Your Health Matters: fall 2020

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ROYAL COLUMBIAN HOSPITAL FOUNDATION MAGAZINE

Your Health Matters FALL/WINTER 2020 EDITION

IN THIS ISSUE

+ UNDERSTANDING COVID-19 Royal Columbian researchers join worldwide efforts to seek solutions

+ COMMUNITY RESPONSE How donors have helped the hospital meet this unprecedented challenge

+ CRITICALLY ILL A 26-year-old is grateful for his life after severe COVID illness

+ IN THEIR OWN WORDS Royal Columbian representatives share first-hand accounts of the pandemic Dr. Steve Reynolds, Medical Director

THIS MAGAZINE BROUGHT TO YOU WITH GENEROUS SUPPORT FROM


with resolve and coMpassion So much has changed since we published the last edition of Your Health Matters at the start of the year. In fact, so much has changed since we put together the initial plan for this edition of our magazine. And change appears to be the only constant as the COVID-19 pandemic continues to circulate around the world, putting our health at the forefront of our thoughts as we navigate the ‘new norm’. When the World Health Organization declared COVID-19 a pandemic on March 11, 2020, the concern was profound. And in the days and weeks that followed, everything seemed to happen all at once. In this issue of Your Health Matters, we look back at those first three months of the pandemic, as the final weeks of March ushered us from winter and into spring, and as spring turned into summer, seemingly out of nowhere. What our foundation saw during those crucial months is an outpouring of support for our front-line healthcare workers unlike anything previously experienced. Our communities, in countless ways, pulled together to provide our caregivers with the resources and encouragement to do their jobs amid uncertainty and anxiety. Our work is not over yet. But during the spring, British Columbians flattened the curve with resolve and compassion. This issue of our publication captures some of the key moments during Royal Columbian Hospital’s role as one of BC’s primary COVID-19 sites. We hope each of you is able to stay safe as we remain all in this together.

tom corsie

Chair, Royal Columbian Hospital Foundation

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Jeff norris

President & CeO, Royal Columbian Hospital Foundation


Your Health Matters

contents

EXECUTIVE EDITOR Jeff Norris

VolUMe 6 • issUe 2

EDITOR/WRITER Jason Howe CONTRIBUTING WRITERS Catherine Cornish Alison Cowie Brin O’Hare Kim Peacock CONTRIBUTING PHOTOGRAPHERS Dr. Paula Meyler Jerald Walliser LAYOUT & DESIGN Gary Slavin COVER DESIGN Paula Heal

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PUBLISHED BY New Westminster Record

ROYAL COLUMBIAN HOSPITAL FOUNDATION BOARD OF DIRECTORS chair: Tom Corsie vice chair: Cameron Belsher treasurer: Catherine Ruby secretary: Jennifer Podmore Russell president and ceo: Jeff Norris directors: Dr. Sukh Brar, Frank Butzelaar, Doug eveneshen, Farid Rohani, Dr. William Siu, emily Taylor, Norm Taylor, Rana vig, Fred Withers

We welcome your comments on Your Health Matters magazine. Please email info@rchfoundation.com or write to us c/o Royal Columbian Hospital Foundation, 330 east Columbia Street, New Westminster, BC v3L 3W7. established in 1978, Royal Columbian Hospital Foundation raises millions of dollars annually to purchase medical equipment, fund innovative programs, and support training and research. To donate, please visit www.rchfoundation.com or call 604-520-4438.

