As the number of COVID-19 cases in Ontario declines, some hospitals in Toronto are now reaching new milestones — zero coronavirus patients in their intensive care units.
Humber River Hospital marked the moment in a tweet on Friday, noting that it was the first time since March 14 that there were no coronavirus patients in the ICU.
“Thank you go the 6th floor staff and physicians that have bonded together and provided exceptional care in this pandemic. Today is a day to celebrate at (Humber River Hospital),” said the tweet, which included a photo of staff in the ICU.
Humber River serves a section of the city that has been hit hard by the pandemic — Toronto’s northwest corner, where a higher proportion of racialized, low-income people live in cramped housing. The Star has been reporting on high rates of coronavirus infections in this part of Toronto and neighbouring regions.
“The northwest section of Toronto had the worst outbreak in the GTA and that’s the area we service,” said Dr. Jamie Spiegelman, an internal medicine and critical care specialist at Humber River Hospital, in an interview Saturday.
North York General Hospital also marked a milestone on Friday, with zero coronavirus patients in its ICU.
“It’s obviously very positive,” CEO Dr. Joshua Tepper said Saturday, adding that hospitals must be conscious of how easily the virus can spread again if proper masking and physical distancing aren’t maintained, as the rising number of cases in the U.S. has shown.
North York General had to delay serious surgeries and cardiac treatments when the ICU was full of COVID-19 patients; now, those treatments can resume, Tepper said.
St. Michael’s Hospital in Toronto had four COVID-19 patients in its ICU as of Friday.
The 20 new coronavirus cases reported in Toronto’s on Saturday were the lowest daily total since March 26, according to the Star’s latest count.
While “holding our breath” for fear of the anticipated second wave of the virus, the medical team at Humber River is prepared for a return of COVID-19, Spiegelman said.
“This time around we know how to treat patients; we know the risks, what precautions we need to take,” he said, noting that no ICU nurses or doctors at Humber River had contracted COVID-19.
“We know the virus is very contagious, so in terms of the (personal protective equipment), we know exactly what we need and don’t need in terms of protecting our staff.”
Spiegelman listed the PPE worn by staff, including “impervious gowns, gloves — we double-glove every time we go to see these patients — N95 masks, face shields, and a bonnet (hair net).
“That’s all we need. A lot of places in the U.S. use higher acuity, mechanical N95 masks and we found that that wasn’t really what we need,” Spiegelman said. “It hinders your treatment of patients, makes you hot, and you’re sweating underneath the hazmat suits.”
He added: “We found we really didn’t need to do that in our ICU, partially because the air circulation in our ICU is good. Everyone room is individualized, rather than shared rooms with many patients.”
The peak of COVID-19 patients in the 48-bed ICU at Humber River hit around late March with 20 cases, Spiegelman said (the remaining cases were not COVID-related), and about 20 people had to be transferred around that time to other ICUs in Toronto hospitals.
“We were over-our-heads busy,” the doctor recalled.
Throughout the crisis the medical team and staff celebrated every “win” — when a patient survived and left the ICU, Spiegelman said.
The first COVID-19 patient treated in Humber’s ICU was there for around three months.
“No one expected him to survive, but he just left the hospital and went to rehab this past week. So that was a big win. He was around 60 years old,” Spiegelman said.
“We didn’t know what to expect initially. He was so sick, needed so much oxygen. There were times we were concerned he had brain damage from lack of oxygen because his oxygen saturation went down so low.
“The fact that he recovered after a tracheostomy and all the feeding tubes … is a little bit of a miracle, I think. We’ve never treated this disease, so we didn’t know what we were treating.”
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There were also tragic cases of younger people who died from the virus, Spiegelman said.
“We know the basic risk factors for getting critical illnesses from COVID — people with comorbidities such as hypertension, diabetes, obesity … But we don’t understand who survived and who doesn’t. We had patients who were stable for a month, cleared the virus, but ended up getting multi-organ failure and dying. There is some inflammatory response to this virus that we don’t understand quite yet,” he explained.
Nurses and doctors at the hospital have now returned to regularly scheduled shifts.