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Situation normal in Alberta's emergency rooms, but ER doctors braced for worst


With a relatively low number of confirmed COVID-19 cases in Alberta, two hospital emergency room doctors say they aren’t feeling overwhelmed by the outbreak.

Yet.

“I would say that there’s just kind of a general level of anxiety, worry. Not necessarily about right now but about what’s to come in the coming weeks,” said Dr. Shazma Mithani, an emergency room physician who works at the Royal Alexandra Hospital.

New measures have been introduced into the ER rooms, including a new pre-triage regime that is meant to identify potential coronavirus cases and separate those individuals from others in the waiting room, Mithani told CBC Radio’s Edmonton AM on Wednesday morning.

Staff are gearing up in protective equipment like gowns, masks and gloves when working with patients who are coughing, feverish or exhibiting other signs of flu, she said. 

And hospital administrators have been preparing backup plans — as well as backups to the backups — to ensure that sufficient staff are in place in the event doctors themselves fall ill.

But health-care staff have two big worries: burnout from taking on extra shifts to cover for colleagues who are in self-isolation, and the fear of getting sick and bringing it home to their families, she said.

“When somebody can’t come to work, the workload gets spread between the rest of us,” she said. “We’re picking up extra shifts, and that’s only going to become amplified as the weeks go on.

“A lot of the other countries in the world have a much higher rate of COVID-19 in frontline, health-care workers because we’re being constantly exposed to these patients, and I think that’s a worry for everybody right now.”

We’ll talk to an emergency doctor in Edmonton about how ERs are handling efforts to contain COVID-19. 3:58

‘Divide our precious resources’

Mithani said emergency rooms aren’t overwhelmed right now because most people exhibiting mild symptoms of cold or flu are taking the guidance of Alberta’s chief medical officer, Dr. Deena Hinshaw, and staying home.

It’s crucial that people take that advice seriously, said Dr. Raj Bhardwaj. The Calgary emergency room physician said going to the emergency room with minor cold or flu symptoms takes away from patients with more serious problems like broken bones or pregnancy complications.

“It’s forcing us to divide up our precious resources: our time, our masks, our isolation gowns,” he said. “Our gloves are starting to get used up because we have to isolate ourselves — we have to gown and mask and glove — for everybody who has cold symptoms, even though the risk that it is COVID-19 is low.

“We’re actually starting to burn through supplies a lot more quickly because of that. And this pandemic really hasn’t even gotten serious yet.”

Here for a long time

Bhardwaj is concerned about the months, not just weeks, ahead.

Ongoing social distancing measures — often referred to as key to “flattening the curve” — are a deliberate effort to prevent the outbreak from hitting a sharp peak that would devastate the health-care system’s ability to treat patients, he said.

The side-effect is that COVID-19 will likely be around for months, meaning many of the practices being introduced now — like washing hands and staying home when sick — have to become part of society for the foreseeable future, he said.

“I don’t know [if] we can say with any accuracy what the new normal is exactly going to look like — it’s going to depend on things that we don’t have answers to, like potential vaccines or drug treatments or immunity. 

“But it’s going to depend a lot on how well we adapt socially so that we don’t spread this virus around too quickly.”



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