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Greetings

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inspired giving

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Fuel for the fight

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planning for a pandemic

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Royal Columbian’s redevelopment fine-tunes during COvID-19

community response

How donors have helped the hospital meet this unprecedented challenge

in their own words

Royal Columbian representatives share firsthand accounts of the pandemic

Meal deliveries hearten our healthcare heroes

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critically ill

A 26-year-old is grateful for his life after severe COvID illness

Behind-the-scenes briefs

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virtual communications

Healthcare’s sudden shift towards tablets and smartphones to ease isolation

Royal Columbian Hospital Foundation Chair Tom Corsie and Foundation President and CeO Jeff Norris

understanding covid-19

Royal Columbian researchers join worldwide efforts to seek solutions

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crisis leadership

Q&A with Royal Columbian Hospital executive Director Sheila Finamore

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INSPIRED GIvING For several weeks this past spring, healthcare workers felt and heard the incredible show of community support every evening at 7 o’clock. As people cheered and banged pots, first responders drove by Royal Columbian to offer encouragement while the hospital faced the challenge of COvID-19.

For the latest royal columbian hospital Foundation news, follow us:

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During the spring, meals were regularly delivered as part of the community’s outpouring of support for the hospital.

FUEL FOR THE FIGHT Meal deliveries hearten our healthcare heroes

It is said that times of crises often bring us closer together as a society. As Royal Columbian faced the unprecedented challenge of COVID-19, spirits were lifted by an incredible show of community support that included nightly rallies, messages of thanks, and a steady stream of donated meals. Food deliveries started early in the pandemic and took on a life of their own over several weeks, as countless restaurants, businesses, and community groups came forward with offers of donated or heavily discounted meals to support healthcare workers. These offers helped launch a meal delivery program headed by Royal Columbian Hospital Foundation, which saw the delivery of thousands of meals to the hospital during a two-month period. “To us, community is like family, and family looks out for each other in times of need,” said the Glavas family, owners and operators of Gino’s Restaurant in New Westminster, one of many participants in Royal Columbian’s meal delivery program. “Supporting our community, including Royal Columbian Hospital, this way is the least we can do, and we sincerely hope our meals have provided joy and comfort to the hospital’s staff.”

Feeding Royal Columbian Hospital’s healthcare heroes was no small feat. During the program’s run, a regular schedule of lunch and dinner donations was established. Nearly every day, donors arrived outside of Royal Columbian’s Emergency Department entrance with hundreds of pre-packaged meals, snacks, and drinks. Meals provided through this program acted as tangible examples of support for our front-line workers. For many, simply knowing that their communities were thinking of them was encouraging during an immensely difficult time. “The community support for us has been incredible. From hearing the 7pm cheer to receiving donated meals, it is amazing to know that our community is behind us,” said Kuljit Minhas, a Respiratory Therapist at Royal Columbian Hospital. Fuelled with support from their community, Royal Columbian’s healthcare team and staff sought to help not only their patients but also those particularly susceptible to hardship during the pandemic. They combined to raise more than $13,000 for the Greater Vancouver Food Bank, further demonstrating that we are all in this together.

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REDEVELOPMENT FEATURE:

planninG For a pandeMic royal coluMbian’s redevelopMent Finetunes durinG covid-19

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andemics and infection control measures have long been on the radar of healthcare planners. Previous international outbreaks, including SARS and Ebola, have made the topic a key consideration in the design of hospitals, including Royal Columbian Hospital’s current $1.49 billion redevelopment. “We talked a lot about how it wasn’t an ‘if’ event, it was a ‘when’ event for there to be a SARS-like scenario,” says Carol Galte, redevelopment’s Chief Clinical Planner. As COVID-19 began spreading worldwide in the early part of 2020, the pandemic had a couple of immediate impacts on the hospital’s multi-year, multi-phase transformation. The most notable was the inclusion of the centrepiece of phase 1 of redevelopment in the province’s response to the pandemic. Scheduled to begin offering care to patients in April, the $258.9 million Mental Health and Substance Use Wellness Centre was instead one of two facilities identified by the province as being available should our healthcare system become overwhelmed by a surge in COVID-19 cases. “It was quite clear that this was a brand new facility that could be called into action,” says Galte. As BC successfully flattened the curve during the spring, the mental health centre was returned to its original purpose and opened to patients in July. The other immediate change occurred behind the scenes as planning continued for the start of construction of phase 2, which features a multi-storey Acute Care Tower. Much like offices that adopted videoconferencing and online platforms to support physical distancing, the hospital’s redevelopment moved design workshops and meetings into the virtual space.

