The virus that causes COVID-19 binds to receptors in a person's lungs. In many severe cases, the lungs will struggle to do their job keeping blood oxygenated.
And in response, it's a respiratory therapist who will be at the head of the patient's bed, operating the ventilator and making sure the oxygen is getting in.
There are about 1,300 respiratory therapists (RTs) in B.C., but you don't hear about them as often as doctors and nurses when the public heaps well-deserved praise on health-care workers during the pandemic.
Kenny Leung is one of them. He works in the emergency department and intensive care unit at Vancouver General Hospital.
Leung and other RTs are bracing themselves for the many COVID-19 cases that are expected to come through hospital doors, while trying to quickly learn how to best treat patients with the virus — a disease that's still full of unknowns.
"I would say tensions are high for sure. I think everybody is a little bit stressed and a little bit on edge," said Leung on Thursday. "The biggest thing for me is the emotional toll."
Leung works in the health region in the province hardest hit by the virus so far. On Thursday officials reported 359 cases in the Vancouver Coastal Health region, followed by 241 in Fraser Health and 125 in the other three health regions combined.
Most of those cases won't require hospitalization, but each patient that does will be assessed by an RT.
Preparing hospitals before cases escalate
Mike MacAulay is the president of the B.C. Society of Respiratory Therapists. He's not based in the Lower Mainland, and it's still relatively calm in his area.
"What I'm hearing in general is that we're looking pretty good," said MacAulay of how prepared RTs are for more COVID-19 cases.
"Most of the therapists work 12-hour shifts, so it's a good length of a shift anyhow. I haven't heard of people having to do 16-hour shifts or anything like that," he said.
MacAulay said hospitals have spent a lot of time and effort making beds available in anticipation of bad virus outbreaks, so there's ample capacity at the moment.
According to MacAulay, throughout most of the province there is one RT for every four or five ventilators, but there may be fewer RTs in some smaller hospitals. He said that's consistent with what he's seen in other jurisdictions.
He's worried that the crisis could ultimately leave RTs overworked, but he said about 70 more have just graduated from Thompson Rivers University and are joining the workforce at the perfect time.
Risk of infection
MacAulay said the risk of getting infected with the virus in the course of their work is a serious concern. During the 2003 SARS outbreak, there were a couple RTs across the country that passed away.
"We're also concerned that we don't want to bring this home to our families," he said, adding that personal protective equipment still seems to be in good supply.
But MacAulay said they took lessons from the SARS experience, and they've had the benefit of learning from other parts of the world that have been dealing with extreme COVID-19 outbreaks before they hit Canada.
In Vancouver, Leung and his colleagues are figuring out how best to treat virus patients — different amounts of pressure to get oxygen into the bloodstream.
He said one good therapy they've used isn't high-tech or expensive, it just takes some muscle: it's called "proning", flipping patients over onto their stomachs, which helps circulate the blood flow.
Even in Vancouver, this might be the calm before the storm, Leung said, but hopefully the efforts to "flatten the curve" will pay off, because these are still stressful times.
He said the nightly 7 p.m. applause for health-care workers is a nice boost at the end of a long shift.
"I love how people are doing it," said Leung. "It's very encouraging to hear the claps and cheers on our way back home."
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