Featuring: Our Healthcare Workers

Why do we fight? Over the past few weeks, our community, country, and the world at large has been hit with a health crisis that none of us have ever faced before. Although the Coronavirus is bigger than each of us, together we are working to lessen the effects of the pandemic. In this unconventional edition of “Why we Fight”, healthcare workers from our local GB family give us insight into what they are dealing with both professionally and personally. They let us know what it’s been like from the inside and share some of their thoughts during this crisis. They are an eclectic bunch with diverse backgrounds – one thing binds them together in the field; they train, they persevere, they fight.

Nadia – Purple Belt – Family Medicine

For Nadia, the weeks leading up to the outbreak were mostly the same; there were murmurs of what was going on in China and Italy, but back in late February, things hadn’t really changed much yet in the CLSCs that she works out of. Nadia actually had vacation plans set which had to change, so they turned into a ‘stay-cation’. She feels fortunate that she had that time to recharge her batteries before everything picked up.

At first, things remained quiet while the medical system tried to adapt to the situation as quickly as possible. Once the coronavirus became an imminent reality in our society, there was a rapid switch to telemedicine consultations. While most consultations were carried out over the phone, more complicated ones were done using videoconferencing to better connect with patients and assess the severity of their complaints. Nadia is a community CLSC doctor, who sees ambulatory patient in clinic, as well as doing home visits to the most vulnerable, including the elderly with reduced mobility and autonomy. Among her expanded roles during the coronavirus pandemic include being part of a team of doctors on a 24/7 call for the elderly living at home or in various long-term care facilities, particularly those without family doctors. She also assists in caring for homeless patients and those without RAMQ. She has been recruited, along with all family doctors, to potentially take part in COVID evaluation clinics which are better equipped to screen patients. Like most of her colleagues, she only sees patients in person if absolutely necessary given they don’t have COVID symptoms, as many healthcare workers fear potentially being a vector for the disease.

Like many of us, she has been practicing social distancing and has been keeping up with the news as it unfolds publicly. But unlike many of us, Nadia also gets information on best practices, newest guidelines, and detailed information which changes daily. Perhaps the most difficult part of the pandemic for doctors is keeping up with all the updated protocols of care, which change as rapidly as the coronavirus cases climb.

Nadia has some great advice that we can all use:

1. Although social distancing practices are generally well observed, she has noticed that people sometimes ‘compartmentalize’ this practice. The 2 meters distancing is not only when we are standing in line outside of the grocery store, pharmacy or SAQ, this needs to also be practiced inside the stores as well. Keep that 2 meter distancing, keep your hands to yourself, and make sure you’re patient when other people are picking things in the isles!
2. There has been a shortage of basic medical supplies, such as face masks and gloves. If you are not a healthcare worker, you need to make do without those items if you stay 2 meters away from someone. If this is impossible or if you are concerned about contracting or spreading the disease, you can make your own mask with simple household items. The Center for Disease Control has actually released a guideline for how to make your own washable masks (attached).

Nadia has been keeping a yoga practice lately, and has picked up sketching, something that she hasn’t done in years – although it may be difficult to limit time reading up or watching the latest news related to the outbreak, this is so important for our mental health. Nadia suggests we take this opportunity to spend time with those who are around us, to call and videoconference with loved ones who aren’t around us, and to start that art or music or craft project we ‘just never have time for’ when life as we know it keeps us too busy.

Isaac – Blue Belt – Surgical Ward Hospitalist

Isaac’s time before the lockdown was also normal; he had just come back from a trip when the social distancing measures and the mandatory 14-day quarantine for travelers coming back to Canada where put into place. Normally, Isaac works about half the time as a hospitalist as part of an orthopedic surgery team, and the other half of the time he is working in pre-op clinics. Up until last week, he was unable to practice in person and instead was practicing telemedicine to help with the increased demand.

One of the consequences of the Coronavirus outbreak is that all elective and non-essential surgeries have been postponed until further notice. This measure has been taken to reduce the total number of patients entering the hospital in the goal of reducing patient risk of contracting the disease. This practice is also to reduce the risk of spreading the disease to the surgical teams, since symptoms of coronavirus manifest late in the contagious phase, and many people with the disease may be asymptomatic, but vectors for the disease. As such, Isaac is working from home and on stand-by like many specialist healthcare workers, waiting to see where/when the need will arise.

An unfortunate side effect of operations being postponed is that once the outbreak has quelled, and life returns closer to normal, there will be a backlog of surgeries. Although this is a much-needed measure right now as healthcare workers buy time and learn how to better manage the spread of the virus, there will be knock-on effects that will be felt for many months after this is under control.