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“Some of the design reviews, we had to be innovative,” recalls Sharat Chandra, redevelopment’s Chief Project Officer. “We had to implement new tools to advance our design and still make sure we are able to provide the feedback from our stakeholders in a timely way.”

The ‘when’ factor With construction of phase 2 proposed to begin in the


acute care tower preliMinary desiGn concept.

coming months, the project’s planning is already well advanced. The pandemic will now cause the project’s team to search for new learnings that can be included in the Acute Care Tower, but don’t expect many dramatic overhauls. “Any changes we make have to be thoughtful and purposeful and directed and not just reactive,” explains Galte. And that’s where all the work that has already occurred is paying off. Infection control measures including hand hygiene sinks and touchless doors are built in to the project. Design elements such as outbreak zones and isolation rooms are too. Planners have been discussing physical distancing strategies such as the movement of the new Mental patients and staff, an increase in virtual health and consults, and even how medical teams substance respond during patient emergencies. use wellness Other adjustments may come, but only centre, as part when they make sense and are based on oF phase 1 oF a rationale. the hospital’s “We want to make sure that those redevelopMent, kinds of changes are validated startinG carinG through proper evidence, and we can For patients in accommodate them into the design,” July 2020. explains Chandra.

Prominent roles The Acute Care Tower will become the heartbeat of the hospital, incorporating many of its busiest departments, including those that have been at the forefront of Royal Columbian’s response to COVID-19. They include an expanded emergency department, which is scheduled for the main floor of the new tower. Total space will increase by more than half as the new ER grows to 75 state-of-the-art treatment bays. It will include the new Jack Gin Emergency & Trauma Imaging Centre, strategically placed within the ER to drastically speed up access to diagnostic procedures. “Having imaging capabilities right in the emergency department is another way to stream and enhance flow,” notes Galte. Meantime, the Intensive Care and High Acuity Units, where the sickest COVID-19 patients were treated, will be part of a 60-bed critical care floor to increase the hospital’s capacity to care for some of the province’s most seriously ill and injured patients. “We are designing the critical care floor so that you can get some flexibility for surges or cohorting patients differently, like we have experienced with the pandemic,” says Galte. With completion scheduled for 2024, Royal Columbian’s new Acute Care Tower will become a focal point in the hospital’s response to future outbreaks, just as planned. ROYAL COLUMBIAN HOSPITAL FOUNDATION I YOUR HEALTH MATTERS

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coMMunity response

With the generous support of donors like you, Royal Columbian Hospital Foundation has been fortunate to help the hospital face the challenge of COVID-19. In addition to examples highlighted elsewhere in this edition of Your Health Matters, the following contributions from recent months and in previous years have positioned the hospital in the fight against the pandemic.

INTUBATION AID Intubation of critically ill patients comes with a risk to both patient and healthcare provider. A Glidescope is a powerful tool that helps successful intubation during emergencies and also provides the caregiver some extra distance from the airways of their patients during this pandemic. With a high-definition monitor, visibility is improved during interventions like artificial airway insertion. With the support of our donors, Royal Columbian Hospital Foundation recently purchased three Glidescopes for the anesthesiology team to help decrease their risk of becoming infected as they perform life-saving care. Glidescopes support successFul intubation oF patients while decreasinG the inFection transMission risk to careGivers.

COVID-KILLING ROBOT

anesthesioloGist dr. Feisal MohaMedali with two types oF ultrasounds purchased by the Foundation durinG the pandeMic.

ASSESSING THE HEART AND LUNGS Anesthesiologists have been providing front-line care for COVID-19 patients, often being called to perform airway management. They have stepped forward to care for patients who require intubation, hemodynamic support and oxygenation. To support the work of our anesthesiologists during the pandemic, the Foundation has purchased an ultrasound to help safely assess cardiac and lung status of COVID-19 patients in areas outside of the Emergency Department and Intensive Care Unit. Having access to a newer model helps ensure the ultrasound can be decontaminated quickly to reduce the spread of the virus.

