In the RED ZONE, A Manitoba ICU during COVID-19
“The hospital system, no matter how well it is running, no matter how much effort we put into opening new beds and new units, we cannot sustain this indefinitely. We should not be counting on our ability to sustain this level of surge over the long term…we should be counting on our case numbers dropping.” – Dr. Bojan Paunovic, Provincial Specialty Lead, Critical Care
Experiencing the sights and sounds of an intensive care unit generally only happens in one of three ways. You either work there, you are sick enough to be admitted there, or you have a loved one who is relying upon the specialized care that is only available from the specialized health care workers in the ICU.
During the COVID-19 pandemic, many Manitoba families are experiencing the fear and anxiety of having a loved one admitted to ICU. Families receive updates from the care team virtually or by phone, but in most cases are not able to visit, and for too many families, their loved one will not come home.
“Because of COVID, we’ve had to limit the amount of family contact and use technology to facilitate end of life plans when a patient is deteriorating or not responding to treatment,” says Paunovic. “We engage with and support the families through any means possible but it’s incredibly difficult for families and very stressful for staff to not be able to provide that support in person.”
These conversations are happening every day says Paunovic. They are more frequent, he explains, because of the high number of admissions Manitoba is seeing as a result of high daily COVID case counts.
As COVID-19 continues to spread through our communities, infecting the vulnerable, the immune-compromised and the elderly, the province’s ICUs are expanding to meet the needs of rising numbers of very sick COVID patients.
“People are being cared and we are finding the capacity to care for the demands we are seeing,” adds Paunovic. “It takes a lot of work and staff from other parts of the system have had to come help in order to support this. Everyone has stepped up but health care workers are tired. This is an order of magnitude way above and beyond what we would normally see.”
Beds are being added and staff are being trained to work in new spaces because patients keep coming. And coming.
“Staff are having to work extremely hard to identify patients who are safe to be transferred, in order to always maintain some capacity for the urgent admissions that have to happen,” says Paunovic. “It’s an enormous workload for the staff.”
In a typical flu season, the ICUs would see the same volume of patients they now see in just a week or two.
“The hospital system, no matter how well it is running, no matter how much effort we put into opening new beds and new units, we cannot sustain this indefinitely,” adds Paunovic. “The less cases we have, the less of these situations we would have to manage. We should not be counting on our ability to sustain this level of surge over the long term…we should be counting on our case numbers dropping.”