Interestingly, Isaac is also a partner in a few cafés and a restaurant, so he also has seen the effects of the virus on local business. They have had to close their doors and temporarily lay off employees during the lockdown, though he knows that once this is over, there should be a surge in business as people finally get a chance to get out of their homes and socialise again.

Isaac does implore people to heed the social distancing measures that are being asked of us in the news. What we all need to think about is not whether or not this disease will affect us, since most of us are healthy and not at risk, but instead think of how we might inadvertently spread the virus to someone who is at risk – over the course of 4 or 5 days that you are asymptomatic but contagious, you can infect dozens if not hundreds of people accidentally. With the mortality rate of COVID-19 being around 1-2%, one of those people will be critically affected and die. Furthermore, there are very high-risk areas, such as nursing homes, which would be catastrophically hit and would not recover. These areas need to be protected, and all of us can do our part by staying home and minimizing our contact with the outside world.

Isaac has been running a lot more lately, but he really misses jiujitsu. Apart from that, with some of the spare time he has, he’s been connecting with friends and family, as well as playing some videogames to help decompress.

Louis-Benjamin – Blue Belt – Geriatrics Nurse

Louis works in what is currently being referred to as a ‘cold zone’ (as opposed to a hot zone where COVID-19 patients are being treated). Before the lockdown, Louis worked mainly in geriatrics, therefore he sees a wide variety of cases, mostly infections which requires antibiotics and active monitoring. Now, like any other healthcare workers, an emphasis has been put on reducing the total number of people who frequent the hospital, and so there aren’t as many post-op patients that he would have seen. That said, everyone in his unit is still going in to work and are on stand-by, helping out in anyway that they can. For Louis, tension in his unit is high (as he knows it is in all units), and everyone is prepared for the worst but hoping for the best.

Now that the need and the demand for more healthcare workers in hotspots, Louis might be working in some of the ‘hot zones’ to relieve some of the increased burden that’s been placed on frontline nurses. Louis explained to me that the entire healthcare system is on standby and that resources will be allocated and prioritized differently.

Like many of us, the main thing that Louis is worried about is the uncertainty that this outbreak has caused. The measures we have taken over the past 3 weeks have helped flatten the curve, but unfortunately it takes time to see the effects of our efforts. The uncertainty of when a vaccine will be available is something on his mind, because that will dramatically speed up a return to normal.

Louis has a few things he’d like everyone to be reminded:

1. The virus itself is not very robust, therefore, increased cleaning and sanitation precautions will greatly reduce the risk of transmission. Washing your hands with generous amounts of soap for at least 30 seconds after you’ve been outside or touched any surface that you are uncertain about does more than people think! Also, cleaning surfaces with isopropyl (commonly rubbing alcohol) or making a 20:1 bleach/water solution will sanitize surfaces (but please be careful about using bleach on your own skin!)
2. Although we are being asked to social distance, the need for blood is ever present. Hema Québec is still accepting donations at this time, but only by appointment. Although even more safety measure are being taken than before, if you are healthy and would like to help at this time, make an appointment with Hema Quebec.

In order to stay healthy, when he has a free moment, Louis has also taken up running. Louis also has a virtual reality headset and has been playing a VR Boxing game that is keeping his reflexes sharp and making him sweat all the while being lots of fun.

Victoria – Blue Belt – Intervention Worker for victims of sexual assault

Although Victoria is working in a para-health field, it is a field that is feeling the stress of the Coronavirus lockdown. Victoria has been working at a clinic for victims of physical and sexual assault, and although these clinics have closed their doors for the time being, the need for mental health practitioners has only increased. Although she has witnessed a slight increase in the total numbers of calls to the center, previous cases that she had been working on are becoming more difficult to manage. As Victoria explained to me, 90% of assault cases are committed by a family member or acquaintances, and so many of these victims are now living in lockdown with their assailants. Just like with everyone else, the increased tension of the social distancing is playing a part in causing more stress and more incidence of domestic abuse in these homes. Whereas before, victims had some respite when going to work or school, could meet with friends and talk, or meet with support groups, these victims are now confined to their homes.

Like many healthcare workers not directly on the frontlines, there has been a reduction in mental health services so as to limit the spread of the virus. Unfortunately, this will cause a knock-on effect down the line. Once things return to normal, like many others, Victoria is worried that this will create a backlog in the system that is already seeing more demand. To add to this, more and more healthcare workers are themselves seeking counselling due to the increased stresses and demands of their work.

