By Dr. Susan Shaw, Chief Medical Officer - seen at right, receiving her COVID-19 vaccination in Saskatoon on December 22, 2020
Last week was my turn to be the lead ICU physician in one of Saskatoon’s two adult Intensive Care Units. I usually love starting a week of clinical service, but as I went to bed the night before starting my shifts, I noticed I was feeling anxious and worried about what my week would be like and how I would make it through. We all are aware of the rising numbers and the challenges our front-line health care workers are going through right now.
As a critical care physician, I am used to seeing the worst. I have also looked after COVID patients before. But my anxiety was well-placed and the week shook me. The after effects of sustained case surges are creating immense strain on our health care workers and my colleagues. At the end of last week, the capacity in our ICUs in Saskatoon were at 160 per cent at St. Paul’s Hospital and 123 per cent at Royal University Hospital. While we face capacity challenges at the best of times, we are all facing additional burdens of illness due to COVID.
But in multiple ways the impact of COVID goes far beyond the numbers. Patients with severe COVID require much more time, energy and attention by all members of the ICU team including the kind of work that is difficult to quantify: the emotional and mental strain. That’s why the daily numbers don’t tell a complete story.
How do you measure time at the bedside for a patient whose breathing can make them feel like death’s door is cracking open? And when family can’t come in, our ICU staff stand in for our patient’s family at the most vulnerable moments of their life. Try that every day and tell me there isn’t an extra emotional price.
There is good news. Decisions we made early in the pandemic are helping us manage the surge. If we had not purchased additional equipment like dialysis and ultrasound machines, I would have had to make difficult ethical decisions last week about which of my patients received access to the best care.
The bad news is that the highly skilled people needed for work in an ICU don’t grow on trees and they can’t be purchased off the shelf. I am so grateful that colleagues from other teams and programs are supporting the team. And we are still at risk of being overwhelmed. We still may have to make those ethical choices. While there seems to be some flattening in our case numbers, our numbers remain too high. Our new cases per capita over the last seven days remain one of the highest in Canada. And Christmas time brings new risks. That, too, is the ugly reality.
The COVID vaccines bring new hope. As does a new year. And we still have a long way to go to get through this pandemic. So let’s make our New Year’s resolution to keep committing to the protections that we know save lives. At a minimum, we must wear a mask wherever and whenever required, wash our hands regularly, keep our bubble to only our household, and say yes to the vaccine when you are invited. After all the bad and ugly news this year, the good news is it’s that simple for you to save a life.