As the number of hospitalizations with COVID-19 patients increases into January 2021, Dr. Peter Goldberg discusses how the MUHC is planning to operationalize a potential increase in patients. These are some of the logistical and emotional choices Montreal area hospitals may have to face in the coming weeks.
Interviews with Dr. Goldberg on the status of Montreal hospitals, and what happens next:
- Director of MUHC critical care says the situation is beyond surreal. Michel Lalonde of the Montreal Gazette, January 13, 2021. Photo credit: John Mahoney /Montreal Gazette.
- Cri du coeur des intensivistes “Ça ne tient qu’à un fil”. La Presse. January 15, 2021.
- Cardiac surgeries latest to be cancelled at Montreal hospital as ICUs fill up. iHeartRADIO. January 14, 2021.
- Doctors conducting ‘dry runs’ to decide who gets access to critical care if hospitals exceed capacity. Benjamin Shingler, Leah Hendry. CBC News. January 15, 2021.
Who will be most affected by COVID-19?
A related post from November 2020:
We are months into the second wave of COVID-19 yet healthcare workers remain unable to predict who will get sick from the virus and who will not. Neither the severity of a patient’s symptoms, nor their age, forecast the ultimate outcome. Nor does the existence of a pre-existing medical condition dictate how things will end. The truth is, healthcare teams do not know who will be most affected by COVID-19. In a recent interview, Dr. Peter Goldberg, associate member of the Meakins-Christie Laboratories and researcher in the RESP Program of the RI-MUHC, expresses his frustration at his inability to save someone who is too young, too alive, to die:
“it was like a forest fire, and all I had was a garden hose.”
Dr. Goldberg
Even patients seemingly on the mend can take a sudden turn for the worse and experience a rapid decline. Suddenly their life is in jeopardy. Physicians must be ready to respond quickly when this happens, but when not successful they are left to watch their patients pass on without the support of their family or friends.
“If there is anything more distressing than seeing someone die, it is seeing them die alone, or a nurse holding up a phone on Zoom or Skype so that family members can watch this,”
Dr. Goldberg
Canada’s case fatality rate is high amongst peer countries, but it is suggested that the trend could be due to testing: in Canada, testing has focused on individuals with symptoms and at-risk individuals, rather than the entire population. Regardless of testing, as the number of people with severe symptoms require hospitalization increases, hospitals become overloaded and physicians are faced with difficult decisions. Reflecting back on the spring and how the hospitals quickly filled up, Dr. Goldberg recalls having “very disturbing” conversations with hospital ethicists, and he sincerely hopes not to find himself in a similar position this time around:
“I don’t think the community knows that these conversations are going on. We’re talking about them — we’re not talking about something esoteric about ourselves. We’re talking about how ICUs, if we reach the limitation of our capacity to treat COVID patients, then we’re going to have to make decisions about who gets the bed.”
Dr. Peter Goldberg
Dr. Goldberg speaks of fighting this virus from a physician’s perspective, and the difficulty to predict who will be most affected by COVID-19, in his interview with Sharon Kirkley of the National Post.
The interview with Dr. Goldberg can be read here:
- Beyond the numbers: Who is dying of COVID in Canada, and how? Sharon Kirkey of the National Post. November 28, 2020.