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Prince George Thursday May 21, 2020
UNBC teams adapting Page 10
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Hospital keeping COVID-19 at bay wildfire
risk high across region
Ted Clarke Citizen staff
Sometimes it takes a team effort to stand up to a ruthless bully and that has certainly been the case within the walls of University Hospital of Northern B.C.
Doctors, nurses, respiratory therapists, pharmacists, cleaning and housekeeping staff, hospital administrators, information technology specialists and communications staff have ganged up against the novel coronavirus and are winning that battle. They stepped into the ring against COVID19, not knowing what kind of punches or kicks the insidious virus had in store for them or their families, and have so far prevented any localized outbreaks. “It’s really been a massive team effort,” said Dr. Marietjie (MJ) Slabbert, head of UHNBC’s critical care department and the regional medical lead for Northern Health critical care program. “Never before since I’ve been in B.C. (four years) has there been so much collaboration between different departments and collaboration between administration and clinicians on a daily basis. People put small differences aside and really worked together trying to problem-solve.” Staff at UHNBC, the referring hospital for northern B.C., have prepared for the worst after seeing hospitals in Italy, Spain and the United Kingdom inundated with critically-ill COVID-19 patients. That hasn’t happened in Canadian hospitals and B.C. has been one of the first provinces to flatten the curve. Northern B.C. has had just 59 confirmed cases and none of those patients have died from the virus. “Our initial modeling and predictions were terrible; we were going to be completely overwhelmed and we have preparations in place for that, but we’ve been lucky so far,” said Slabbert. “The initial concern was we were going to have the same type of surges they had in Hubei (province in China) and I think that made everybody quite on the edge, but also motivated to prepare for that. We feel we have processes in place and we’ve not been overwhelmed but we see how bad it is in the rest of the world. Some of my friends in the U.K., it’s hard for them to be positive
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Arthur Williams Citizen staff
Handout photo
An anesthesiologist and anesthetic assistant, part of the COVID-19 intubation team at UHNBC, prepare to intubate a patient.
when there’s 700 patients dying every day, it’s totally unheard of.” As a specialist in anesthesiology and critical care, Slabbert met twice a week via teleconference with clinical and administrative ICU leaders from the five provincial health authorities to develop a COVID-19 strategy. Regional protocols were developed based on provincial, national and international advice. UHNBC established a COVID-19 airway management team - seven anesthesiologists and the department heads of anesthesiology and ICU who serve as team coordinators - which stays in close communication with similar teams in other health regions. Ventilators were requested and moved to several Northern Health hospitals and respiratory therapists traveled to some of the smaller hospitals in the region to train nurses. Very few physicians before the outbreak had ever been fit tested for N95 masks and nursing educators stepped up in a collective effort to train hospital staff how to manage all personal protection equipment (PPE). As Northern Health’s triage intensivist, Slabbert coordinates the referrals and transfers of patients from other hospitals in the region and her airway management team is on-call and available at any time to intubate the sickest patients. Since the pandemic began in mid-March, the team has been activated on average about three times per week and has intubated most of the patients who warranted the activation. UHNBC’s normal critical-care capacity is 10 patients and a second unit was prepared for COVID treatment which has an additional 15 beds. At no time during the pandemic has the COVID patient count
reached double figures. “If someone comes in to the hospital and is a suspected or confirmed case of COVID, the airway team actually gets activated to intubate the patient,” Slabbert said. “We’re trying to protect the rest of the health-care teams from the virus exposure and it’s working well. “Not all patients come back positive (for COVID-19) but you can’t really wait initially to activate the team” she said. “There are some patients who actually do better if you don’t intubate them, but it’s tough to know who those people are.” Depending on how sick the patient is, the alternatives to intubation include highflow nasal oxygen therapy or continuous positive airway pressure machines which present a higher risk of spreading airborne particles that can infect health-care workers. “You weigh that up against early intubation of a patient (which keeps them unconscious under general anesthesia) and then have them in a closed circuit where they stay in minimal risk of exposure to the staff,” said Slabbert. “It’s not just the risk at the hospital, it’s the feeling that you might take it home to your family. I think that’s what’s making individuals very anxious.” The uncertainty of not knowing if a patient has COVID-19 forces medical staff to suit up with full airborne PPE (N95 mask, gown, face shield, gloves). But a repurposed testing device brought to hospitals in Prince George and Terrace in mid-April is producing much quicker pointof-care COVID-19 test results which can relieve Northern Health medical staff from that PPE discomfort. - See WE’RE ALL GRATEFUL on page 3
The risk of wildfires across much of northern B.C. is high to very high, according to data from Natural Resources Canada. Richard Carr, a wildland fire research analyst with the national Northern Forestry Centre in Edmonton, said similar conditions are being seen all across Western Canada. “Over the last couple weeks, northern British Columbia has been a bit dry,” Carr said. “If it continues into June or July, you’re set up for potential trouble. In 2017-2018 we had similar conditions...” The centre compiles the data from two different computer models, and then compares it to last 30 years of records, he said. The centre also looks at data coming from the U.S., to get bigger picture view of what’s happening in North America. “I think we’re looking at fairly dry conditions through the northern parts of the province,” Carr said. “(But) it’s a tough thing to forecast. One (computer model) is predicting fairly dry conditions.” While dry conditions allow wildfires to spread faster and burn hotter, it doesn’t mean there will necessarily be a bad fire season, he said. “We don’t panic when we see these weather conditions. The ignitions are the important features,” Carr said. “(And) chances are it’s not going to be completely widespread through that area. It looks to be more of a muddled pattern.” People and lightning are the two main causes of wildfires. With the COVID-19 pandemic, there may be fewer people out in the landscape casing fires, Carr said. “This year, every year really, we are urging people to stay alert to changing fire conditions,” he said. Currently there is a province-wide ban on open burning, however camp fires and forest use remain unrestricted. For the most current information, go online to: http://bcfireinfo.for.gov. bc.ca/hprScripts/WildfireNews/Bans. asp.