Via The Sudbury Star, a Montreal Gazette report: Quebec health system headed for massive burnout in pandemic, expert warns. What Dr. Liu says about Quebec is likely true of every healthcare system in North America—not to mention Europe, Latin America, and South Asia. Excerpt:
As Quebec is poised to declare a tally of more than 100,000 COVID-19 cases over the weekend, the province’s foremost pandemic expert who accurately predicted the second wave would target the regions is now warning of a potential breakdown of the health-care system in the months to come.
Dr. Joanne Liu, who in her former role as president of Doctors Without Borders led the fight against cholera epidemics in Haiti and Yemen and against Ebola in West Africa, said the sight of nurses blocking bridges this week follows a pattern she has observed in nations struck by chronic health catastrophes.
“There is something that I call the behaviour of epidemics,” explained Liu, who was appointed last month to an independent panel of the World Health Organization that is evaluating the WHO’s response to COVID-19.
“One of the things I remember with Ebola is people were going on strikes in the streets because the government was not giving them their allowances for danger work. I don’t want to criticize the (Quebec) government, but we have to acknowledge that having staff doing compulsory overtime over and over again, at this rate we will not last until Christmas.”
On Friday, the province’s largest nurses’ union called off a weekend overtime strike after Treasury Board president Sonia LeBel pledged to address the issue in negotiations.
“What you start to see is a general fatigue in the population,” Liu said. “I’ve seen that in every single epidemic in my life. It’s always what hits us after six to nine months. The general population gets tired, but the medical staff who work day in and day out in a hospital, it’s the constant stress of, ‘Am I going to bring this back home? Am I going to expose all of my family?’
“We’re seeing this across the (Quebec network) and that’s why there are demonstrations now. People are not machines. It’s this emotional wear and tear, an accumulation of that, and we have to factor this in.”
One veteran nurse, who agreed to be interviewed on condition of anonymity for fear of professional reprisals, confirmed the burnout among colleagues.
“Despite an average of 1,000 (new pandemic) cases per day — virtually the same number as the first wave — nurses are now expected to handle the virus just like we handle everything else,” the nurse said. “I don’t see any efforts by management to get us food or free parking or anything like that. We are no longer (Premier François) Legault’s guardian angels. Instead, it feels like we’re chopped liver.”
In her experience, Liu noted that the phase of anger and frustration among medical staff during a lengthy epidemic is followed by one during which the health system starts to fall apart.
“I call it the burnout of the health system,” she said. “It’s real. I’ve worked in war zones, and it has gotten to shape my way of thinking. This is not what we’re trained for in Canada. What we’re going to see is all the indirect impacts of COVID-19 that have been lasting for so long, all the indirect stress on the health-care system that is not caring for its population.”
Liu was alluding to delays in cancer treatment and elective surgeries, as well as growing mental health problems. On Wednesday, the Montreal public health department released a survey that found nearly one in two young adults was experiencing symptoms of generalized anxiety or major depression.
“I think mental health (issues) are going to be big, big, big,” Liu added. “It’s always big in epidemics and it’s always overlooked.”
For those reasons, Liu, who works in the emergency room of Ste-Justine Hospital, urged Quebecers to avoid going to ERs unless absolutely necessary.
“If there is one message I can give, it is to keep asking yourself as a citizen, ‘Do I really need to go?’ If people do that, it might make the difference of the one extra bed I’m going to have in my ICU for your child when he’s going to be really sick.”
