PPE shortage the biggest worry ahead of expected COVID-19 surge
Dr. Scott Anderson says early data suggest social distancing is paying off, but warns we can't let up now
A doctor who works in London's busiest intensive care units said he feels local hospitals are well prepared for the expected surge in COVID-19 cases, but a shortage of personal protective equipment is a pressing concern.
Dr. Scott Anderson splits his time between intensive care units at Victoria Hospital and University Hospitals.
He's paid close attention to caseload and fatality data as coronavirus spreads across North America and daily case totals and death counts climb.
He's cautiously optimistic Canada can avoid the disaster unfolding in the United States, where no less than 100,000 are projected to die in the coming weeks. Still, staff are preparing for a possible caseload spike he likens to a tsunami.
PPE shortages
Anderson said the shortage of protective gear, such as masks, is the biggest worry.
"Throughout North America there have been efforts toward pandemic planning but I don't think anybody truly appreciated the intensity and duration of how this pandemic would present," he said.
"The supply chains have become overwhelmed and the ability to provide the optimal amount of PPE for everybody has been challenged. It's not just a London problem, it's a problem in Ontario, Canada and throughout the United States and the world. We're following the provincial guidelines but when you don't have unlimited supplies of PPE, you have to make difficult decisions."
London hospitals are asking staff to re-use PPE in ways they otherwise wouldn't to stretch the supply. But it's a tradeoff: The more PPE is reused, the greater the infection risk to staff and patients. CBC News reported Thursday that healthcare workers make up roughly 1 in every 10 of the known COVID-19 cases in Ontario.
"I think the hospital is trying to make the most appropriate decisions on how to ration it, but also on how to keep people safe," he said. "We don't want to find ourselves in a situation next week where we have nothing."
Anderson said his colleagues have seen the toll that fighting the virus without enough PPE is having on hospital staff in the hardest-hit areas of the world and can't help but worry.
"When you can't be sure the supply chains will provide the needed amounts in short order, it can be challenging," he said. "This is really a difficult time for health care workers. They want to do their job, but they want to be safe. They don't want to go home and infect their families."
What about ventilators?
Anderson said, for now, he's confident the supply of ventilators will meet the need of the expected surge in cases.
"We're using 20 per cent of the ventilators in the province to manage COVID-positive and COVID-suspected patients. That is reasonable and well within control and we have the ability to surge well within that capacity," he said.
"I'm confident that if the numbers continue the way they are ... we will have the ability to manage the situation. If we let down our guard and social isolation is relaxed, and we see spikes of cases, that will overwhelm the system."
Anderson said there are also plans to move some patients to a temporary field hospital in London if necessary. In those cases, it's the non-COVID patients who are moved off site.
Young patients with coronavirus?
Anderson said he's been treating young patients in London's intensive care units who had no health concerns before COVID-19 hit them.
That's why he says it's crucial for everyone, including young people, to not let up on social distancing measures.
"What we need to remember is that the actions we do now are going to result in a delayed effect and I think what we're seeing right now are the benefits of having socially isolated two to three weeks ago," he said. "But now is not the time to become complacent."
Could what's happening in many U.S. cities happen here?
He's confident Canada can avoid the kind of staggering infection rates emerging in the United States due largely, he said, to a stricter and earlier adherence to social distancing.
He said health care staff here are dealing with "anticipatory anxiety" as they wait and wonder when exactly the case surge will come.
"It's like you're getting ready for this tsunami and if it doesn't come, great," he said. "This is what we train for. At this point in time we're all in this together. And hopefully we'll learn some lessons from it and we'll be better prepared for next time."
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