It feels like a typical morning. The kids are up at the crack of dawn. I stumble into the kitchen to cries of “I’m hungry, where’s my breakfast?”
Except it’s not typical. I think about the epidemic that has snuck into our world. Of the work doctors like me will be asked to do over the coming weeks. Of the risk we will all take to care for the sickest patients with the Coronavirus or Covid19.
I find myself wondering, “Are we ready for what’s coming?”
Covid19 is the greatest threat that physicians of this generation are facing. It’s faster and deadlier than the flu. There are 206 countries around the world. This disease began in December 2019 and within 3 months later, the virus spread to nearly all countries. Many health systems have been overwhelmed.
Conservative estimates suggest that 60% of the Canadian population will get sick – that’s 22.2 million Canadians.
The good news: the majority will recover with rest and isolation.
The bad news: 10–20% will get very sick and need hospitalization. That’s 2.22 to 4.44 million Canadians.
The scary news: 5% will need aggressive care and life support. That’s 111, 000 to 222,000 Canadians who will be so severely ill that they will be on life support for weeks. We have 3,170 ICU beds in Canada with a surge capacity up to 5,000.
Even if we conscript operating room ventilators as makeshift ICU beds, our hospitals will be overwhelmed. Because face it, appendicitis, fractures and heart attacks are not going to stop for this epidemic and many of our beds are already full. Canadian hospitals have already been operating at above 100% capacity right through the winter.
Doctors and other healthcare workers will be stretched in ways beyond imagining.
The government of Canada and the provincial governments have issued aggressive containment and social distancing measures. States of emergency. Travel restrictions. School closures. Cancellation of community events. The government has pledged financial assistance for those who can’t work.
People are asked to avoid crowds of any sort – parties, dinners, conferences, weddings, church gatherings and so on. Many museums and community places have shut down.
All of this, to slow down the exponential spread of the virus. Flatten the curve.
There is disbelief among some. No doubt, social distancing and containment are a huge inconvenience. For those who have invested in conferences, events, weddings, funerals and so on, this is a huge setback. The economic impact will be far-reaching.
But containment and social distancing works.
If I get Covid19, I will likely recover. If my mom who is on immunosuppressants or my dad who has heart failure gets it, they will likely die.
So I fight for them, for the many older Canadians who have serious illnesses already.
Social distancing slowed down the virus in other countries, notably South Korea, Taiwan, Singapore and parts of China. The doctors in countries that did not adopt social distancing and containment early on, like Italy, Iran, France, and the UK, are struggling to care for the sheer numbers of sick patients. They have brought doctors out of retirement. They have repurposed entire hospitals to only care for patients with Covid19. They are even triaging who gets their inadequate healthcare resources and who does not – the young and healthy, the young and unhealthy or the old and frail?
We have no vaccine for this virus. We have no cure for Covid19. All we can do is flatten the curve and slow down the spread. The same total number of people will be sick. But the numbers will be spread out over time so as not to overwhelm our healthcare system.
So that our doctors are not forced into a position where we have to decide who to save and who, with the grace of God, to let die.
The pressure will be intense.
There is a twist. There is a global shortage of personal protective equipment like masks, gowns and gloves. Though there might be faint hope on the horizon as local manufacturers try to repurpose their equipment and make more, there is very little coming for a while.
Hospitals are analyzing their pandemic supplies. Many are ramping down non-essential surgeries to conserve their stores. Physician offices in the community have already begun running out of masks and gowns.
I’m asking our hospital system to consider sharing their supplies. Because once they run out, community physicians will not be able to care for patients with Covid19 without great personal risk. If community doctors stop working or get sick, more patients will end up in our overloaded hospitals for care. If a doctor like me gets sick, we lose staffing for not just a family medicine clinic, we lose a doctor who also worked in the ER, OR, OB, inpatient wards and so on.
This is not just a health human resources crisis in the making. As masks and gowns run out, healthcare workers may have to care for the sickest, most contagious patients without adequate personal protection.
As a society we must remain aware of what we’re asking our healthcare workers to do – and step up to help.
We must stay calm. Slow the spread of Covid19. Cancel everything. Adopt social distancing if feeling well. Accept isolation if feeling unwell. Check in on one another. Keep one another safe.
Covid19 is our generation’s war. We face it, together.