The dire situation in Ontario’s intensive care units (ICUs) is all so preventable, say Hamilton Health Sciences’ (HHS) doctors.
“Although 20 per cent of the eligible population of Ontario are unvaccinated, they represent 80 percent of hospitalizations and nearly 90 per cent of ICU patients,” says Dr. Sunjay Sharma, Medical Director at the HGH ICU. “It is very clear that being fully vaccinated significantly decreases your risk of getting seriously sick and hospitalized from COVID-19 – as well as decreases the chance of our hospitals being overwhelmed.”
They’re caring for the sickest COVID patients and know all about what it’s taking to keep unvaccinated people alive in the ICU.
“It’s sad to see people who could have easily avoided these life-threatening COVID infections with a simple vaccination, now on death’s door,” says Dr. Paul Engels. “Sadly, some will certainly die and leave their families without fathers, brothers, mothers, sisters.”
Last resort treatment for critically ill COVID-19 patients
An ECMO (extra-corporeal membrane oxygenation) machine is one way to keep seriously ill COVID patients alive
An ECMO machine is a type of life support that acts as a person’s lungs when their own can’t function.
This cutting-edge type of life support replaces the function of a patient’s own lungs by pumping blood from the patient’s body to an artificial lung (oxygenator) that adds oxygen to it and removes carbon dioxide. Still the chances of survival with EMCO treatment is about 50-50
“Providing ECMO care to patients with such a high burden of illness can be emotionally and physically exhausting., said Dr. Engels.
HHS, which is one of only four large hospitals in Ontario to provide ECMO care, introduced the life-saving machine early in 2020.
All of the HHSC ECMO patients were unvaccinated
All of the patients with COVID-19 that have required ECMO at HHS have been unvaccinated. During a CTV News’ visit to Hamilton General Hospital on September 15, 2021, all of the COVID-19 patients in the ICU were unvaccinated, and eight were on ECMO. ECMO has been used to treat over 8000 patients worldwide, with almost half of them dying in hospital.
“These patients are very ill, and their care demands attention to detail and vigilance, and certainly can be challenging to manage,” says Engels.
“The road to recovery is unfortunately long and winding for patients requiring ECMO,” says HHS intensivist and ECLS team member Dr. Julian Owen. “It is tremendously rewarding to see ECMO patients recover to the point of coming off the ventilator, leaving the ICU, and even walking out of the hospital.”
“It can be very demanding,” says Owen. “Patients are extremely sick and often require other forms of life support in addition to ECMO. There is a high degree of complexity in their care and high stakes for every decision that the team makes.”
ECMO doesn’t work for everyone and can cause complications
ECMO patients are at highest risk of complications from being critically ill, including infections, blood clots, bleeding, kidney failure, heart dysfunction and chronic lung disease, says HHS intensivist, member of the ECLS team, and anesthesiologist, Dr. John Centofanti. Older people generally can’t tolerate the physical stress of this type of machine, so it is most often used with younger, otherwise healthier patients.
Pandemic causing healthcare worker burnout
Centofanti fears we have entered a stage where people are “done with COVID” – but healthcare workers know this stage by another name: the fourth wave.
“Lives have been altered, and in some cases, turned completely upside down. I understand the need to return to normalcy and a sense of complacency with new rules, restrictions and guidelines,” he says. “Nonetheless, COVID is not done with us. Viruses have a unique way of trying to survive and prosper, changing, adjusting, mutating.”
Being fully vaccinated against COVID-19 is the best prevention against serious illness, hospitalization and death.
Healthcare workers are frustrated and burnt out.
“Providing ECMO care to patients with such a high burden of illness can be emotionally and physically exhausting,” says Owen. “Patients requiring ECMO support are often young and it is difficult to see them fighting for their lives and their loved ones devastated by their illness.”
“I think we are all experiencing fatigue in different ways,” says Centofanti. “A healthy mindset and balance are important for everyone. A cohesive, trusting, and enjoyable group of family and friends help to lighten the load and remind us of the world outside of the ICU, and outside of COVID terror. Prioritizing this is important for ensuring our team is rejuvenated when it comes to providing patient care.”
These doctors who are fighting to keep people alive are asking residents to please receive the vaccine as soon as you are eligible. To find out where to get a shot, click here.