Researchers at the British Columbia Centre for Disease Control estimate that less than one percent of this province’s population was infected with COVID-19 during the pandemic’s first wave. That’s good news and bad news. The bad news, of course, is that the vast majority of us are still susceptible to the virus and must remain vigilant. The good news, however, is that the steps BC took to combat the pandemic worked to keep exposure and transmission rates low.
Salt Springers are familiar with the very public role Provincial Health Officer Dr. Bonnie Henry has played in teaching British Columbians about combatting the COVID crisis. However, few have been privy to what it was like inside the hospital, learning to deal with COVID.
Lady Minto Hospital Site Director Sara Gogo says it was a rollercoaster. “With the information changing so quickly, we’d tell the staff one thing and then, sometimes that would change minutes later. We were really excited about some of the changes that were taking place because it felt like we were addressing the concern in a really meaningful, thoughtful way. And yet there was this constant anxiety in the community and therefore in the hospital, which made it a difficult place to navigate for a lot of us, for a long period of time.”
And then, she says, it started to get better. “I can’t really name a date but it was probably only really within the last few weeks, when I noted laughter, hearing the nurses laughing, and hadn’t actually realized that was something I had not been hearing. This is a hospital where our staff relationships are very strong and tight, and it was just really good to walk onto the unit and see that happening, and then make the realization that wow! This has been a long time since the mood has been this light. Everyone got worn down, we are counting on this reprieve as a time for all of us to get rested and rebuild our resiliency banks.”
Trained as a registered nurse, Gogo notes that while nursing school teaches about epidemics and pandemics, they are infrequent enough that when one actually occurs, one is never trained for this exactly – unless you’re Dr. Bonnie Henry. “A lot of us were able to pull on a lot of skills that we’ve developed about planning, to pull things together and, I think, do it in a way that was pretty effective overall. I can’t say enough about Bonnie Henry and her leadership and her experience, because she has been through – and led through – incredible situations. So having her in British Columbia – she’s just been amazing, and has brought such a sense of assurance that we’re doing the right thing.”
Gogo believes the pandemic and the health care system’s response to it has changed medicine irrevocably. “In terms of what we’ve been able to achieve regarding virtual visits, for instance, I can’t believe that we’ll ever go back to the way it once was. I think we’ve made some great and really exciting advances, not only with virtual care, but also in just rethinking what people need, how we deliver care, and how we do it in a timely fashion. In my own experience, I can ‘see’ my doctor now faster than I ever could before, and for me, most of the time, a conversation on the phone is absolutely adequate. And I think that’s true for a lot of people.”
The pandemic has also changed the physical layout of Lady Minto Hospital with the creation of a COVID Pod, an ingenious ‘quick fix’ to a sudden problem. “Early on, we identified that we needed to have a different stream for patients to present to the hospital if they were potentially COVID-positive,” Gogo explains. “So we built a wall on our Acute Care Unit that took a number of patient rooms, our physio office, our sunroom, and multipurpose room and could be accessed separately from the main entrance. We were able to set up a tent in front of the hospital, assess individuals, and if they any potential COVID symptoms, direct them right into the COVID Pod.”
The Pod allows for a fuller patient assessment by nurses and physicians in an area that can then be fully cleaned after each visit. It allows the hospital to maintain its inventory of personal protective equipment more efficiently. The hospital also acquired a trauma stretcher, so that a patient can be x-rayed while lying on the stretcher. “While we didn’t necessarily have to deal with them in the first wave, we realized we would need that ability in order to care for very sick patients,” Gogo says.
The COVID Pod also contains the hospital’s Negative Pressure Room. “’Negative pressure’ is a very specific system that minimizes the ability for droplets to move around in a room,” Gogo explains. “It takes them from the room and cleans them out. This one specialized room, used in other times for things like an active TB case or any number of infectious illnesses where there are droplets concerns, allows us to care for someone safely in a room that doesn’t flow into other patient rooms. So it was a key part of the Pod area and worked out really nicely.”
The first wave of the pandemic might have an impact on Lady Minto Hospital’s Emergency Department Redevelopment Project, which is now in the design phase. Gogo notes that it may be necessary, for example, to rethink the entrance to the new Emergency Department. Perhaps there should be more than one entrance in the event of another outbreak like COVID. “We cannot have someone come into the Emergency Department unconscious and just assume that they’re not COVID-positive,” she says.
Maintaining a state of perpetual readiness is crucial as the pandemic continues to be in our midst.
“On a practical level, it’s relatively easy. We’re still being very, very cautious,” Gogo reports. “The way we’re assessing patients with symptoms remains the same. We continue to have the Pod going. It certainly slows down our community members when they enter the hospital, but people are still accessing care in a timely way.”
But there’s also the issue of maintaining the emotional and mental level of preparedness. “That’s a really good question,” Gogo replies. “I think a lot of us are trying to take a break from that and yet, it’s difficult to do so because of the necessity to remain vigilant. Completely ‘cranking it down’ is quite impossible from my perspective.”
Gogo and the team at Lady Minto Hospital appreciate the ongoing encouragement from the community. “We’ve had incredible support from our community, from all the people going out at 7 o’clock to bang their pots and blow their horns, to the thoughtful words people have sent our way…..and the food! The many, many people who’ve sent us food. I think we all feel like, okay, it’s time to step away from the carbs a little! But it’s important to express the gratitude we have as medical professionals going through this. We’re so appreciative!”
When asked if anyone was admitted to Lady Minto Hospital with a confirmed COVID case, Gogo pointed out that as a matter of policy, health authorities in BC do not disclose specific communities where COVID exists or the number of people who’ve tested positive in specific communities unless public health providers can’t be certain they’ve reached everyone who needs to be contacted and might therefore be a risk to the public. It’s an important privacy issue, she says. “If people know their privacy will be protected, they’ll feel safe contacting us for treatment and follow up, and that allows public health providers to do the work they need to keep everybody safe.” Gogo says Dr Henry’s message is clear: ““Every single person in every community needs to be aware of the risk. It’s in your community too and it doesn’t serve anybody to think it’s not. Everyone, everywhere, must follow the precautions, including physical distancing, frequently and properly washing your hands, and staying home if you’re sick.”