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At the heart of the preventative measures that healthcare facilities are taking to protect patients is a commitment to cleanliness. The Foundation is funding one of two ultraviolet germicidal irradiation (UVGI) robots that will be used to deep clean and disinfect “hot spots� in the hospital to kill pathogens, including the SARS-CoV-2 virus that causes COVID-19. The robots are used in areas like the Intensive Care and High Acuity Units, emitting concentrated ultraviolet light to kill SARS-CoV-2 that may linger on surfaces. The ultraviolet light emitted by the robots also kills other potentially deadly microorganisms including methicillin-resistant Staphylococcus aureus (MRSA), Clostridioides difficile (C. difficile), and Candida auris (C. auris). Ultraviolet light is effective at killing bacteria and viruses because it destroys the molecular bonds that hold their DNA together. the ultraviolet GerMicidal irradiation robot helps disinFect patient rooMs.


CARING FOR CAREGIVERS In addition to fundraising for the purchase of equipment, which continues to be part of the core of the work we do as a charity, there have been a number of other needs that have been identified as requiring attention. Based in part on volunteers used their learnings from elsewhere in the world where patient volumes sewinG skills to Make dramatically surged, we recognized that emotional support is an important component of the service we can provide to hospital scrubs For those who work at the hospital during the pandemic. careGivers. This resulted in a number of initiatives aimed at providing encouragement – from sharing with the hospital numerous messages of support that have been sent through the Foundation’s website, an ID badge initiative for caregivers who wear PPE, and additional scrubs and laundry service to address concerns about medical and hospital staff needing to bring home their hospital clothing.

PORTABLE LIFE-SUPPORT Generous support has allowed the hospital’s Extracorporeal Life Support (ECLS) team – the only mobile retrieval team of its kind in the province – to become the first in British Columbia in 2017 to acquire the CARDIOHELP system, a portable machine that takes over the function of the heart and lungs when a patient’s health is rapidly deteriorating. Royal Columbian Hospital’s ECLS team is asked by other hospitals in the Fraser Health region to retrieve critically ill patients when their heart or lungs are failing and all other options have been exhausted. The equipment provides the patient with enough oxygen and allows time to recover in cases where cardiac or pulmonary failure might be reversible. the hospital’s extracorporeal liFe support (ecls) teaM is called to other hospitals to retrieve critically ill patients when their heart or lunGs are FailinG.

the 2015 openinG oF new trauMa ER INFECTION CONTROL bays in the hospital’s Royal Columbian opened two eMerGency new isolation rooms with the latest infection control measures departMent allowed For for the emergency department in conjunction with the donora space to be supported opening of new trauma converted into er bays in 2015. isolation rooMs. Each room includes negative pressure airflow to prevent organisms from going into hallways and potentially infecting others. Nearby anterooms also provide crucial space for members of the health care team to safely put on or remove protective equipment as they treat patients in the isolation rooms.

ICU EXPANSION With Royal Columbian being among the province’s primary COVID-19 sites, the hospital’s Intensive Care Unit has been at the forefront of the care provided to patients who have become critically ill because of the virus. The ICU is better equipped to face the challenge following a major expansion more than a decade ago. In 2007, and with the support of donors, the unit grew to 16 private rooms from its earlier configuration of 12 cubicles separated by curtains and two small an expansion in 2007 isolation rooms. This renovation provides allowed For private rooMs privacy for all patient beds and is more in the intensive care unit. than double the size of the former unit. ROYAL COLUMBIAN HOSPITAL FOUNDATION I YOUR HEALTH MATTERS

