Watching people die alone hardest part of pandemic: doctor
‘Window of opportunity’ now to ease restrictions after two years of public health measures
Relatives teared up behind a screen or glass barrier as patients took their last breaths in a silent hospital room.
Palliative care doctors such as Dr. Sarah Mcmullen desperately tried to relieve their symptoms by ensuring comfort at the end of life from a medical standpoint.
But the most traumatizing part for the palliative care staff, says Mcmullen, who works at Halifax’s Queen Elizabeth II Health Sciences Centre, became watching the relatives’ emotional pain. They watched from a distance as the critically ill COVID-19 patient slipped away while surrounded by strangers dressed in personal protective equipment (PPE).
“There were a lot of things we had to get used to when the pandemic hit. But I think the relatives or friends not being there with the patient was undoubtedly the toughest part. It was hard for everyone,” says Mcmullen.
“I don’t know that we, the staff, ever really got used to it. And after the first wave, amid the Delta surge, we had a tremendous attrition rate for intensive care unit (ICU) nurses. So, I think that was probably a big part of the challenges.”
‘SO MUCH UNCERTAINTY’
Mcmullen says the palliative unit before the pandemic was family focused, with relatives and friends surrounding their loved one and involved in the discussions and decisionmaking.
When the world shut down, the unit significantly changed to one with everyone on alert.
After work, Mcmullen would bleach her phone carried in a plastic bag, wash her clothes, and sanitize to mitigate any spread.
In addition, she took up regular exercise, crafting and keeping in contact with understanding friends to stay resilient in the face of uncertainty.
“Doing these things was key for me during the first wave of the pandemic when there was so much uncertainty. So, make sure to exercise and get outside and take joy in the little things because you never know when things will change,” she says.
“I have to say leadership and government stepped up early on and made it clear that the health and welfare of the frontline workers were vitally important. As a result, measures were put in place to protect staff, patients and the public.”
Mcmullen says every patient was treated with the same dignity and respect, regardless of their vaccination status. Although, she admitted some frustrations over the unvaccinated when patients started filling empty beds.
“The Delta variant is a killer. It is horrible. We had by far a worse mortality rate in the ICU with those infected with Delta, particularly in unvaccinated patients,” she says.
“These patients were sick as you can be and still alive. And unfortunately, despite the state-of-the-art critical-care equipment, a significant proportion of those affected with Delta died in the ICU. It was scary for us to see.”
She says palliative patients with the Delta variant suffered from organ dysfunction, and required more support and extended stays.
“These patients were sick as you can be and still alive. And unfortunately, despite the stateof-the-art critical-care equipment, a significant proportion of those affected with Delta died in the ICU. It was scary for us to see.” Dr. Sarah Mcmullen
The sickest patients were in the age bracket of 40. “They were incredibly ill.” The immune-compromised, obese, diabetic and unvaccinated were hit the hardest.
FRUSTRATION
After being on the frontlines and watching people die, Mcmullen says she feels frustrated when it comes to antivaxxers.
“There is a difference between anti-vaxxers and vaccine-hesitant. Although, I do feel like we’ve had vaccines for 18 months, and there is lots of data to prove they are effective. Some people haven’t gotten around to getting vaccinated for whatever reason,” she says.
“But I feel like most of us don’t have a lot of sympathy for those who have specifically and deliberately chosen not to get vaccinated, decided not to wear masks or take care of themselves or their loved ones as a result.”
Initially and upfront, there’s anger and shock, but that melts away at the bedside when dealing with the human in front of you, she says.
“It’s hard to watch somebody die, regardless of how they got there.”
Mcmullen notes she has a hard time respecting and understanding those who work in health care and refuse to be vaccinated.
“Why would you want to put yourself in a high-risk position with no support? It makes no sense.”
TIME IS NOW
As each province begins to ease COVID-19 restrictions, Mcmullen says this is a “window of opportunity” as all the tools are in place.
“I think we need to do it because we are at the time and place where the pandemic is hitting hard the mental-health systems. We know that vaccines work. We have an idea of the variants. And while Omicron is highly contagious, people don’t tend to get very sick with it,” she says.
“This is the time to end the restrictions and give people a mental break. But then, we will have to see how it goes. I think there will be an uptick in illnesses and hospitalizations, but, hopefully, we know how to deal with things, and hopefully it will become endemic.”
Mcmullen says working together and solidarity are crucial to protecting the population.
“I look at what is going on in Ukraine. You see the bordering countries in Europe
doing everything they can to help the Ukrainian citizens. People are putting themselves in harm’s way to help. Whether it’s taking them food, driving them from the border to somewhere else, or housing families, this is real solidarity,” she says.
“I think we’ve seen a lot of that during COVID. Solidarity and working together will get us through, which means getting vaccinated, wearing a mask, hand hygiene, and looking after others and yourself.”
That kindness, she says, needs to continue.
“When I think about the most challenging things of the pandemic, it is watching people die alone or watching people on the frontlines get abused because they are following the health guidelines,” she says.
“People at restaurants telling customers to put their masks on and then having rude remarks thrown at them is not helpful. We are all in this together. Think about your fellow human beings because it is the only way we are going to get beyond this, by working together.”