Ottawa·ON THE FRONT LINE

Pandemic fatigue setting in on the front lines

Front-line health-care workers are starting to hit the wall, dealing with dying patients, bone-deep weariness and their own unexplained illnesses. We check in again with an intensive and palliative care physician, an ICU nurse and a rural paramedic.

A doctor, a nurse and a paramedic report from the field, where battle fatigue is taking its toll

Dr. Kwadwo Kyeremanteng struggled this week as he watched an elderly patient die without family nearby, all because they were afraid they'd contract COVID-19 if they came to the hospital. (Kwadwo Kyeremanteng)

Front-line health-care workers are starting to hit the wall.

Throughout the coronavirus pandemic, CBC Ottawa has checked in weekly with an intensive and palliative care physician, an ICU nurse and a rural paramedic. This week, they've been dealing with dying patients, bone-deep fatigue and an unexplained illness.

The doctor

At the General campus of The Ottawa Hospital, there are signs the pandemic is on the decline, Dr. Kwadwo Kyeremanteng says.

At one point on the morning of May 20, there were 11 patients in the 28-bed intensive care unit, and none was a confirmed case of COVID-19. "The incidence has gone down significantly," said Kyeremanteng, 42.

Which is not to say there aren't crushing examples of the ongoing human cost of the illness. 

When we tried to contact the family? They didn't want to come in because they're scared of getting COVID-19.- Dr. Kwadwo Kyeremanteng

Kyeremanteng treated a patient last week who had put off coming to the hospital due to an infection, for fear of contracting COVID-19. That patient has since died.

This week, the other side of the same difficult coin.

Kyeremanteng was treating an elderly patient with COVID-19 who declined to be intubated. "The patient started to get worse … and was dying," Kyeremanteng said. He said when they tried to contact the family, they were reluctant to come in because they're scared of getting COVID-19.

"This is the saddest thing in the world," he said. "This poor elderly patient is going to die alone because people are afraid of getting this virus when — even in the ICU — there were hardly any cases at the time. And the [number of] cases are reducing in Ottawa.

"You've lived your whole life, you've got kids, but no one's coming to see you? In their last days, hours and minutes? It brought a tear to my eye."

Some families are having these final conversations over Facetime or on the phone, but Kyeremanteng said in his experience as a palliative doctor, "being able to formally be there for your loved one can have a lot of healing value."

Queensway Carleton Hospital nurse Peggy Freemark is usually assigned to the PACU, or post anaesthetic care unit, but she's been redeployed to the ICU since the start of the pandemic. (Theresa Wilson)

The nurse

Peggy Freemark admits she's starting to feel the effects of the COVID-19 workload.

"I'm tired of the 12-hour [shifts]. My back is sore. I find it very hard … to be standing for 12 hours."

The morale of the people I work with … is a little low right now. We're just tired of doing this.- Peggy Freemark

The nurse at Ottawa's Queensway Carleton Hospital knows she's not alone.

"We just try and get through the shift and get home. The morale of the people I work with … is a little low right now. We're just tired of doing this," said Freemark, 55.

She wishes she could go back to her regular job as a nurse assigned to PACU, the post anesthesia care unit. "I don't want to be an ICU nurse," she said.

And it's not even the COVID-19 patients who are keeping her on her feet. 

"There are a lot of sick people right now, [but] it's non-COVID. It's people who wait too long to come to hospital because they're afraid they're going to get COVID," said Freemark. "They're terrified of catching it. They probably think emerg is the worst place to go."

But she said anyone who turns up with COVID-19 symptoms is immediately whisked outside to a separate entrance.

"The emergency department is probably safer than going to the grocery store," she said.

Hazel Frances Freemark-McLean was born May 1 at the Queensway Carleton Hospital. Her proud grandmother, nurse Peggy Freemark, has yet to hold the infant, but has heard her cries over Facetime. (Submitted by Peggy Freemark)

Freemark is eagerly awaiting a week-long holiday, which was approved before the pandemic. She was going to spend it helping to care for her new granddaughter, whom she has yet to hold because she's been keeping her distance.

"They just brought her to the door and we stood … and ogled her," Freemark said. "They just want to keep her safe, and so do I. I'm OK with it, but it's hard. I don't want her to not know me.

"People are just tired of this, as everybody is, not just people who work in hospitals," she said. "I'm worried about the second wave. Once they open everything up, I'm sure we're gonna see another wave."

The paramedic

Renfrew County paramedic Chris Day came down with COVID-19-like symptoms and was swabbed early last week. The results were negative. 

His family physician was worried about a false negative and ordered a second test, but it, too, showed the 44-year-old was clear of COVID, despite a persistent cough and lingering tightness in his chest.

Day was relieved, "but now … we need to figure out what is going on with me. If it's not [COVID-19] then I picked up a bug somewhere," he said.

I ran myself into the ground a little bit, which of course makes you more susceptible to picking up something.- Chris Day

"Something as simple as being in a grocery store. Or it could have happened when I was pumping gas. Nobody else at home has been sick," Day said. "Nobody else at work has had anything. [But] in our profession we are always around sick people. Bugs can still spread." 

Day may have been an easy target, clocking more than 60 hours a week at work through April. "Probably to my own detriment, I ran myself into the ground a little bit, which of course makes you more susceptible to picking up something."

Renfrew County paramedic Chris Day has received more than a half-dozen COVID-19 swabs since the pandemic started. (Kody Koepsel)

In the meantime, Day has checked out of the hotel room in Pembroke, Ont., where he was in quarantine, and is now isolating in his own basement while catching up on desk work. Despite his negative tests, he's not allowed back on active duty until he's free of any symptoms for 24 hours.

The isolation is no picnic for Day. "Not enjoyable at all. I miss running. Sitting around is not my forte."

Neither is it easy to be separated from his kids, especially his five-year-old. "I get messages from Amy. She misses me. She kind of understands, 'I can't see daddy because of the virus,' but I know that she cries at night sometimes and is upset," Day said.

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