‘Sicker and younger’: Toronto ICU faces pressure in third wave of COVID

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Click to play video: 'Ontario hospitals forced to reorganize staffing as COVID-19 cases push them to the edge of capacity'



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TORONTO⁠ – Critical care nurse Jane Abas assesses her patient, checks her medications and monitors her heart rate.

The 68-year-old woman tested positive for a variant of COVID-19 shortly after arriving at Humber River Hospital in Toronto for an unrelated health problem. Her condition rapidly deteriorated and she had to be placed on a ventilator, suffering from cardiac arrest after the intubation process.

Abas says the woman is more stable this morning, but as cases involving variants of the new coronavirus increase, a patient’s situation can change quickly. The day before, another COVID-19 patient in a similar condition – who had just retired last month – died. She says it happened quickly.

“We tried to bring them back, we couldn’t,” she recalls. “It was so sad.”

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RN Jane Abas cares for a COVID-19 variant patient who is intubated and on a ventilator in the intensive care unit at Humber River Hospital during the COVID-19 pandemic in Toronto on Tuesday the 13th April 2021.


THE CANADIAN PRESS / Nathan Denette

Abas and his colleagues are exhausted, but they know the third wave of infections continues to increase. Claire Wilkinson, another intensive care nurse treating a patient in the next room, says she is noticing the increase in the number of critically ill patients.

A few minutes later, across the room, intensivist Dr Ali Ghafouri begins to rally team members for an immediate intubation procedure. A 60-year-old patient who arrived in the emergency room earlier in the morning with shortness of breath is struggling to breathe.

A team of medical personnel quickly donning head-to-toe personal protective equipment storm the room with supplies and medicine, working swiftly to heal and reassure the frightened man as he longs to breathe.

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This is a situation that ICU staff at this hospital say they see on a daily basis. The procedure is traumatic for patients and can leave them in an induced coma for weeks.

Ghafouri says it’s an illustration of life on the front lines a year after the start of the pandemic. Today, so far, it’s a little quieter than the day before, when Ghafouri says the team had to intubate four patients, one after the other.

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“This is what life is like here,” says Ghafouri. “People are getting burned out, including myself and some of my colleagues. We don’t know how long this will last. “

It is a struggle for doctors and nurses in intensive care units across the province.

A year after the start of the pandemic, staff at Humber River said they now have more experience treating the disease, but the relentless pace, staff shortages and much younger patients are weighing heavily on them.

“Patients who come in sick with COVID are much more acute,” says Raman Rai, who manages the ICU. “They are sicker and younger, which is difficult for the team to see that.”

The increase in the number of cases has strained the capacity of intensive care across Ontario, prompting discussions about the possible need to triage life-saving care.

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There are about 50 intensive care patients in Humber River on Tuesday, more than 60% of them with COVID-19, Rai says. Staffing has become a challenge as exhausted nurses seek time to rest. Transfers from other units have helped ease some pressures, but Rai says she still worries about staffing, especially the lack of nurses trained in intensive care.

Across the province, there were 644 patients with severe illness from COVID-19 in intensive care beds on Thursday, according to Critical Care Services Ontario.

Hospitals are reducing all non-essential surgeries this week and moving sick people from one jurisdiction to another. The government has pledged to create up to 1,000 additional intensive care beds in response to growing needs.

ICU workers, especially in hard-hit Toronto, are witnessing the human side of the startling numbers.

In Humber River, after any serious development involving a patient, Olivia Coughlin walks away to make a call. As a unit social worker, she is the point of contact for the families of critically ill patients who cannot be at the bedside of their loved ones.

Family visits are allowed, although many parents cannot visit them because they are also positive for COVID-19. Coughlin says the emotional support job was more difficult than she had expected.

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Ontario hospitals forced to reorganize staffing as COVID-19 cases push them to the edge of capacity



Ontario hospitals forced to reorganize staffing as COVID-19 cases push them to the edge of capacity

“It’s really horrible, there’s no better way to put it,” she said.

She has a desk to make phone calls, but today she calls a family from the living room of the ICU, a few feet from the patient’s room.

“I know they’re sitting at home around the phone waiting for this update,” she said. “I like to try to do my best to contact them as soon as possible.”

Like her other colleagues, Coughlin says she was struck by the young age of some of the intensive care patients who are arriving now.

The case of a previously healthy COVID-19 patient of her age – barely 28 – stood out for Coughlin.

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Two floors above the ICU, respiratory patient Jose Garcia is feeling much better after being admitted to hospital two weeks ago with COVID-19 straining his breathing.

He’s still taking oxygen after a frightening battle with the disease which at one point thought he was killing him.

“The doctors helped me like crazy,” says the 67-year-old Brampton, Ont., Resident from his hospital bed.

Garcia does not know where he caught the virus. He is retired and he wears a mask when he goes out. Other members of his family have also been infected with COVID-19.

However, he doesn’t dwell much on his illness, repeating his rush to return home once he’s tested negative for the virus. His message to others: take the virus seriously.

“People have to be careful,” Garcia says. “Anyone Can Get It.”

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© 2021 The Canadian Press

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