The calm before the storm
Posted on Thursday, April 9, 2020
As the number of diagnosed COVID-19 cases in Ottawa continued to rise in April, we checked in with Dr. Lorne Wiesenfeld, vice-dean of Postgraduate Medical Education at the Faculty of Medicine and a practicing emergency physician at the Ottawa Hospital.
What thoughts were going through your mind before you started your shift in the emergency department at The Ottawa Hospital this past weekend (April 4-5)?
My thoughts were: One, we’re fortunate we're in Ottawa. I look across the world, where other frontline health care providers don't have the luxury of having personal protective equipment. We're not there yet. Maybe we will be. And I cannot imagine the personal, moral dilemma I’d have, if I had to care for somebody and I didn't have any type of protective equipment. This infection is so virulent, in being able to spread, that I know that I would inevitably get ill, and then in mere days I would not be able to help anybody else. So I'm feeling fortunate that, at least for now, we have not had to say: No, you go in without a mask. Or without any gowns.
I think of the healthcare providers who’ve become ill and those who’ve lost their lives in in other countries such as the United States, or in Europe and China, just to name a few. And I think of my family. I'm 51 years old. That puts me at a higher risk. But I do have a duty to serve. I have an ethical obligation to care for patients to the best of my abilities.
What was the situation like in the emergency department this past weekend?
There’s a lot of avoidance of the emergency department of hospitals during this time; patients are staying away. If they can stay away, that's great. We do worry that somebody who might be having a heart attack chooses to stay away, and becomes more ill, or succumbs to their illness at home. We don't want people to do that. But are volumes are down. We are seeing fewer patients.
I think this is a calm before the storm. Since this virus is spread so easily, I think it's out there in our community. The social distancing is taking effect, and it’s taking time for cases to multiply. But it's only a matter of time before our volumes catch up and we'll see the larger numbers of patients, and these patients will be sicker.
What do you do when a patient comes into the emergency department, who could be COVID-19 positive?
When we see somebody with the symptoms, like a fever and a cough, in the emergency department, we do the necessary test to see if it's COVID-19. We don't get the swabs back on our shift; so for us, they are all presumed cases. There are people being admitted with what we think might be COVID-19, or it could be influenza or just or regular bacterial pneumonia, which is common enough or a combination of these conditions.
When we're seeing any patient with COVID or potential COVID infection, we're wearing a mask, of course. And a gown, which we don't normally do. And we also wear full gloves and so there's no exposed skin or minimal exposed skin. We are more vigilant. It is causing more stress in the hospital because patients have to be kept as much apart as possible from other patients, because you don't want the infection spreading to those who don't have it. It is very stressful to our patients and since late March, because of COVID-19, patients are not allowed visitors.
What can people in the community do to support you and your colleagues in the hospital?
We are very appreciative all the support the community has given us. Walking to the hospital and seeing a hand-painted sign saying: “Thank you very much to healthcare workers,” really, really helps. Different restaurants and people are providing free meals. Just those little things really make a big difference and really raise the morale of everybody here.
When I walk around Ottawa on my daily walk with our dogs, I do see that people, for the most part, are practicing social distancing. People are staying at home. People are vigilant of their activities. And I'm hoping that we flatten the curve so that whatever illness is out there, it will be spread out over a longer period of time, so that we can absorb it much better.
A big thank you to those who are doing social distancing. And a big ask to those who don’t think it’s important: You're not just putting yourself and your loved ones at risk — you’re putting us at risk. Putting my family at risk. So please, this is serious.
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