And so it begins. The request to start back-up COVID planning. Overcapacity planning. Surge planning. The question lingering in the back of our minds "will this be the wave where we triage?"
There are many unknowns still with omicron, but what is a fact is that our healthcare system in AB is in such a precarious position that even a blip of a wave will bring it all crashing down.
We have not recovered from the fourth wave, and in many hospitals, we are still into surge ICU and medicine ward spaces. With staffing shortages plaguing the ability to get back to "normal activity."
The stress, impending sense of doom is all palpable this week. The flurry of behind-the-scenes activity is familiar and disconcerting.
And you know what else is familiar and disconcerting? The seemingly laissez-faire attitude of our Premier, which is in stark contrast to hospital activity, planning for the worst.
And so while healthcare workers and hospitals will continue to plan and respond, how much longer can we pick up the pieces of bad public health policy and governance?
Spoiler alert- not much longer. Folks, I'm scared. And tired. The seesaw is just barely on a balance. The weight of this wave will be crushing if our leaders don't start to take it seriously. #ableg#covid19AB#OmicronVarient
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21 months ago, I had no idea what to expect. I entered the battlefield, ready to fight, respond, create plans of action. No template. Just adrenaline, moral obligation, duty. /1
18 months ago, past the first wave, naively thinking that the "fall might be slightly busier."/2
13 months ago, I couldn't believe the death and devastation I was deep into. A record number of death certificates signed amongst our medicine COVID units in one day. And then breaking that record the next day. /3
One of the reasons COVID has affected physicians deeply (aside from the soul shattering moral injury, repeated trauma, and exhaustion-- since those aren't enough)- is because we are learning an entire pathogen and illness from scratch.
Only now are we starting to understand some of the inflammatory cascade that COVID causes and trying to target our therapies towards lessening this effect.
What we know even less about is long COVID. In early 2020, we thought we were going to see an incredible amount of pulmonary sequelae, lingering lung disease.
Long (but necessary) Thread on Hospitalizations: GIM (Internal Medicine) and ICU, and what it means to be "COVID Recovered"
We have gotten used to the slew of numbers thrown at us daily. Active cases. Deaths. ICU and hospitalizations. And over the last few weeks, we have seen a very slow decline in these numbers.
But I caution us all not to get excited or comfortable with these numbers. They do not tell the whole story.
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)
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."