Question 2: “Out of all the incredible challenges, what was the most challenging moment for you during the pandemic?”
Some challenges were to do with changes in work. Bart Niko, local paramedic, said, “the most challenging part of the pandemic were cardiac arrest calls, because we have to wear extra protective equipment and we can’t rush in which creates anxiety and tension for us and the family of the patient who are waiting for us to start CPR.”
Dr. Vyselaar found the biggest challenge was losing access to the Cardiology ward and the nursing expertise, stating, “the cardiac ward was turned into the ward for COVID patients and our heart patients got stuck elsewhere.” Also he found changing into scrubs difficult, clarifying, “I am a big guy, 6’9”, and they never fit right!”
Dr. Bicknell found that procedures became more complex with the onset of the pandemic. He says,“my specialty involves a lot of what we call ‘intervention’ or small surgeries on generally awake, but sedated patients. On COVID positive patients we had to be very careful during potentially aerosol generating procedures (and protecting ourselves and staff) especially in the first phase of the pandemic when we were learning about the virus.”
Helen Kaparniuk, our community RN, found more problems in the community, citing that, now, “ the hospital patients were discharged home to die, with the promise of 24 hour nursing care. We do not have that type of care readily available to us but rather hire agency nurses to provide the overnight care.”
Dr. Smiljanic found the effect on his patients the most challenging aspect, such as, “breaking bad news over the phone. Having difficult conversations virtually. Although it’s the safe thing to do, it really just doesn’t feel right. It would also be nice to see a face rather than a mask.”
COVID itself obviously played a large role in these challenges.
Dr. Jaeger discussed the lack of predictability, stating, “The most challenging moment was in the beginning, fearing the worst and not knowing what was coming. The lack of information, research, and guidance forced us to put our heads together and plan. Many long days, sleepless nights, and endless meetings in an effort to keep everyone safe.”
Dr. Haaf said the first challenge for him was, “probably the first patient I had to swab early in the pandemic, when there was still so much unknown about the virus and a lot of fear.”
Dr. Vrana agreed about these initial fears when so much was unknown, stating, “the very start of the pandemic was extremely stressful and frightening. Because this was a novel virus, we didn’t have any guidelines, protocols, or personal protective equipment recommendations. So we had to figure all of that in those first few days on our own, reaching out to colleagues around Vancouver, Canada and even to our international colleagues. We felt very vulnerable and were scared that not only might we get sick, but that we might bring it home to our families and loved ones.”
Dr. Jaschinski spoke from the heart. His biggest challenge has been, “seeing someone die within a few hours from COVID knowing that was little I could do to change the course.”
Dr. McLeod echoed his words, stating, “it has been really hard seeing older patients die from COVID in the hospital when they can’t have family around, in the early days before any vaccine availability, if your spouse was in their 70s and you were at high risk as well and couldn’t easily visit that person you love before they died.
A North Shore Family Physician also found his work to be challenging, “I have experienced a fair bit of Covid in my work and one of the most troubling things is how it has affected the old folks. People with dementia who do not understand they can’t leave the room and I can’t talk to or touch other people. People who are isolated and can’t have visitors. I also feel really badly for the nurses working in the hospital. I come and go on the hospital ward with the Covid outbreak, but the nurses have to work there for 12 hour shifts. They are in PPE dealing with patients’ bodily fluids and put themselves at risk for infection all day long. I have seen a lot of hospital staff go down with Covid infections. Now as we are dealing with our third outbreak where I work I see the nursing staff approaching despair.”
Dr. Heffner was worried about the spread of the illness, “making sure we are doing proper PPE so we do not get COVID or spread COVID in the hospital to our patients and each other.”
Some challenges were more personal. Dr. Robertson realised one of her challenging moments was that, “I will lose friends over my need to follow public health guidelines. I have lost friends who didn’t think they needed to follow the guidelines.”
And sadly it is not just friends who have been lost. Dr. Murphy said, “the other challenge was when my mum got COVID and died. I was actually thinking of not travelling home due to the risk of me getting COVID on the plane and at the nursing home, but I am very glad that I did travel.”
RN Sandra Sodvat was worried about taking COVID home, “the most challenging thing for me in the pandemic has been the fear of bringing COVID home to my family. I would change my clothes into hospital scrubs at the beginning of work and then change back to my own clothing at the end of work. My clothes that I wore home I would put in the washing machine right away and change again to my house clothes. That’s a lot of changing! Thankfully we all have been covid free thus far.”
For community doctors there have been other challenges. Dr. Walton-Knight was worried about her colleagues and advocating for the needs of community physicians with the health authority. “Community physicians are seen as others that do not register on the health authority radar and so when the pandemic hit, providing PPE, communicating protocols and getting the support we needed was met with a lack of understanding, The pandemic has led to much better collegiality and appreciation of team-based care for the community that we all serve.”
Dr. Hughan feels that the larger challenge was being spread thinly, “it has been a struggle have enough time to deal with so many overwhelming patient concerns and mental health issues in a proper way, as well as doing home visits and palliative care in the community, and it has been even worse to lose patients to COVID who were precious to you.”
Resident Dr. Boskovic found it difficult, “not being able to see my family and close friends, during a time in my training when I would appreciate/need the support the most. Our medical school graduation was cancelled and we started residency without seeing classmates, so there hasn’t been the feeling of collegiality and support like we had during medical school.”
Question 3: “What would you say to people who are vaccine hesitant?”
Many of the answers centred around a theme; come and see for yourself.
RN Sandra Sodvat said, “if you saw how sick it can make people of all ages you would get the vaccine. I have seen outbreaks take hold and spread so fast that many have died unnecessarily. I also say it is important to listen to the scientists who have spent many years researching this subject and not to listen to your friends’ opinions on the internet.”
