'we're not able to provide good care to all of them': quebec doctors stress as more kids become seriously ill
cma president dr. alika lafontaine calls the situation “dire,” but he says health-care professionals and the public are in a better position to manage because of what they have learned: "the same thing is happening with kids instead of adults now."
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canadian medical association president dr. alika lafontaine advising canadians to wear masks, stay home if sick, and get vaccinated. photo credit: canadian medical association.
while covid-19 numbers are trending down in quebec, the wave of respiratory illness cases for young children has put the health-care system in turmoil — again — much like the early days of the pandemic, experts say.
the college of physicians of quebec (cmq) recommended on social media early this week that people wear a mask in public places and “behave cautiously and responsibly” in the coming holiday season to curb the spread of respiratory viruses, lesoleil reported. quebec health minister christian dubé said wednesday that a trio of respiratory viruses, including respiratory syncytial virus (rsv), covid-19 and influenza could signal a difficult winter, according to the montreal gazette.
“we are facing a potent cocktail for the next weeks if not months, so it’s time to return to good practices of prudence and vigilance for everyone,” dubé said. “as of now, wear masks in crowded areas, in public areas, and this is for everyone. you can come across infected people, but also infect vulnerable people. we must all do our work to eliminate the risk.”
811 pediatric line set up to help montreal parents
an 811 pediatric information line to help parents navigate care for their children is now running in montreal and coming to other regions, and three new urgent care clinics run by specialist nurses are being set up in montreal to help relieve er overflow.
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dr. caroline hosatte-ducassy, an emergency doctor in montreal and spokesperson for the quebec association of emergency physicians, laid out just how serious the situation is:
“typically, within a shift you would see one, two, maybe three pediatric patients. now it’s 20 to 40 per cent of our patients, and most of them are for respiratory illness. so it’s a burden on our emergency because we’re not equipped to face these numbers of pediatric patients who are usually very small babies with respiratory illnesses.”
hosatte-ducassy, who works in community hospitals with cisss of montérégie-centre, has seen the capacity of emergency beds double in response to the demand, putting two patients in a room instead of one, and icu and pediatric wards completely reorganized to try to manage the surge. she’s also spent the last three weeks in the emergency department at montreal children’s hospital and witnessed the anxiety of parents with sick infants.
‘moral stress’
“in emergency medicine, we’re trained to work with stress,” she says. “i think the main stress right now is more on a human level because we have so many patients to see that we’re not able to provide good care to all of them. so it’s more of a moral kind of stress to not be able to have this feeling that we do a good job and provide the level of service we should do. and it’s difficult for the team in general, not only the doctors. the nurses have that pressure from the waiting room, people are anxious, especially when their kids are sick, it’s very emotional for them. so it all adds a level of stress to what we’ve been facing over the last two years.”
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the canadian medical association (cma)’s national physician health survey, released in august, revealed that 60 per cent of doctors in quebec have experienced burnout, which is seven per cent above the national average, so another round of acute viral infections burdening the health-care system is going to take a toll.
and while cma president dr. alika lafontaine agrees that the situation is “dire,” he says health-care professionals and the public are in a better position because of what has been learned from covid-19 over the past two-plus years.
“the same thing is happening again, just with kids instead of adults now,” he explains. “quebec is the first place in canada dealing with these really high rates of [pediatric emergencies] overwhelming the system and it’s now spread into ontario. quebec has seemed to be an early indicator of what the rest of canada is going to experience.”
we need a ‘united approach’ to curb the spread
the best approach is a united response to curbing the spread, he says. cma supports all steps that help to mitigate the spread of respiratory illnesses, especially those that curb the spread through the air through droplets. recommended masking, for one, has proven effective in the past.
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“masking, staying away from people when you’re sick, if there are vaccinations available, get vaccinated, improve indoor ventilation,” says lafontaine. “i know some of these things are tough to do, but the reality is everything by itself definitely makes a difference, but everything together makes an enormous difference. and the more of us that do it, the more difference it makes.”
mask mandates work
just as health authorities are recommending masking in public places, including schools, a new u.s. study out of harvard university revealed that schools that kept mask mandates in place have experienced significantly fewer covid-19 cases.
hosatte-ducassy says public masking is important and effective, along with other pandemic safety measures. but she says the majority of the virus transmission likely happens when people let their guard down in private settings among family and friends, forgoing masks and shrugging off cold and flu symptoms to relax and enjoy socializing.
“when the barriers go down, even with, ‘i just have a little sore throat, but it’s okay, i’ll take advil and go to the party anyway’ and then you talk and you share food. i think this is where the most of the transmission actually occurs, and public masking won’t solve that problem,” she says. “nobody wants to go back to where we were confined, no gatherings, everything outside. nobody wants to go back there, but i think we all have to do little steps to make our gatherings to happen as safely as possible.”
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karen hawthorne is a toronto-based writer.
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