CTV News Vancouver has learned that a shortage of personal protective equipment for physicians and support staff has Vancouver doctors turning patients away from their offices as the provincial health-care system begins to show the strain of potential COVID-19 infections.
Doctors of BC, an association of doctors and medical residents, says physicians across the province are concerned about the shortage of supplies like face masks, with no timeline for new supplies despite a government injection of hundreds of millions of dollars.
Aquarius Medical Clinic director Dr. Linda Jando says her supply is so depleted, the clinic directed 20 patients who had called with possible COVID-19 symptoms to call the 811 health line, which is what the provincial health officer recommends, or attend acute care centres or the ER if they’re experiencing respiratory distress.
“My doctors won't see patients any longer that have fever and cough,” said Jando. “They feel unsafe coming to work and they're worried about their patients' safety, while I'm worried about my doctors and patients and my staff's safety.”
Jando says she’s reached out to Vancouver Coastal Health, the Ministry of Health and her association but found zero help in finding more face masks. She says a patient, physician and nurse should each wear fresh masks for each appointment. On Wednesday, the doctors at her clinic saw more than 230 patients and they only have 150 masks to last them months.
“We have newborn babies in our office, we have sick elderly patients, patients with immune diseases waiting in our waiting room and we don’t want these patients to be infected with COVID-19,” she said.
Doctors of BC president Dr. Kathleen Ross says her group has concerns about protecting frontline workers’ health because the function of the healthcare system as a whole depends on it.
“We want to maintain a workforce that can care for the sick people, but we also want to reduce the chance of the physicians themselves becoming purveyors or vectors of infection,” she said in her Coquitlam practice.
CTV News went to an urgent care facility in downtown Vancouver where Aquarius Medical Clinic has been directing patients who may have the new coronavirus to go for testing. There, more than a dozen masked people were outside waiting to be called in for assessment and testing.
Two women outside said they’d waited on hold for much of the morning after calling the 811 health line and never got through, so they opted to go to a clinic for help.
The province responds
When asked whether these factors point to the provincial health system already being at a tipping point in fighting the disease, B.C. provincial health officer Dr. Bonnie Henry insisted that challenges “wax and wane.”
“We do know 811 has been a challenge and we're working closely with community physicians about addressing [their] needs and how they as practice communities can more effectively organize,” said Henry at a daily COVID-19 briefing in Victoria.
"Some of the glitches we are seeing in our community are from people who have milder illness who have concerns about this [going to see a doctor] and the bottom line is we need for them to stay home until we can make a way for them to be assessed safely,” she said, insisting that the first move for someone who thinks they’re sick should be to self-isolate, then call 811 for assessment and next steps.
She said anyone having trouble breathing should call 911 and explain they may have a respiratory infection, so that paramedics can respond appropriately.
Health Minister Adrian Dix also said more resources would be going to the nurse’s line to deal with the surge in calls.
“On an average day, they receive between 1,000 and 1,100 calls,” he explained. “[Wednesday], they received and answered 3,795 calls and we're working hard to deal with even higher call volumes by adding resources.”
Changes coming soon
CTV News has learned there are discussions underway for physicians to provide “virtual care” via phone and video chat to avoid the need for a clinic visit. While there’s no timeline on implementation, a bulletin to physicians from the Doctors of BC says news will come “very soon”.
Both Henry and Dix have referred to plans for testing centres that aren’t at emergency rooms or other medical treatment facilities. They said they should have news on that front by the end of the week.
On Friday, Ottawa opened such a test centre at a community skating rink, but was only offering testing for those with symptoms who’d travelled or been in contact with someone who’d received a positive COVID-19 diagnosis.
Ottawa’s medical health officer says the goal is to take pressure off emergency departments and insisted not everyone needs testing.
“It is a specific population that needs to be assessed for coronavirus at a centre like this,” said Dr. Vera Etches, noting they could test up to 400 people a day there.
Symptoms and what to do
The World Health Organization says the most common COVID-19 symptoms are fever, fatigue and dry cough; Vancouver Coastal Health adds trouble breathing. Some cases also have flu-like symptoms that can include aches, runny or stuffy noses and a sore throat.
Officials are urging anyone with those symptoms to call 811 or their family doctor, who can direct them on when and how to best approach their office to minimize the risk to others.
Healthlink BC has resources for people who've been told to self-isolate or monitor themselves for symptoms, particularly after travelling.
Most importantly, doctors want people to know the coronavirus doesn’t necessarily require medical attention.
“We decide: Are they ill enough to come in? Do they need testing? Or can that just be managed at home?” said Ross.
Jando wants people to recognize health-care professionals are doing their best, with limited resources amidst a global medical supply shortage and difficulties getting the equipment they need to safely treat those who need it most.
“It's absolutely unreal the amount of stress my doctors have been feeling," she said.