowledge well,” said Dr. Kevin Smith, president and CEO of the University Health Network in Toronto.
Staff are feeling the strain, and fear longer wait times in crowded hospitals will mean worse health outcomes for patients.
“Let’s say the ICU is full. That’s a real risk right now,” said Mithani. “How do you make the choice about which person deserves a ventilator or an ICU bed more?”
While the spring wave saw a frantic scramble for enough medical supplies, equipment and hospital beds, this new wave threatens a shortage of trained people who are not as easy to find and replace.
Lonee Rousseau, a registered nurse and the vice- president of the United Nurses of Alberta local at the Royal Alexandra Hospital in Edmonton, said the demands during the pandemic has led to “moral distress” for workers.
“When you can’t provide the quality of care that you have in the past, it becomes that much harder to tell yourself you’re doing a good job,” Rousseau said.
One Edmonton emergency room nurse who requested anonymity said “everyone is just extra tense, extra nervous.” Her colleague, who also requested anonymity, because they feared a backlash from Alberta Health Services, said they worry they’re going to be unable to keep up. With workers off sick or to care for family or because of exposure to the virus, the “pool of nurses is getting smaller and smaller.”
“We’re all really, really scared about what the next — not even just the next couple weeks, it’s the next few days — we know that ICU numbers can increase by leaps and bounds in a matter of hours,” said one of the nurses. “We don’t know if we’re going to be able to keep up tomorrow or the next day, forget the next couple of weeks.”
Nursing unions say the staffing shortage existed long before the pandemic, and a number of people the Post talked to said the already tense relationships between medical workers and their provincial governments only add to the stress.
Nurses around the country are sounding the alarm. In Steinbach, Man., nurses have said patients are being forced to wait in their cars because there isn’t enough space in the hospital. The Manitoba Nurses Union has called for more staff.
In the province of Alberta alone, more than 3,200 health- care workers have been infected by COVID-19, according to self- reported data published by the Alberta government. Data from the Ontario government published earlier this month shows more than 8,400 health- care workers — from dentists to first responders to respiratory therapists to personal care workers — have caught COVID-19 since the spring.
Kerry Williamson, the executive director of issues management at Alberta Health Services, said less than one per cent of all AHS employees have tested positive. And while outbreaks at care homes and those in acute care have strained staffing, “positive cases in employees are not causing any significant staff shortages.”
“Any absences due to positive cases are being managed through scheduling or overtime as with any other absences,” Williamson wrote in an emailed statement.
“The thing with staff, if you’re full- staffed, you’re great, everybody shares the workload equally,” said Mithani, the Edmonton ER doctor. When there are people off for whatever reason — burnout, COVID — the same or more work is spread among fewer people, leading to more burnout, more illness. “It’s basically a vicious circle,” she said.
It isn’t just emergency doctors and nurses feeling the effects. When Dr. Christine Gibson, a Calgary family doctor, is deciding whether or not one of her COVID-19 patients needs go to the hospital, she will drive to their home and leave an oxygen saturation monitor in their mailbox for them to check their breathing.
“It’s so busy,” Gibson said. “This is the forgotten part of the pandemic.”
Family physicians are responsible, she said, for managing about 90 per cent of COVID-19 patients in Alberta — triaging COVID patients by severity, endless phone calls with them. Much of this work is unpaid.
“When we talk about burnout, it’s because we are really being called to go above and beyond what we would naturally do in our general family practice,” Gibson said. “I’m really tired, I’m really, really tired ... we’re just at the early stages of this wave.”
Right now in Calgary, the city and its hospitals are tracking a couple of weeks behind Edmonton in terms of the pandemic.
“The fear right now is that this is only getting worse and so there’s an anticipation, a dread anticipation, going on within our system,” said Dr. Joe Vipond, an emergency room doctor in Calgary.
His daily work in the emergency room means spending more time with those who come in with suspected COVID cases. He said visits seem to be slowing down for non- COVID- related illness, as people stay away from hospitals because they fear catching COVID.
“We really need to see people when they’re sick,” Vipond said. “There was this mortality bump (in May and June) ... basically due to people putting off hospital visits for illnesses when they should’ve (come in.)”
Everyone seems to be anticipating the challenges over the next few weeks, as hospitalizations lag spiking case counts. Vipond said he’s seen two COVID- 19 deaths recently.
“And that may seem like, whatever, you’re an emerg doc, you see death,” Vipond said. “But this is different. And so fast. And we just know that it’s going to get worse.”