TORONTO -- The truth of the fourth wave of COVID-19 in Canada is starkly clear inside the intensive care unit at Hamilton General, where the majority of the COVID-19 patients struggling on life support are young 鈥 and unvaccinated.
The team at Hamilton General invited 麻豆影视 inside the tense ICU in the hopes of giving Canadians a look at the reality they go through every week as Delta cases climb.
鈥淚 think it's important for Canadians to see that this is real,鈥 Dr. Sunjay Sharma, medical director of critical care, told 麻豆影视. 鈥淣one of these people thought two months ago they would end up here. And now they're here. And some of them won鈥檛 survive.鈥
Inside this ICU, on the day of CTV鈥檚 visit, 30 per cent of the 45 beds are COVID-19 patients fighting for their lives, most of them infected recently.
And every person that was admitted during the fourth wave declined vaccination or just didn鈥檛 get around to it before they fell ill.
鈥淚t鈥檚 crazy people don鈥檛 believe it,鈥 Sharma said. 鈥淲e come to work every day. This is real. It鈥檚 like someone telling you the sky is not blue.鈥
They want those who don鈥檛 believe the risk of COVID-19 is real to see the enormous strain that this work is having on health care workers, who are already exhausted from almost two years of fighting.
The unvaccinated COVID-19 patients this hospital is seeing are younger and healthier, in their 30s and 40s. Many them require a specialized form of life support called ECMO, in which their blood is removed to be given oxygen and pumped back into the body because their lungs have failed.
It鈥檚 the 鈥渉ighest level of life support you can get anywhere,鈥 Sharma said.
He pointed out a patient in his 40s, who is hooked up to an ECMO machine.
鈥淭here's a catheter the size of a garden hose in his neck, and there's a catheter the size of a garden hose [at his] groin,鈥 Sharma said.
鈥淎nd basically it takes the blood out of his groin, puts it the machine, takes the carbon dioxide out, [puts in] the oxygen, and then comes back into his heart.鈥
Most of the patients who are on ECMO with COVID-19 don鈥檛 have significant co-morbidities.
鈥淚t鈥檚 scary. It鈥檚 people younger than me, in some cases healthier than me,鈥 Sharma said.
Only four hospitals in Ontario offer ECMO support. Toronto General is one of the four, and told 麻豆影视 that they have 13 COVID-19 patients on ECMO currently, all of whom are unvaccinated.
And it鈥檚 not only happening in Ontario. Alberta鈥檚 Chief Medical Officer of Health, Dr. Deena Hinshaw, that of the 218 COVID-19 patients who are in ICU in the province, 92.3 per cent are unvaccinated or partially vaccinated.
There are several million Canadians who are not vaccinated, some who have chosen not to get even one dose of the vaccine.
Some may have legitimate medical exemptions.
But there are others who refuse saying the vaccines don't work, they aren't safe, that COVID-19 itself is a hoax.
Health workers who see patients stricken with the virus every day know it is no hoax and say that across the country hospitals and ICU's are slowing filling up with patients 鈥 almost all of whom are unvaccinated.
The fourth wave is a wave almost entirely among those who have not gotten their shot, they say.
At Hamilton General, all of the COVID-19 patients in the ICU are unvaccinated, and eight are on ECMO.
Dr. Faizan Amin, medical director of the ECMO unit, said he hoped seeing into the situation in the hospital would change some minds.
鈥淪ome of the viewers that have those beliefs will be able to watch this on TV, and there is nothing unreal about these people, they鈥檙e real life people, they鈥檙e real fathers, mothers, brothers, sisters 鈥 real human beings and they're getting very sick,鈥 Amin said.
A month ago, this ICU had just one COVID-19 patient. Now they have 14 -- and four-to-five requests a week to accept more patients from other hospitals who need more intensive care.
And as the ICU fills up with COVID-19 victims and other patients suffering from urgent issues such as strokes, heart attacks and physical trauma, other surgeries get cancelled.
鈥淭his ICU serves cardiac surgery, or surgery and trauma, vascular surgery, stroke. It is the regional hospital for all of this region for 2.5 million people,鈥 Sharma said, adding that around 15 other hospitals frequently send patients here if they need a higher level of care.
THE VACCINE STRUGGLE
Some COVID-19 patients have expressed regret once they understand the magnitude of their situation.
Erin, an ICU nurse who asked us not to use her last name, told 麻豆影视 that 鈥渁 lot of people have been asking for vaccines, right before they get intubated. But it鈥檚 too late.鈥
But some skeptics don鈥檛 change their mind even when on the edge of death, she reported, adding that some who have been on ECMO and recovered still say there isn鈥檛 enough research about the vaccines that would鈥檝e likely prevented their own suffering.
鈥淭here is a small subset of people that we're still seeing who feel that this is not a real disease, or it's not as dangerous as some people are making it out to be 鈥 but the reality is in front of our eyes,鈥 Amin said.
One of the patients who has been on ECMO in Hamilton General for the longest period of time is a patient in his 30s who has been in the hospital for months 鈥 he fell ill before he was able to be vaccinated because it hadn鈥檛 been opened up to his age group yet.
