Here’s what Quebec doctors and nurses are seeing in the emergency room during the Omicron wave
The Omicron variant of the coronavirus may be less serious, but it is still causing an unprecedented wave of hospitalizations in Quebec.
In interviews, doctors and nurses across the province described how the new, highly transmissible variant has created new challenges as they try to provide care.
Nathan Friedland, a nurse who has worked eight of the past nine days at Lakeshore Hospital in Montreal’s West Island, said the emergency room was “overwhelmed”.
“We get so many COVID patients that we can’t properly isolate them,” he said. “ERs are not designed to withstand an outbreak like this.”
On Friday, the province surpassed 3,000 patients in hospitals with the coronavirus. The number of deaths has also risen to its highest levels since last January, with more than 400 in the past two weeks alone.
“People are still getting sick and even if they don’t get sick to the same extent, they still are, and those with comorbidities will likely die of it,” said Dr. Peter Goldberg, chief of intensive care at the McGill University in Montreal. University Health Center.
But there are also signs of hope, health care workers say, including in improved care and the effectiveness of vaccines in preventing serious illnesses.
Booster gives a boost
Proportionally, those who received two doses of the vaccine in Quebec are much less likely to end up in hospital, as has been the case elsewhere.
In Quebec, only 13% of people aged five and over have not received two doses, but this group currently accounts for 32% of hospital admissions and 46% of ICU admissions in the past 28 days, according to provincial ministry of health. This means that an unvaccinated person has been 13 times more likely to end up in intensive care during this time.
In a statement, the Department of Health said that “most often (but not always) the people who die and are properly vaccinated are people who have health conditions that make them vulnerable.”
The province doesn’t have a breakdown for those hospitalized with three doses, but several healthcare workers said in interviews this week that they’ve seen few to no patients who received a booster.
Dr. Joseph Dahine, an intensive care specialist at the Cité de la Santé hospital in Laval, said patients with COVID-19 at his hospital can be divided into two general categories.
The first is for unvaccinated people, many in their 30s and 60s, who were previously healthy. The other group of patients are older, mostly over the age of 70, with two doses of vaccine, and often presenting with existing health conditions.
Given advances in care, Dahine said his team was able to treat people faster, often without intubation, especially if they were vaccinated.
But, like others, Dahine noted that some patients who come for treatment for an illness seemingly unrelated to COVID end up testing positive.
“They usually have an exacerbation of their underlying disease,” he said.
Even if they don’t require the usual care needed by a COVID patient, precautions should be taken to ensure they don’t spread the virus further inside the hospital, he said.
Nearly two years into the pandemic, Melanie Jade Boulerice, an emergency room nurse at a Montreal hospital, said protocols have improved, as has the understanding of how to care for patients. But she said the workload took a toll.
“There is a high level of burnout. There is turnover,” she said.
Hidden cost of postponing critical care
The INSPQ, the province’s public health research institute, has published a report Thursday that projected hospitalizations had peaked or would do so in the coming days.
Yet pressure on the health system and staff shortages have created major challenges.
Already, many regions have reached the highest alert level, meaning surgeries and other crucial forms of medical care have been canceled.
“People who are supposed to be in intensive care aren’t,” said Dr. Michel de Marchie, an intensive care physician at the Jewish General Hospital in Montreal.
“People with cancer are not having surgery. People who were scheduled for heart surgery are having it postponed. People who were scheduled for hip surgery are suffering at home.”
In the long run, he says, “they are going to pay”.
While the first wave in Quebec largely affected older people in care, de Marchie said he now sees a range of ages in the hospital.
“The death toll, at least among Jews, is not as high as we have seen before,” he said.
Benoit Barbeau, a virologist at the University of Quebec in Montreal, said the next month will be difficult, even if projections suggest that new daily hospitalizations will gradually decrease.
“Even if the variant is not as pathogenic, due to the number of infected cases, individuals will be hospitalized and this will translate into more deaths,” he said.