612. The number of days since AB first declared Public Health State of Emergency due to COVID. On almost all of those days, I've woken up, checked the census of internal medicine and COVID patients in my hospital.
95 days. Roughly the number of days we have been in the 4th wave in AB. A wave that may have peaked, but now has plateaued into what we are calling at the hospital "the new normal."
150%. The amount each of my internal med docs have worked over the last 21 months, above their usual contractual obligations, in order to staff the COVID and internal med surge teams. (Should out to @BisonGIM - #TeamGIM)
2. The number of little humans in my family who have sacrificed so much these last 612 days, when adults couldn't get their act together. Who are FINALLY eligible to get vaccinated. And tonight.... Those are the only numbers I care about. ♥️
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With every wave, there is the peak and then the steady decline, where for a moment or two, it feels like the pressure cooker has settled. Where we feel like maybe things are over and the worst is behind us. /1
The reality is that with each wave, the cumulative healthcare effects from March 2020 are more dire, with this current reality the worst we have faced as a province./2
COVID: cases have come down, and hospitalizations are down. All true. BUT any internal medicine service can tell you that our ward COVID patient numbers have plateued, unlike any other wave. Previously, we would see a fast decline as soon we saw cases go down./3
Hi Jane. This is Dr. Bakshi calling from Edmonton. I am not sure if you're aware, but your mom Anne was admitted to the COVID ward about 2 hours ago. I'm calling because she is not doing well, and will likely not survive the day."
...deafening silence....followed by a chilling shriek.... Tears... Gasping for air trying to form words... Phone clicks. 5 minutes pass, and I call again.
"Hi, Jane. I know that was a lot to take in."
Through her tears, Jane responds: Yes. I'm so sorry for hanging up on you. I was shocked. I didn't even know she wasn't well, I spoke to my mom two days ago. I am in BC. I won't make it in time, will I?
"I don't think so, Jane. I am so sorry.... Jane, tell me about your mom."
Thread on healthcare system collapse. Warning: it's long.
Just finished handover for the acute inpatient GIM service I take over tomorrow, and several observations that may help explain further why this crisis is not like anything we have seen before, and why cutting nursing renumeration makes literally zero sense.
An average GIM service will have a mix of patients awaiting long term care/subacute care with a number of medically acute patients. For many years, the flow out of the hospital has relied on numerous factors, including availability of community and alternate level of care spaces.
As I reflect on AB's cases, I can't help but get angry at the privilege and selfishness of so many.
I am talking first hand w/ relatives in India, where oxygen is being rationed, saturations of 75% are all of a sudden "acceptable."/1
Families are pooling funds together to purchase their own high flow machines. I am talking to the doctors, walking them through COVID management as many of them are not at all critical care or hospital trained.
People are dying in the waiting area, in the entry ways, at home/2
Our per capita case load in AB is higher than that of India. But we are fortunate because we have resources. Privilege of being able to social distance and isolate. To attempt to save our healthcare system from triage and crumble./3