Unlike the COVID-19 patients coming into the ICU this month, 鈥渉e did not have a choice,鈥 Sharma said.
The man has been totally healthy before he contracted COVID-19, Sharma said.
Health care workers are dedicated to giving everyone the best care possible, but it is frustrating seeing patients who didn鈥檛 need to be suffering to this degree, they say.
鈥淭o know that their families didn't have to go through that and the patients didn't have to go through that, if they just got [a shot] that takes 30 seconds,鈥 Sharma said. 鈥淚t's frustrating, and you just can't understand the rationale behind why you wouldn't get a vaccine.
鈥淲e see this every day 鈥 this is where you end up when you don鈥檛.鈥
Sharma said that when they have patients who are unvaccinated, their family members often change their own minds about vaccination after seeing their loved one suffer.
鈥淢any of the family members of people who are here and are unvaccinated, after seeing their family members here for a week, get vaccinated,鈥 he said.
鈥淚t's unfortunate that it's taken sort of that experience to change some behaviours,鈥 Amin said.
Sharma is not only frustrated with the individuals, but with the larger machine of misinformation that leads people to be confused about vaccines and what is best for their health.
鈥淚t's anger with the social contract that got them into this situation, it is anger of people posting on social media that COVID-19 is not real, or that vaccines don鈥檛 work,鈥 Sharma said. 鈥淭hat basically preys on vulnerable people, that makes them make bad decisions that lands them up here.鈥
Seventy-eight per cent of eligible Canadians have been fully vaccinated. Side effects are rare according to public health officials as are breakthrough COVID-19 cases, and vaccines have been proven to drastically minimize severe cases of COVID-19 as well as death in the event of a breakthrough case.
And yet, in this fourth wave, we鈥檝e seen a baffling level of animosity displayed towards health care workers from a small subset of people, ranging from anti-vaccine groups protesting outside of hospitals to individual health care workers receiving threats.
A year ago, it went unquestioned that health care workers were heroes. But now some groups are looking for someone to blame.
鈥淭his morning I got some angry phone calls from people in the public because of my advocacy for vaccines,鈥 Sharma said.
He said it鈥檚 not only frustrating, but personally insulting that people would think that he鈥檚 taking time away from his family not to take care of sick patients but to prop up some lie about the virus.
"I have two young kids who I went for weeks without seeing, because I was here [at the hospital],鈥 he said.
鈥淚 don鈥檛 think that there's any motivation for healthcare workers to lie.鈥
Nurses told 麻豆影视 that they know colleagues who have been spat on by protestors, booed.
鈥淭hey think it鈥檚 a hoax and that honestly is a slap in the face to us after everything that we've been doing,鈥 said Erin.
A HEALTH CARE HOUSE OF CARDS
That animosity is one more burden for health care workers during this fourth wave, on top of increasing burnout and short staffing.
Amin pointed out that when the third wave hit in the spring, it put more pressure on the health care system than had occurred in a year of COVID-19.
鈥淲e've been going at this in full gear for 18 months, and working that hard for that long for all the healthcare providers here that are looking after these patients, it's very difficult,鈥 he said.
Michael Plaunt, clinical manager of the coronary care unit at Hamilton General, told 麻豆影视 that everyone is tired.
鈥淭hey're burnt out, they're exhausted,鈥 he said. 鈥淎t the beginning, we didn't have any way to prevent this. And now that we have a way to prevent this, we should be seeing that improve, and we're not. So that's the frustration.鈥
Health care workers say the circumstances of many of these fourth wave cases eats away at the compassion that is integral to their work.
鈥淲e will come in in the middle of the night to take care of a sick patient, no matter the time of day or the day of the week,鈥 Amin said. 鈥淏ut when it's an easily preventable situation, you start to start to lose some of the empathy. And that's a key factor of what we do as healthcare providers 鈥 we are empathetic and compassionate and you want to continue being that way.鈥
Medical staff are becoming clearly fatigued, in more ways than one. At Hamilton General alone, around 12 staff members have left their job between the third and fourth waves.
鈥淭he system is cracking,鈥 Amin said. 鈥淭he fourth wave is in many ways worse than the third wave. Although the number of cases in the community are not as high as we were seeing in the third wave, the amount of resources we have left within the healthcare system are much less now than they were in the third wave because of things like burnout and exit of staff members.鈥
He pointed out that because of the burden on the health care system from COVID-19 patients, those who are getting ill from other diseases and conditions are having their care further delayed because of mostly preventable COVID-19 cases.
Health care workers are urging those who are still on the fence about vaccination to get their shots.
鈥淚 don鈥檛 think we are at the crest of the fourth wave,鈥 said Sharma. 鈥淚 think the wave is building. I think it鈥檚 going to get worse.鈥
And if health care workers don鈥檛 get a moment to breathe soon, it could mean big problems not just for COVID-19 patients, but everyone.
鈥淚 don't think a wise thing would be to push those people again to the max, because we still have a healthcare system to run after COVID is over,鈥 Sharma said. 鈥淎nd I think we can't lose sight of that.鈥
