Thu. May 26th, 2022

Moira Wyton, Local Journalism Initiative Reporter, The Tyee – | History: 357191

Record numbers of pandemic cases and hospitalizations are already sending Vancouver hospitals in a state of emergency, with staff sick, too many COVID-positive patients to allow isolation and overcrowded emergency departments.

Contact tracing for cases and exposures between staff and patients at Vancouver General Hospital has stopped, according to a recent email from a senior physician shared with The Tyee.

“Individuals are therefore not informed that they have had a contact,” the doctor wrote last week, noting a number of new positive things among nurses and doctors. “Each of these people may have had dozens of contacts in the previous days. Many of these contacts do not know they were a contact.”

Doctors and residents have also been asked not to encourage wearing N95 respirators in the hospital despite limited isolation and test measures in place, according to another doctor at the hospital.

And at Lions Gate Hospital in northern Vancouver, patients who have COVID-19 or later test positive flood the emergency room with nowhere to isolate themselves while waiting to be admitted, according to a nurse. Many are older.

On Thursday, a record 534 people were hospitalized with COVID-19, surpassing the previous peak of 515 patients in April. Modeling suggests the number could rise to 4,000 at the hospital by the end of January.

Two healthcare professionals told The Tyee that staffing and infection control are already collapsing due to more patients and isolation of staff as hospitals prepare for a deluge of patients in the coming weeks.

From Jan. 3 to Jan. 9, health care workers missed 27,937 individual shifts due to all diseases, including COVID-19, with 5,183 of them in Vancouver Coastal Health, according to Department of Health data provided Tuesday. About 3,800 guards are missing a day among more than 120,000 health workers in the province.

Vancouver Coastal Health did not disclose the number of unanswered guards at VGH or Lions Gate Hospital when The Tyee was asked.

Health Minister Adrian Dix said this week that the province is looking at a field hospital “if necessary” at the Vancouver Convention Center, but he did not specify how it would be staffed.

Frontline employees are concerned about the rapid spread of Omicron and the exhaustion of staff.

“The fact that [Omicron] is milder, it does not help hospitals when the case is so high, ”said a doctor at Vancouver General Hospital who was not authorized to speak in public. “But this is not the first wave; we do not have the energy we had in the beginning.”

On Monday night, 26 of the 46 patients to be admitted to Lions Gate remained in the waiting room or hallway overnight after the hospital’s 20 intensive care beds were filled, according to the nurse, and a scheduling email shared and confirmed by The Tyee.

The emergency room nursing team had 10 nurses that night instead of the usual 16, and beds in other units where patients would normally have been sent were closed because staff were on sick leave, the nurse said.

“Spending the night in the emergency room at the best of times is awful … but having to spend the night in the waiting room as an elderly person is even more of a problem. It exacerbates their illness,” the nurse said in an interview.

“We are not able to provide the level of care we would like to provide. We are not able to get in touch with patients or make them feel safe or heard. And having to pull some plastic curtains around if someone in the waiting room to toilet them is just degrading. ”

Tyee does not name the nurse because they were not authorized to speak in public.

Lions Gate’s four appropriate isolation rooms for airborne protocols required by COVID-19 patients are almost always full, the nurse added. And tests for the virus ordered at the hospital often do not return until hours later.

“We often have patients who are COVID-19 positive who spend hours or even a day in the emergency room,” they said. “They have short staffs upstairs and close beds so everyone backs up in case of emergency.”

“This is the worst it has ever been,” said the nurse, who estimates that as many as 15 colleagues have left the emergency room since July either to change professions or to work as nurses elsewhere.

In a statement, a spokesman for Vancouver Coastal Health said “hospitals reflect what is happening in our communities, which means we are still seeing COVID-19 cases.”

The statement did not address an issue of protocols taken to address the reported shortage of bed and staff at Lions Gate or Vancouver General, but said beds are opened and closed daily based on needs and staffing levels.

“This process takes place throughout the year and is not specific to COVID-19 related staff shortages.”

The Vancouver General physician described similar staffing challenges. At least two shifts in the last month have been understaffed, and several other shifts have required all backup options to be completed.

People work longer hours, get in on days off and return to work after only five days of COVID-19 isolation because several units are understaffed.

Staff with children or other household contacts who have tested positive are also allowed to work if they do not have symptoms when they would have previously been referred for isolation.

“It’s just exhausting and everyone is working at 110, 120 percent of their capacity and I think it’s harder just knowing it’s an unsustainable level of work,” the doctor said. “Maybe something terrible has not gone wrong yet, but it is inevitable that it will.”

“I’m anxious about whether the cases continue to get worse and with even more patients and staff illness … I do not really know how long it can continue to be.”

The doctor and colleagues have informally encouraged their team to wear KN95s or N95 masks whenever possible.

But management has ruled out the need for the masks, which increases anxiety as contact detection for cases at the hospital has ceased, the doctor said. “I was told over the weekend that the hospital is not conducting any contact tracking for positive COVID-19 cases,” they wrote.

Many patients have also been tested positive for the virus after being admitted for other problems, which has revealed several staff members who do not have the resources or space to isolate potentially positive patients while awaiting test results.

The doctor said at least two colleagues who did not wear N95 masks had been infected by COVID-19 patients in recent weeks.

Contrary to parts of the email shared with The Tyee, Vancouver Coastal Health said in a statement that it still provides hospital testing and follow-up on cases, but did not specify whether routine testing of all new patients had stopped.

N95 masks are worn in high-risk environments, the statement said, especially during aerosol-generating procedures with patients who have confirmed or suspected COVID-19 cases.

“VCH has been consistent in its approach to PPE, which is in line with the most current provincial guidelines,” the statement said.

But the doctor said without routine testing and with a high risk of infection throughout the hospital, “it has been frustrating to feel that we can not fully take steps to protect ourselves.”

The province’s health officer Dr. Bonnie Henry has downplayed the importance of wearing an N95 mask or the increasing risk of aerosol transfer.

The BC Center for Disease Control’s current infection control protocol document on masking also does not mention aerosol transfer and only recommends the use of N95 or similar masks when the risk of transfer is high.

Dix has said all health authorities have protocols in place to call staff back from vacations and days off and extend shifts if other employees are sick.

Both the nurse and the doctor stressed that they had not witnessed a staff level they considered unsafe and said all their colleagues and supervisors are working hard to keep things going.

But they expressed deep concern about how much longer they and their colleagues could continue to work at this pace and who will leave the healthcare sector because of this experience when the pandemic eventually disappears.

“It’s just a matter of time before people burn out,” the nurse said.

“The system is mainly supported by people stepping up and being willing to take extra shifts for colleagues … that’s what we all feel responsible for doing,” the doctor said. “We do it just because we have to, and we do not see many alternatives.”

Leave a Reply

Your email address will not be published.