One of Victoria’s take-homes is that we need to take time and check in with our loved-ones and to be particularly sensitive to any changes in mood. Most people are trying to keep busy and don’t want to burden they friends and family with anything they might be going through, and often people don’t even realise that they are acting or feeling differently. Check in with them and be specific with what you are asking or noticing in them, vague open-ended questions are a great way for people to duck out of an uncomfortable conversation! If you do know someone is going through a particularly difficult time, make sure to check in with them regularly.

Victoria would also ask that those who have the means consider donating to non-profits help centers (such as Dans la Rue or the Montreal Sexual Assault Resource Center because these centers rely mainly on donations to operate. Centers like these do great work year-round but are particular in need during times of crises.

To keep healthy and happy, Victoria has been keeping a routine, waking up on a regular schedule, doing yoga at home and also play fighting with her partner (to replace the energy outlet BJJ provided). She loves spending time with her cat these days. The cat isn’t affected by the lockdown and is completely oblivious to what the humans are going through – Victoria finds it refreshing and therapeutic.

Photo by Jason Shahin

Evelyne – Blue Belt – Intensive Care Unit Nurse

Evelyne has been an ICU nurse for the past five years, ever since she graduated from nursing. Like many healthcare workers in high-intensity and high-stress units, she absolutely loves her job. Interestingly, the weeks leading up to the official lockdown on March 16^th was filled with preparation – the unit heads had been monitoring the situation in China and Italy closely. As such, once the lockdown actually occurred and centers began preparation, her group was well on her way to being ready for increase number of ICU cases due to Coronavirus. That said, much like other healthcare workers, stress has been higher, but she is infinitely grateful for the work that everyone put in which has lessened the impact of this shift.

One positive change of all this is that now, people in her unit constantly check in with each other and make sure nobody is feeling overworked or burnt-out. Evelyne feels like the preparation beforehand and the daily struggles faced by her unit have brought them closer as a team because they now recognize how qualified and competent their team is.

At First, Evelyne was definitely worried about the prospect of being a vector for the virus – simple things like groceries (which she has been doing 1 every 2 weeks) or simply going for a walk outside concern her. To add to that, about 2 weeks ago Evelyne fell sick with a serious fever and had to stop work and get tested for the virus twice. Luckily, she tested negative both times, and is back to working in the ICU.

One thing Evelyne definitely was surprised about was the patient population affected by the virus. As seen in the media, the virus affected patients of various ages, socioeconomic and ethnical background. Although most of us understand that the demographics that are at highest risk are the very old, those with pre-existing respiratory diseases or individuals who are immuno-compromised, no one seems to be spared. Like most of us, this epidemic has allowed her to reflect on her own mortality and the fragility of life.

Like many of us, Evelyne has needed time to adjust to the new reality we are living in, but she recently listened to a podcast that gave her a new perspective (Fact vs Fiction). The podcast details the experience of astronaut Scott Kelly, who lived on the international space station for just 10-days shy of 1 year. Though he was not alone on the space station, he was certainly socially isolated from his friends and family. One of the take-aways that Evelyne got from the podcast is the idea of balancing the concepts that on the one hand, this is temporary and will pass, but that on the other hand, we need to treat this as the new normal. We need to treat our day-to-day like we did before the lockdown. It’s important to schedule our time wisely, and stick to that schedule. Sticking to a schedule and varying the kind of activities we fill our days and weeks with will make our days pass more quickly and with much less stress and worry.

Finally, Evelyne also hopes that the government values public services like the healthcare system and education system in the future. The austerity measures that were put in place back in 2014 by the Liberal government definitely hurt the healthcare system, and those cuts have been felt up to this day. She hopes that the outpouring and appreciation that she has witnessed during this pandemic doesn’t end with the lockdown – these public institutions are the last defenses in times like these.

Artwork by MJ Hiblen (Instagram)

Take care everyone and stay positive during this difficult time. Take this time as an opportunity to do the things we often say we didn’t have time for in the past; reconnect with lost friendships, try cooking that dish that takes all day to prep, or try a new art/music/craft project (Youtube is such an amazing free learning resource!).

For those of us not working directly in healthcare, staying home, staying healthy and staying happy is the best thing we can do right now.

We recognize that these are only a few perspectives of the healthcare workers from our Gracie Barra community; we unfortunately couldn’t reach out to everyone but know that there are many others out there doing excellent work right now. On behalf of everyone at the various Gracie Barra’s, I thank you very much for your continued work during these trying times. Thank you so much to these 5 members of our GB community, for continuing to frontline and care for us, and for taking the time and checking in and giving us insight to what is happening on the inside.

Thank you.

All content by Dan Aponte. You can check out his website: www.danaponte.ca

Or you can follow him on instagram @just.dan.thingz