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The novel coronavirus pandemic has caused a global panic among the general public, as the number of confirmed cases continues to rise.
Earlier this month, Prime Minister Justin Trudeau urged Canadians to do their part by staying home and practicing self-isolation and social distancing whenever possible to help “ease the burden” of the coronavirus on the healthcare system.
While Canadians have been called upon to help flatten the curve of the virus, the country’s healthcare system faces its own challenge to increase capacity and secure enough resources to manage and treat the virus.
Yahoo Canada spoke to four healthcare workers to share their experiences and concerns as front line workers during the COVID-19 pandemic. They have all asked that their identities not be revealed due to instructions by their employers not to speak with the media.
With more than 10 years experience working as a nurse practitioner, Ashley* said she is used to working extra hours, often without compensation; the COVID-19 pandemic is no different.
“It has definitely been busy and at times all consuming,” she told Yahoo Canada. “There is a lot of uncertainty among nurses about how this is all going to pan out. We are gearing up, preparing for the worst, hoping for the best outcome, which includes flattening the curve and [admitting] minimal inpatients with COVID-19, so we don’t exhaust all of our resources.”
Prior to the outbreak, the hospital where Ashley works, like others in the area, faced consistent capacity issues . Ashley said she worries that unless we stop the spread of COVID-19 infection, the healthcare system will not survive.
Within the past week, all hospital employees where Ashley works are being screened upon arrival. With multiple tele-conferences and emails per day about the virus, she is balancing the protocol of the virus on top of her daily responsibilities.
“It’s difficult because I still have to ensure I’m delivering high quality care to the current patients I have and making sure they are still getting the same care that they are entitled to even without COVID-19,” she explained. “People will not stop being sick and needing healthcare just because we are in a pandemic.”
Ashley said she hopes Canadians are aware of how lucky they are to have access to quality healthcare, helmed by frontline workers willing to put in the time and effort to help stop the spread of the virus.
Thousands of nurses, doctors and healthcare workers across the country, some of whom are in retirement, have volunteered to help wherever possible.
“Everyone is stepping up to the plate and giving it their all right now,” she said. “I do have a family at home who also needs me. The extra time I spend at work is time away from them. Luckily, they are understanding of the role I play in this situation. They are also making sacrifices to ensure the safety and well being of us all.”
Sarah*, an intensive care unit (ICU) registered nurse in Ontario said she has serious concerns that the public is unaware of the strain the virus will put on Canada’s healthcare system.
“Our healthcare system was in crisis mode long before this virus even existed,” she told Yahoo Canada. “Now we are in a position where there is no wiggle room left. I fully expect to be treating patients in the hospital auditorium if people don’t heed warnings and help flatten the curve.”
Sarah said her biggest fear is that there won’t be enough ventilators for patients or personal protective equipment (PPE) for hospital staff. In 2003, 40 per cent of SARS cases in Toronto were made up by healthcare workers. Sarah is concerned the same will happen with COVID-19 if there are not enough PPE for frontline workers.
“If you look at numbers coming out of Italy we will be in the same boat within the next couple of weeks,” she said. “There is evidence that N95 masks are safest for healthcare workers to wear. The hospitals and Public Health Ontario, WHO and Centers for Disease control and Prevention (CDC) keep saying it's just contact droplet precautions, but this is the same mistake they made during SARS. Critically ill patients during that time became super shredders of the virus and many healthcare workers became ill.”
Earlier this month, the World Health Organization (WHO) issued a call for manufacturers of personal protective equipment (PPE) such as face masks, respirators, face shields, gowns and gloves to increase production by 40 per cent to meet global demand during the coronavirus pandemic.
During a March 18 press conference, Chief Public Health Officer Dr. Theresa Tam said there are daily meetings to discuss the logistics of securing equipment and that there have already been preemptive orders for ventilators on the federal level.
“The reality is there are global challenges in securing certain supplies and certain types of personal protective equipment,” Tam said. “What I do know is that of the personal protective equipment that is needed by Canada we can currently expect to meet those needs about at least 75% of the requests.”
Minister of Health, Hon. Patty Hadju, stated that Health Canada and the Public Agency of Health Canada has been working with the Minister of Procurement to place “large” orders of supplies.
“We know that even though the provinces and territories have indicated what they think they might need,” Hadju said. “In fact we may need more.”
Sarah anticipates significant changes to her work schedule, and is prepared to be potentially working at the hospital for extended periods of time, switching on and off with a “team” of nurses, but not going home. For now, she is doing her best to stay healthy and is taking added measures to avoid potential contamination.
“My front door has turned into a decontamination zone - scrubs and work shoes stay at work. My personal items don't leave the locker room,” she said. “Everything I wear and take in and out of the hospital gets wiped down and I shower before doing anything else. I wont stop to get groceries or even gas on my way home because I am generally concerned I could transmit the virus from being at the hospital.”
Mark* a registered practical nurse (RPN) in the greater Toronto area received his first suspected case of coronavirus six weeks ago. Despite the WHO’s advisory that the virus is spread through respiratory droplet contact, Mark said management instructed his team that all suspected cases of COVID-19 be on airborne, droplet and contact precautions as an added safeguard against transmission.
Initially, Mark said he was instructed to follow Public Health Ontario’s Infection Protection and Control (IPAC) directives and admit suspected novel respiratory infected patients to airborne infection isolation rooms (AIIR) formerly known as negative pressure isolation rooms. When there became too many suspected COVID-19 admissions, patients were given single rooms with the door closed, as is IPAC protocol.
Despite multiple admissions due to suspected coronavirus, at time of publication, Mark said there has yet to be a confirmed case at his facility. He worries what may happen without a concrete plan of action or a designated COVID-19 unit to treat patients moving forward.
“Not one person of influence wants to put anything in writing as a template to go on. It was, and still remains a pass the buck situation,” he said. “We’re now in a position where nurses are having mixed assignments, caring for patients that are mixed [suspected] COVID-19 and non-COVID-19 patients.”
Although healthcare workers are on the frontlines of fighting the virus, some admit they struggle not to give in to the public panic. Monica* an advanced care paramedic told Yahoo Canada she has been “constantly anxious” since the virus outbreak which has taken a toll on her day-to-day routine. Although working as a first-responder is already considered a high-stress profession, Monica said she has had trouble sleeping and has a lack of appetite.
“I’m constantly faced with both sides of the spectrum,” Monica said. “There are people who are not taking this seriously at all... and there are people that are inducing panic in me.”
Although she said it has been “beyond frustrating” to see the public not taking the threat of COVID-19 seriously, she’s become nervous that she won’t have enough equipment to protect herself on calls.
“Today I went out and spent $100 on a p100, a heavy duty mask and a pair of heavy duty safety glasses because I fear we will run out of supplies- it’s just a matter of time,” Monica said.
According to Monica, she has noticed that supplies have gone missing from the service, which she believes is because of workers feeling the same panic as the public. The service she works for has sent several memos to staff to avoid hoarding supplies and to use them responsibly.
“I couldn’t take that anxiety of having to do a call without equipment so I bought my own,” she explained. “It’s a scary time. In times like these, I wish I wasn’t a paramedic.”
*Names have been changed