Every breath is a fight. Their chest hurts. They can not eat and those that can drink are lucky.
And, these are not the sickest patients suffering from COVID-19 at Windsor Regional Hospital.
Doctor Eli Malus agreed to give BlackburnNews.com some insights into what is happening on intensive care units in Windsor, and around the world, as he and other healthcare providers fight to save as many lives as possible from a virus few had even heard of just a year ago.
"I've had patients beg me to put them on a ventilator because they're so tired," said Malus. "So often, when the decision finally comes to put someone on a ventilator, which is not something we do trivially -- often there's a sense of relief from the patient."
As for the sickest of the sick, those who are on life-support, Malus hopes they never remember the ordeal. Those patients lie prone on their stomachs for 16 hours a day, unconscious, hovering between life and death often for weeks.
"There's no question that these patients are sicker than any other viral pneumonia, really, that I've seen, quite frankly, in my career," said Doctor Eli Malus. "Every time we put a patient on a ventilator, that's a patient that would have died without it."
Chief of Nursing Staff Karen Riddell enters a COVID-19 treatment room at Windsor Regional Hospital. (Photo courtesy of Steve Erwin)
It is grueling work for those caring for those patients, often working 12-hour shifts without a break in full personal protective equipment. Malus estimates it is triple the workload for nurses and respiratory therapists.
"We're happy to do it," he said repeatedly through the interview, but it is taking its toll.
"We already know that in high acuity, busy parts of hospitals and healthcare, there's higher rates of burnout," he expanded. "What's causing most of the problem is how sustained it is -- and then there's the fear of catching it. There's the fear of giving it to your family. There's the fear of getting sick and dying just from doing your job."
And yet, it could be so much worse.
Recently, the Ontario government issued a critical standard of care in the event of a major surge.
Windsor Regional is among hospitals that are continuously working to create capacity for COVID-19 patients. But, what happens if there are no more hospitals to transfer patients to, no more room to place beds, and more patients in need of critical are than there are ventilators? This is the nightmare scenario that doctors in Canada have not faced, but have to think about. It is the catastrophe that doctors in Italy and Spain had to work through early on in the pandemic, and more recently in California.
According to the document, there are three levels of triage care in Ontario. Hospitals only move to this stage if they no longer can create capacity. In the worst case scenario laid out in the paper, patients who suffer a cardiac arrest will not be prioritized for critical care. Those who have a predicted mortality of over 30 per cent are no longer prioritized.
"I don't think we're going to come to that, honestly," said Malus. "What we're trying to do is avoid a situation, like what they had early on in Italy or New York, where there is no guidelines. What we want is the right patient in the right bed at the right time. With new guidelines, that may or may not be used, we're going to make sure we treat everybody that we can treat with critical care."