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As news from Italy and New York foreshadowed possible worst-case scenarios for BC during the onset of the pandemic, Dr. Doug Brown contemplated how technology might help Royal Columbian cope with a sudden surge in COVID-19 cases. The emergency department physician became an early adopter of in-hospital virtual healthcare. With the support of Abby Holder, an Emergency Nurse Educator, Dr. Brown set up a system using smartphones and tablets to make communications safer and more effective. “Patients with COVID-19 symptoms find themselves isolated with limited contact to their families and healthcare workers,” says Dr. Brown. “Having virtual tools such as tablets and smart phones in isolation rooms allow patients to call, text or video chat with their family and healthcare team”. Dr. Brown moved quickly, purchasing tablets to trial in the emergency department. RCH staff, medical staff and the Foundation immediately recognized the need for his creative solution and 50 iPads were purchased to further virtual care efforts at Royal Columbian.

Isolation

eMerGency physician dr. douG brown helped introduce a coMMunication systeM For patients and staFF usinG tablets and sMartphones.

virtual coMMunication healthcare’s sudden shiFt towards tablets and sMartphones to ease isolation 10

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Dr. Brown recalls entering an isolation room to provide a patient with one of the devices. “Originally, she was apprehensive as I entered to room in personal protective equipment (PPE). I gave her the tablet and explained that she could now text and communicate with her nurse. It was amazing to watch her fear and anxiety dissipate”. As hospitals moved in early March to restrict visitor access due of COVID-19, technology became key for families to stay in touch with patients. In some cases, the tablets have been used to allow families to say good-bye to their loved ones during end-of-life. The devices have also helped the healthcare system manage the use of PPE by providing caregivers the ability to communicate with patients without the need to use medical masks, gowns, and goggles. “Having virtual tools in isolation rooms is essential to provide patients with better care and alleviate the stress of isolation in the time of COVID-19,” says Dr. Brown. As the clinical team looks beyond COVID-19, tablets and smartphones may become an integral part of care at Royal Columbian Hospital.


CRITICALLY ILL A 26-year-old is grateful for his life after severe COVID illness

Twenty-six-year-old Vince Li had been battling a fever for several days in March 2020 when he made his way to the hospital in Burnaby. The results of an X-ray and blood test revealed tell-tale signs of COVID-19. Doctors decided to immediately sedate, intubate, and send the young man to Royal Columbian Hospital, one of the province’s primary COVID-19 sites. There, he became the youngest COVIDpositive patient to be mechanically ventilated in the hospital’s intensive care unit during the pandemic’s spring peak. “I didn’t have a chance to tell anybody,” Vince recalls after hearing he would be placed in an induced coma. “My mom was outside at the waiting area in the ER, and social workers called her.” “His blood levels of oxygen were ridiculously low, so he needed quite a lot of oxygen to support him,” explains Dr. Robert Sharpe, a critical care physician at Royal Columbian Hospital. “His carbon dioxide levels were also quite high. It was quite difficult to blow off CO2 because his lungs were greatly inflamed from the body’s reaction to the virus. He was pretty touch and go early on.” A personal trainer and competitive

mixed martial artist who controlled his type 2 diabetes through diet and exercise, Vince remained hospitalized for a month and remembers nothing about the first three weeks. During that time, ICU teams kept a close watch on his blood gases, made sure his organs were getting enough oxygen, and watched for signs of new infections.

a while to start moving comfortably again. “In the beginning, it was pretty rough,” Vince says. “I didn’t realize that being in a bed for a month, I could have so much muscle atrophy.”

Giving time Since there is no specific treatment yet for COVID-19, patients are supported medically in the hopes they can fight off the virus. “He fooled us a couple of times, where we thought he was ready to come off the ventilator,” says Dr. Sharpe. “And then we just needed to give him more time, and he turned around.” When he regained consciousness, Vince was surprised at the amount of weight and muscle he lost. It took him

While his time at Royal Columbian is hazy, he says the care – from the doctors to the nurses and physiotherapists stands out, as well as other, simpler milestones. “My fondest memory was getting the tubes out of my nose and eating actual food for the first time in a month,” says Vince. “That felt pretty good.”

