‘People in their 30s, 40s and 50s shouldn’t die at this level’: one day in an ICU in Victoria

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If vulnerable older people in nursing homes were the face of the first wave of the pandemic, unvaccinated young people intubated in intensive care wards are the hallmark of the fourth.

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On any given day in British Columbia, the vast majority of people in hospital intensive care units are not vaccinated. On November 5, 59 of the 64 COVID patients aged 59 and younger in the province’s ICUs were not vaccinated.

Fully vaccinated people who end up in intensive care are almost exclusively elderly with existing health problems. Of 19 fully vaccinated people in intensive care on Friday, 15 were 60 or older.

However, it is difficult to convey in statistics what ICU RN Carrie Homuth, who manages the adult intensive care unit and the high acuity unit for Royal Jubilee, and her co-workers see every day in those hospitals. “When you come to us and walk down these corridors, there is the true story of the pandemic that is not reflected in those numbers.”

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The Times Colonist visited the intensive care unit of the Royal Jubilee Hospital one day last month to open that curtain and show what life is like for the people behind the daily COVID statistics: the patients, the doctors, the nurses, the therapists. respiratory, housekeepers.

On that day, ICU leader Dr. Grant McIntyre said that all ICU patients in the fifth floor ward were not vaccinated.

“One of the eye-opening things we’ve seen in recent weeks is that many people, before they are put on life support, are very regretful to us,” McIntyre said. “Some people have told me that they made a terrible mistake just before being intubated. It is something very sad to hear ”.

Dr. Omar Ahmad, head of Island Health’s department of emergency medicine and critical care, said that many patients and families are unprepared for the relentless nature of the disease. “With COVID, you have healthy people who a month ago were totally fine and are now on their deathbed.”

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Royal Jubilee physicians have lost at least one unvaccinated patient in their 20s and several patients in their 30s.

“How do you reconcile that in your mind?” Ahmad said. “It is brutal, heartbreaking. Families are not ready for that. “

Ahmad said he took the hands of newly admitted COVID ICU patients and tried to offer hope: “There is so much fear and so much anxiety.” But the reality is that there is not much hope to give.

The ICU and ER physician, Dr. Adam Thomas, wears a Star Wars cap that covers his forehead and a surgical mask that falls below his tired-looking eyes. “People in their 30s, 40s and 50s shouldn’t be dying at this level,” Thomas said. “We deal with death every day in the ICU, but not at this level.”

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Thomas, 36, said he is treating parents his age with young children, putting them on a fan “knowing that they are unlikely to see their children again.”

It is unbearable for families and it is affecting healthcare workers. “It’s a lot,” he said.

Watching patients die knowing it was preventable makes losses more difficult, healthcare providers say.

And it’s getting worse. Since July 1, the mortality of ventilated COVID patients in British Columbia has seen a “significant increase” to nearly double, Thomas said, although it is worse in some areas than others.

The increase in deaths coincides with the fact that Delta becomes the predominant variant, Thomas said. “To do this job, we usually have tricks that work, but not many work now.”

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Some otherwise healthy patients have died within a week of being admitted.

Critical illness progresses differently in different people for a variety of reasons, be they genetic, personal, or environmental, but one thing is clear: a patient’s physical condition has no effect on how their immune system fights the Delta variant, Thomas said.

In some patients, doctors cannot stop the progression of the disease, he said. “It is humiliating”.

Intensive care nurse Graeme Inglis said the nature of the ICU is for some people to die and some to live, but it has been difficult to watch people work so hard, from housekeepers and porters to directors, to no avail.

“We don’t always have successful results here, but especially in the last few months, we’ve seen a lot of sad stories, families by the beds,” Inglis said. “I have seen young wives, I have seen young husbands left behind.”

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Healthcare workers have the added burden of having to hide their emotions as families seek them out to save their loved one, even when everything possible has been tried, Inglis said.

“Unfortunately, patients living in this state do not know how their decision [not to get vaccinated] It has affected them, they can make that decision, and that is great, but we see the families that are left behind and that is something very difficult to see ”.

A small number reject the diagnosis of COVID and some even threaten legal action if they are not given “treatments” that have not been proven.

Treatments used include steroids, immunotherapies, and extracorporeal membrane oxygenation, which is similar to the heart-lung bypass machine used in open heart surgery. At one point, even lung transplants were performed at the Vancouver General Hospital transplant center, but were stopped due to poor results.

“All the treatments that have proven positive, we are using them,” Ahmad said, “but there is no real magic bullet.

“People expect miracles, but the miracle is the vaccine.”

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