In every corner of the planet struggling to contend with COVID-19, the goal is to keep the most severe cases of the disease down to a level where health-care systems can respond to them.
Physical distancing measures are not expected to prevent all infections. Complete containment is impossible, without encasing every human on the planet in double layers of plastic bubble wrap for two weeks straight.
The actual aim of distancing is modest. Governments are trying to slow the pace of infection to the point where the number of critically ill COVID-19 patients is lower than the number of intensive care unit beds or ventilators.
This didn’t happen in in northern Italy, Madrid and New York City. Italian doctors have been forced to choose which gasping patients get a chance to survive on a ventilator. The Palacio de Hielo, an Olympic-sized ice rink in Madrid, was converted into a morgue. Health-care workers in New York City have compared their hospitals to war zones.
None of these scenarios have emerged in Canada, where serious COVID-19 cases have yet to overwhelm the health-care system in any province.
Ontario and Quebec have borne the worst of the brunt; the two provinces account for 90 per cent of the nation’s coronavirus death toll with only 61 per cent of Canada’s population. Alberta and B.C. are also burdened with four-digit caseloads.
Manitoba, meanwhile, has been graced with small pandemic numbers: Three deaths to date amid 217 known cases, 193 them still active as of Tuesday afternoon.
Of the Manitoba patients who are are living with COVID-19 symptoms, a total of 12 are in hospital, including six in intensive care.
Those numbers are well within the capacity of the provincial health-care system, which has 63 fully staffed intensive care beds and 270 ventilators, plus another 136 ventilators in surgical rooms that are underutilized at the moment due to the cancellation or postponement of elective procedures.
Low numbers, high impact
Nonetheless, COVID-19 has already impacted operations at no fewer than four Manitoba hospitals, where the infection of 14 health-care workers — and the late discovery of an infected patient — required dozens of doctors, nurses, technicians, aides and other workers to be sent home to self isolate.
An emergency doctor went to work for three days with symptoms in Selkirk, potentially infecting patients and colleagues alike. Infected workers were also found at Winnipeg’s Grace Hospital, St. Boniface Hospital and Health Sciences Centre.
At HSC, the largest hospital in Manitoba, the COVID-19 diagnosis of a longstanding patient created particular disarray last week, according to accounts from several workers who spoke to CBC News under the condition of anonymity.
HSC had procedures in place to isolate infected workers and trace their contacts. The hospital also had plans in place to prevent suspected or confirmed COVID-19 patients from infecting anyone as they were admitted to the hospital.
The discovery of a COVID-19 patient who was already in hospital and had interacted with dozens of workers, however, forced no fewer than 100 doctors, nurses, technicians and other workers to quickly finish off their immediate tasks and head home.
That figure was cobbled together from the Manitoba Nurses Union, Canadian Union of Public Employees Local 204 and the Manitoba Association of Health Care Professionals, or MAHCP.
While that’s just a fraction of the staff at HSC, a small city unto itself, the absences created staffing issues.
Four HSC nurses who underwent isolation have tested positive for COVID-19, said Darlene Jackson, president of the Manitoba Nurses Union.
Other nurses in isolation were asked to return to work before their 14-day self-quarantine was up, provided they had no symptoms, chief provincial nursing officer Lanette Siragusa confirmed.
Some MAHCP members, whose ranks include laboratory technicians, social workers and pharmacists, have also been called back to work before their isolation period is up — something union president Bob Moroz said they should resist if they do not receive this instruction in writing.
At one point last week, 14 out of the 40 radiation technologists at HSC were off work, forcing the other 26 to pull double shifts, Moroz said.
“You take a third or better of a workforce out of a specific department at the provincial centre of health, that is an enormous impact — not only on the workload, but on the people who are left behind as well, in order to try and carry on the work,” he said.
Moroz also said some MAHCP workers received verbal reprimands for wearing too much protective gear before the HSC incident occurred, only to be reprimanded after for not fully complying with a new directive to wear gowns, masks and gloves while interacting with any patients.
Moroz said he sympathizes with hospital management, given that there is no precedent to govern hospital operations during a pandemic.
“The managers, sometimes they’re going to be doing the best they can, because it’s confusing. There are consistently three, four or five different things a day that they have to deal with in terms of changes,” he said.
The problem, he said, is there is no consistent communication. He claims his members are stressed out before the burden of caring for large numbers of COVID-19 patients has even arrived in Manitoba.
“We see everywhere that the health-care professionals are being lauded for their courage and bravery for coming to work, and I see the other side of it,” he said.
“They may be devastated or terrified. They’re in tears. There’s just a lack of consistent approach and I don’t know how to fix that.”
Over the weekend, Siragusa said events in Manitoba hospitals and personal care homes can occur so quickly, the general public may be aware of issues such as worker infections before she is told of them.
She conceded she does not know how many health-care workers are in isolation at any given moment, but said the health-care system is capable of adaptation.
The resilience of the system will be tested by something far more formidable than a single infected patient, should the number of serious COVID-19 cases rise sharply in Manitoba in the coming weeks.
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