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IN THEIR OWN WORDS In March 2020, Royal Columbian Hospital was designated one of three primary COVID-19 sites in BC. We spoke with staff about their pandemic experience, from the early days to what may come next. Here’s what we heard. Barb Sutherland, Director of Clinical Operations: We had reports of a new virus that had pandemic potential. We’d created a pandemic plan for the Ebola crisis, so we started there. Kathy Rasmussen, Clinical Operations Manager, ICU: The most challenging part for me was to keep ahead of all the information – it was changing hourly. It took a lot to distill it down into something concise, up to date, and usable. Jason Zurba, Respiratory Therapy Supervisor: When we got reports out of Italy, it started to get real. Their systems

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were completely overwhelmed. When we started to hear reports from Seattle, we realized we could be facing a tidal wave here. Dr. Feisal Mohamedali, Department Head, Anesthesiology: We heard as many as 70% of the population could be infected. Do the math: if 10 – 15% of those are hospitalized, and 5% would require ventilators, that’s scary. Carmen Juba, Registered Nurse, ICU: We were all trying to figure out what to do about our families. Lots of my coworkers were planning to isolate,

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but I have a 1 ½-year-old daughter and knew I couldn’t do that.

By mid-April, Dr. Bonnie Henry was reporting increased cases, and deaths, every day. BS: Staff was anxious because we were going through masks so quickly. Would we run out? Would we be able to protect staff? JZ: There was a feeling of impending doom, wondering when the tidal wave would hit. But when you’re faced with a pandemic that will swallow up the system, and people will lose loved ones, we felt like this is what we trained for. Let’s get this done!


lunch and dinner. People would show up and give us supplies. It was very kind.

together and said let’s get it done. I’m really proud of the teamwork.

JZ: I’m an RT and used to having to explain what I did. Suddenly, respiratory therapy and ventilators were in the news. After one long day at work, I saw a mural for RTs downtown, and I burst into tears.

KR: The fall certainly causes us anxious moments, but I think all the work everyone has done to date will serve us well.

CJ:. We were given iPads to communicate with patients and their families. I felt so bad for families not able to see their loved ones, sometimes saying goodbye through a window. It was heartbreaking. eMerGency departMent teaM perForMs a siMulation exercise in a treatMent rooM.

FM: Our anesthesia team has the most experience in intubation, so our team prioritized the COVID unit and took the lead in creating best practices to ensure our staff stayed safe. CJ: There was fear of the unknown – how bad is it going to get? New protocols meant you had to work with patients by yourself unless absolutely necessary. It was weird – quiet and lonely. When I came home, I had to put my clothes in a bag, shower, and scrub myself before I could see my daughter.

Throughout the pandemic, the community and the RCH Foundation stepped up.

BS: When it was decided that the 5th floor was going to be the COVID unit, another unit sent ‘love notes’ saying, “We’re in this together, we’re thinking of you, we’ve got you.” KR: Space, infection control, equipment— these were all challenges. The Foundation was extremely supportive, especially in those first few weeks. Food would arrive at

In June, the government started easing restrictions, while warning of another possible wave of COVID-19 come fall. BS: When you’re in it you don’t have time to reflect. Everyone just pulled

CJ: One patient came in extremely sick. He was on a ventilator. Eight weeks later he was talking to his wife on the iPad and preparing for transfer out. Only your co-workers really understand what you do and why, but when things go well it feels amazing. JZ: We are just so grateful people stayed home, washed their hands, and allowed us to flatten the curve. People had lost their jobs, their businesses, and still everyone did their part. The public are the real heroes.

barb sutherland, director oF clinical operations

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royal coluMbian hospital Medical director and critical care physician dr. steve reynolds leads a teaM that is lookinG into Mechanical ventilation on patients who are adMitted to the intensive care unit because oF covid-19.

understandinG covid-19 royal coluMbian researchers Join worldwide eFForts to seek solutions

