'I come home and I cry': Rise in patients with respiratory illnesses leaving health-care workers drained

One-on-one with Dr. Theresa Tam Dr. Theresa Tam says she’s hopeful of COVID-19’s shrinking impact but urges people seeing family to get boosters if they haven’t already.

Patti Champoux, an X-ray technologist at Niagara Health’s general hospital in Niagara Falls, Ont., says the facility has been operating at full capacity since the start of the COVID-19 pandemic. But over the last few weeks, health-care workers at the site are seeing a sharp rise in the number of patients with respiratory illnesses, she said.

Not only that, but the patients visiting her for X-rays appear sicker than they usually are around this time of year, said Champoux.

“People I’ve seen in the last three weeks are incredibly ill,” Champoux told CTVNews.ca in a telephone interview on Thursday. “They’re in the emergency room and they’re white as a sheet, lethargic [and] feverish … They are weaker than I’ve seen in a long time.”

Part of the reason for this is the increased circulation of a “trifecta” of respiratory illnesses, Champoux said. In addition to COVID-19, health-care workers are now seeing a rise in the number of patients with influenza as well as respiratory syncytial virus (RSV). Champoux is one of several health-care workers who reached out to CTVNews.ca to share how they are handling the surge in patients with respiratory illnesses.

This increase is leaving hospitals and health-care clinics across the country overwhelmed with patients, experts say. Pediatric hospitals have been hit especially hard. In British Columbia and Alberta, the increase in sick children has resulted in postponed surgeries and hospital wait times of up to 17 hours. Ontario’s pediatric intensive care units are also operating well over capacity, with some hospitals opening additional ICUs to handle the demand.

The largest children’s hospital in Atlantic Canada is also seeing “historic levels” of sick children, said Dr. Andrew Lynk, chief of pediatrics at IWK Health Centre in Nova Scotia. In a press conference on Nov. 17, Lynk said the hospital has recently seen as many as 200 sick kids in the span of 24 hours.

While Niagara Health’s general hospital does not exclusively care for pediatric patients, it has seen a significant increase in the number of children visiting its emergency room, said Champoux, particularly those with RSV and pneumonia.

“There’s been an increase of 40 per cent of children that I’ve seen in the emergency room,” Champoux said.

In order to meet the demand of higher patient volumes, Champoux said, overtime among health-care staff has become the norm. She and her colleagues are constantly scrambling at work and breaks are a “luxury,” she said. This adds to the burnout she and her colleagues have been feeling throughout the pandemic, Champoux said.

“[Some] part-timers are working 90 or 95 hours in two weeks,” she said. “They get tired and then they get sick, and now all of a sudden, their shift needs to be filled. Then that circles back to people working overtime.

“It’s a vicious circle.”

According to a survey conducted by Statistics Canada in 2021, 95 per cent of health-care workers said their job was impacted by the COVID-19 pandemic. These impact included an increased workload and feeling more stressed at work. Additionally, data from the Canadian Institute for Health Information (CIHI) shows health-care workers clocked more overtime hours in 2021 than they had in a decade.

Stress from work is also having an impact on her home life, Champoux said. The exhaustion leaves her too tired to spend time with her husband and 19-year-old son.

“Sometimes I come home and I cry,” she said. “Once in a while, I have to push an in-patient to the next day because there's just not enough time in the day to do their X-ray and … I feel guilty because I think I’ve delayed their care.

“It’s with a heavy heart that we can’t get to everybody all the time.”

LACK OF STAFF MEANS ‘EVERYONE IS JUST WAITING’

Also struggling with increased patient volumes are those working in the emergency department of the London Health Sciences Centre in London, Ont., said Dr. Alex Dong, a physician at the facility. For months, the emergency department has been under-staffed while operating over capacity, he said.

The lack of health-care workers at the hospital is affecting the number of patients that can be treated, Dong said. The emergency department he works in has about 35 to 40 beds. On most days, at least 20 per cent of these beds are closed due to a lack of staff, he said.

“We’re short on nurses and it's unsafe to have one nurse being in charge of so many beds at the same time,” he told CTVNews.ca in a telephone interview on Thursday. “From a patient safety point of view, we do have to close those beds because we can’t safely staff them.”

