It’s 11 a.m. on April 8.
All at once, phones start buzzing and ringing throughout the intensive care unit, breaking up the monotony of gentle, constant beeps from each patient suite.
“A stay-at-home order is in effect,” reads Ontario’s latest emergency alert, signalling the start of a heightened lockdown across the province after a stretch of rising COVID-19 case counts and record-breaking critical care admissions cut short provincial reopening plans.
On this day, more than 500 patients with COVID-19 are in critical care units across the province, including 24 here at Centenary Hospital, filling the majority of the available beds. Just a week later, the provincewide tally hit 635.
Lorraine Pinto, a soft-spoken social worker who helps patients’ families navigate their loved one’s critical illness, stresses that many of those being admitted simply can’t stay home as the province requests.
Often, people getting infected are essential workers, she says. Many bring the virus back to multiple generations living under one roof.
“Imagine someone just like you and me who was functioning very well, may have gone to a job in a factory, contracted COVID, maybe in their 40s or 50s.”
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Across Toronto, those trends have been clear for months, with outbreaks popping up in all kinds of indoor settings deemed essential, including schools, food processing plants, shipping centres, factories and manufacturing facilities. And people of colour are bearing the brunt.
The vast majority of cases reported across the city — roughly 76 per cent — have been among people who identify as a “racialized group,” according to the most up-to-date demographic data available from Toronto Public Health.
And, after adjusting for age, the hospitalization rate in the city’s lower-income population is roughly three times higher than the rate among residents in higher financial brackets.
Patients recently admitted to the Centenary ICU are of various backgrounds and ages, including one man in his 50s who’s being cared for by longtime registered nurse Jose Pasion inside an isolation room while the team awaits the results of the patient’s COVID-19 test.
After carefully removing his protective gloves and gown, Pasion exits through the room’s sealed door. It’s striking, he says, that he’s now caring for critically ill patients who are often in the prime of their lives. Recently, the team has even started treating some young adults in their 20s and 30s.
“In the first wave we saw a lot more older ones,” he says. “But this trend in the third wave, younger generations are pouring in.”
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Dr. Martin Betts, medical director of critical care for the Scarborough Health Network, points to widely circulating virus variants, which can spread rapidly among family members.
“So far in Wave 3, we’ve admitted seven husband-and-wife couples,” he says. “I think it’s a sign the virus is getting into homes, infecting everybody, and because it’s so much more powerful than the previous virus, more people are coming into hospital together.”
On a recent Saturday, Betts put eight patients with COVID-19 on mechanical ventilators back-to-back overnight, the most intubations he’s ever done in one shift during his career as a physician.
“And the hardest part of all of it was the conversations before having to do so, and seeing them say goodbye,” he says.
“Because we know they’re going to be on a ventilator for some weeks, in a medically induced coma so we can provide mechanical ventilation, and we know probably half of them aren’t going to survive.”
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