Dr. Vyselaar reiterated this, “Wake up people! The vaccines are a far, far better option than getting COVID. The stories of people getting very sick or dying are very real and it could be you or a family member. I have seen a number of COVID positive patients with cardiac complications and they were very, very ill. Some did not survive despite every effort we could make.”
Dr. Jaschinski was to the point on this issue, stating of vaccine hesitant people that, “they are playing with fire. This disease can affect healthy people very suddenly and severely with minimal contact.”
Dr. Jaeger agreed, stating that the complications of COVID are much worse than any side effects of the vaccines, stating, “We know that the vaccines reduce not only the chance of infection, but also the chance of requiring hospitalization and intubation if you do get sick. Our hospitals are full, our ICUs are full, and our resources are more limited than they have ever been. Healthcare workers are tired, stressed, and overworked. We need the support of our communities more than ever, and vaccination is a huge help.”
A Family Physician also made this plea, asking, “come have a tour of the hospital wards where normal healthy people with Covid pneumonia are lying “prone” (on their stomachs) all day on high flow oxygen sweating bullets and feeling like crap. And perhaps mention how they will likely be fortunate to benefit from the herd immunity as those that can are lining up for vaccinations for themselves and for the protection of those around them.”
Dr. Hughan agrees, saying, “I wish people could see what we have seen and then I feel they would not be as hesitant. Obviously, I ask them why they are hesitant and try to address those issues with scientific explanations, put in layman’s terms, but when they suggest one of many internet theories as to why the vaccines are harmful, it is difficult to maintain professionalism at times.”
The second bit of advice from local healthcare advisors advised people to listen to science and not opinions. Dr. Robertson stated, “I have studied medicine for over 20 years. The researchers and advisory boards that study and recommend vaccines are the smartest, kindest and caring doctors. I trust them 100%. Myself, my family and my children will be the first in line to get the COVID vaccine and any vaccine recommended.”
Dr. Vyselaar also took the scientific approach and also questioned the conspiracy theory that all governments and doctors are trying to control people, saying,“ the quality of the studies about the vaccines are excellent and the data is available for anyone to read. People can go read the original article and digest it and critique it! Instead of believing these idiotic conspiracy theories and misinformation. One example (is the website https://www.nejm.org/doi/full/10.1056/nejmoa2034577.) Do people really believe all doctors, governments, and pharmaceutical companies are all working together to control the population? Really? With all the leaks we have about everything else?”
Dr. Murphy also took this theory on, “I try to reassure them that Physicians are not led mindlessly and it is based on science. We cannot even decide on one type of electrical plugs as a world population (48 different types, I think), so the idea that we could all get together and concoct C19 and the vaccine to control people is ridiculous.”
Dr. Walton-Knight tries to get the crux of the issue as to why the patient is hesitant and address it appropriately and also says, “to those that believe the vaccine is somehow a government led population monitoring system I ask how worldwide governments that struggle to agree on most issues would suddenly all come up with some secretive population plan? In the end, I can but give the date, give my opinion and leave the choice to them.”
Dr. Vrana also uses this approach, so that she can address patient fears, stating, “I would like to understand why they are vaccine hesitant, so I would probably ask them to explain to me the reasons behind their hesitancy. Hopefully by understanding their perspective, we could then have a meaningful and informed discussion that could allow them to feel more confident and safe moving forward with vaccination.”
Another answer to this question is that vaccination will enable us to get back to our normal lives and help our neighbours as a societal responsibility. Dr. Haaf stated, “vaccines are safe, effective and free. It’s easy to forget the consequences of the disease we are preventing when people get caught up in the potential side effects of the vaccine. The vaccine is our best chance to return to a reasonably normal life again, but for it to work, we all need to have it.”
Dr. McLeod agreed, “The vaccine works really well. It dramatically reduces your chance of getting sick with COVID, landing in hospital, or dying. The more people we can get vaccinated the quicker we can get everything opened back up and have a better normal summer.”
Dr. Bicknell feels the vaccine will get us out of the pandemic eventually, “it is a safer way to give each one of us protection and to really reduce any chance of severe illness as well as reducing the risk of spreading the disease to others.”
RN Helen Zaparniuk agrees and says that people, “do have a choice and will never be forced to do anything they are unwilling to do, but that this virus is very deadly for some and the only way to get back to a “ normal “ life is for the majority of people worldwide to become vaccinated.”
Resident Ana Boskovic is convinced by the research that has gone into the vaccines, “there has been a lot of research done regarding the vaccine to ensure they are effective and safe. It has been done quickly because we are fortunate to live in a time with the technology that we have, and has been a worldwide effort which has expedited the process. Getting a vaccine not only protects the individual, but all their loved ones – no one is immune to this virus without a vaccine!”
Dr. Smiljanic also is reassuring and discusses the importance of vaccination for his cancer patients who are often immunosuppressed, “firstly, Canada has been so behind other countries – we can look to them to see how they have done with vaccinations and be reassured that in particular the Pfizer and Moderna vaccines have proven extremely safe. Secondly, my patients fall into the category of immune compromised. They usually are very happy to get the vaccine, but this gives me a special incentive to talk to the vaccine hesitant. Every healthy robust patient that takes the vaccine creates good strong herd immunity – which very much can help my patients who despite the vaccine may not get adequate protection from Covid. Vaccines are a population-based treatment, not just an individual one. Trying to get people to understand that helping their neighbours is really important.”
If for no other reason, Dr. Heffner encapsulates all these feelings in one sentence; “It’s safe, effective and will give you your freedom back to be with your friends!”
Check in tomorrow to read PART Three:
“When we can all travel again, where is the first place you would like to go for a well-deserved break?”
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