Medical teams around the world are rapidly learning all they can about the coronavirus, and Royal Columbian Hospital is part of that global effort. During the early days of the COVID-19 pandemic, hospital Medical Director and critical care physician Dr. Steve Reynolds and his team launched research to better understand how to treat critically ill COVID patients. Dr. Reynolds was intrigued by what physicians in Northern Italy were observing. COVID-19 causes acute respiratory distress syndrome (ARDS), and ARDS occurs when fluid builds up in the tiny, elastic air sacs (alveoli) in the lungs. The fluid keeps the lungs from filling with enough air, which means less oxygen reaches the bloodstream. This deprives organs throughout the body of the oxygen they need to function. With ARDS, lungs scar and can stiffen. The typical protocol for treatment would involve mechanical ventilation, where a ventilator is used to assist or take over spontaneous breathing for the patient. However, in Northern Italy, some COVID-19 patients in intensive care units had atypical ARDS presentation. About half had lungs with a better than expected ability to stretch and expand. Physicians suspected standard protocols for

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mechanical ventilation for these patients were causing greater lung injury and contributing to multi-organ failure in patients with ARDS.

Global conversation Dr. Reynolds wanted to find out if they were right. He and his research team began observational studies using imaging technology known as Electrical Impedance Tomography (EIT) to watch closely the lungs and heart of COVID-19 patients on mechanical ventilators in Royal Columbian Hospital’s ICU. The data will be used to help inform mechanical ventilation protocols for patients with COVID-19 and will be shared with the international scientific and clinical community. Dr. Reynolds and his team of six at Royal Columbian are uniquely positioned to conduct this research. With specialized pulmonary and physiological expertise gained in previous research trials over a number of years, they are able to deploy a wide array of sophisticated measures and techniques to gather ventilator-lung interactions in this group of patients. “This is a disaster for folks across the world,” Reynolds said. “This is a way we can contribute to the global conversation and improve outcomes beyond just what we see in front of us.”


Crisis leadership Sheila Finamore is Royal Columbian’s Executive Director, helping to lead the hospital’s response to COVID-19 amid a series of measures and developments that were as dramatic and fast-moving as they were unprecedented across our healthcare system. Foundation: What was the most difficult challenge for the hospital during the first several weeks of the pandemic? SF: From my perspective, the most difficult challenge was in supporting individuals to feel confident that they could safely provide quality care during this pandemic while guidelines and recommendations constantly evolved. This has been an experience none of us have worked through before. The early information coming from elsewhere in the world about what we could expect raised a great deal of concern as to whether we could safely provide care during this pandemic. Would we have enough capacity? Ventilators? PPE? Could we keep staff safe? Information was coming at us so quickly from other countries where the pandemic had already hit and the healthcare systems in those countries were being overwhelmed. Ultimately the experience and the learnings from other parts of the world supported the strategy in BC, which helped to ensure we had sufficient capacity this spring. Foundation: What stands out to you about the hospital’s response to COVID-19?

SF: What stands out for me is the way the community, both internal and external, came together to contribute and support the COVID-19 pandemic efforts. People collaborated, shared ideas, and supported one another. All of this happened through a wide group of community supporters and the Foundation. Foundation: What role has the Foundation and its donors had on the work of the hospital? SF: The Foundation and its donors had our teams’ backs. Jeff Norris played a key role with our emergency operations centre by listening for areas that could be supported through the Foundation and its donors. The Foundation helped to provide additional scrubs and PPE, made photo badges, distributed iPads to support virtual visits and physician consults, funded cell phones to enable easy communication between patients and families. All of this prevented unnecessary exposure. The countless meals provided to physicians and staff were a comforting and well appreciated gesture. We felt cared for! Foundation: What impact has the community’s support and encouragement had on morale? SF: The silver lining of this pandemic has been collaboration, connection, and resilience. Ultimately, teams feel supported and cared for. The support RCH was provided enabled all of us to come and do our best through this pandemic and know we are not in this alone.

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