This is contributing to longer-than-ever wait times that are routinely in the double digits for non-emergent care, Dong said.

According to a press release dated Nov. 9, wait times for non-emergent care at the London Health Sciences Centre are anticipated to exceed 20 hours. Some patients are also being seen by doctors in hallways due to the limited availability of beds, Dong said.

Understaffing has been prevalent in hospitals across Canada since before the COVID-19 pandemic took hold, according to the Canadian Federation of Nurses Union (CFNU). Data from Statistics Canada reveals there were 126,000 vacancies in the health-care and social assistance sector in 2021 alone.

The reason behind the influx of patients with respiratory illnesses stems from the removal of physical distancing measures that had been in place during most of the COVID-19 pandemic, Dong said. Lockdowns and limits on social gatherings largely prevented Canadians from gathering in large groups. As a result, they have been getting sick less frequently over the last two-and-a-half years, Dong said.

“Now that we are no longer having restrictions … when we do get sick, our immune systems are not used to it, so it tends to be a worse illness,” Dong said. “If you have a cold today, it will feel a lot worse than a cold that you would ever remember … because your body's not used to it.”

With beds in his emergency department either closed or already occupied by sick patients, there are times when there is no space to admit new patients from the waiting room, Dong said. As a result, physicians are also left waiting for patients. His shifts often start with waiting about an hour before a new patient can be assessed.

“Everyone is just waiting,” Dong wrote in an email to CTVNews.ca on Tuesday. “From a physician’s perspective, it is quite frustrating.”

HEALTH EXPERTS PUSH FOR PREVENTION MEASURES

It’s not just hospitals that are seeing a surge in patients with respiratory illnesses over recent weeks – individual clinics are feeling the strain as well. Dr. Marina Abdel Malak, a family physician based in Mississauga, Ont., said she has been working more hours to accommodate for the increased number of patients she is seeing, even taking her work home with her.

“I'm reviewing the results and having to look over my schedule, trying to open more appointment slots,” she told CTVNews.ca in a telephone interview on Friday.

Abdel Malak works at two clinics, one of which is specifically for cough and flu patients with symptoms such as fever, cough, runny nose and nasal congestion. Two months ago, the clinic saw about 20 patients with these kinds of symptoms each day. Now, doctors are seeing between 40 and 50 patients per day.

“We’ve certainly doubled our volume in the past two months,” she said. “The amount of coughs and runny noses and flu and rashes and fevers has gone up significantly … It's not unusual to see our lineup outside fill up even before our clinic opens.”

Operating over capacity has contributed to longer wait times for patients at both clinics, Abdel Malak said. Complaints from patients frustrated with having to wait for care is taking a toll on her and other clinic staff members, she said.

“I completely understand that they’re frustrated because you're having to take a significant chunk out of your day to visit the doctor,” she said. “But at the same time, there is no way that I can manage 40 or 50 patients a day without somebody having to wait.”

The Ontario government recently distributed a memo asking family health-care workers to work evenings and weekends to help ease the burden on pediatric hospitals. But at her clinic, Abdel Malak said she and her colleagues already aren’t taking breaks, nor are there specific times for staff members to eat lunch or use the washroom.

“What more can we give? We're really giving our all and we're staying open as much as we can,” she said. “So many forget that doctors are humans too.”

With so much more viral activity being reported than usual during this time of year, and the cold and flu season just getting started, Abdel Malak said she is unsure what to expect over the next few months.

“It’s going to be an interesting winter, we don’t know how much longer our clinic can support this,” said Abdel Malak. “This is just the beginning.”

Going forward, Abdel Malak said she would like to see stronger public health measures in place across Ontario. This includes the implementation of mask mandates, as well as encouraging residents to get vaccinated against COVID-19 and influenza. Other infectious disease experts are also encouraging Canadians to maintain good hand hygiene and wear masks indoors.

“An ounce of prevention is worth a pound of cure,” said Abdel Malak.

With files from The Canadian Press and CTVNews.ca writers Tasha O’Neill and Michael Lee