What a thrill it was to watch the Canadian women’s soccer team win the gold medal in a dramatic and nerve-racking shootout. We, as a nation, were able to pause for a moment, take pride and share in their Olympian success as we celebrated the teamwork and comradery that was on display.
It was then that it struck me, a question that had been intruding on my mind for some time: Why has our nation been unable to rally together behind the battle against COVID-19 in the same way we rallied behind these incredible athletes? Why have we not been able to come together as a team but instead have had a minority playing by its own rules?
The degree of vaccine hesitancy – despite vaccinations being our best line of defense against the COVID-19 virus – continues to be surprising. As of Aug. 23, just over a quarter of Canada’s eligible population still had not been vaccinated despite adequate supply; vaccine hesitancy has been reported at 18.5 per cent for men and 16.5 per cent for women. In light of the delta variant’s prominence, this is particularly troubling.
Individualism is not the way forward, especially when it comes to health care. Health cannot be delivered without a well-coordinated team. What would you think if your family doctor never spoke to your cardiologist or if your surgeon did not confer with the anesthesiologist? Each provider has a purpose, and none should take precedence over the other – they are all essential to ensure your well-being.
As a resident in Family Medicine, I see my job as the conductor of your health. I strive to know about your mental, emotional and physical well-being so that I can provide you with the best care. I orchestrate and arrange your specialist visits and I take their expert opinions and ensure the advice considers you as a whole person. When I see an elderly person with dementia, I work with geriatricians, with pharmacists, caregivers, psychiatrists, social workers, nurses and family members to better understand what may be contributing to this. When I see adolescents with intellectual and developmental delays, I am reliant on the work already completed by developmental pediatricians, geneticists, psychologists, other pediatric specialists and generalists whose documents I depend on to gather an understanding of my patients and their needs. When I meet patients, I rely on them, their families, occupational therapists, speech therapists, physiotherapists and behavioural therapists to ensure they are equipped with the right equipment and supports.
Unless the full orchestra is assembled, I do not have the tools I need to direct a harmonious piece. I remember seeing an elderly female patient in the emergency department with respiratory concerns, what she and her family physician had thought was pneumonia but that was more than likely COVID-19. I watched as her oxygen saturation levels, a way to measure the percentage of oxygen in blood, slowly started to drop. She continued to talk, completely oblivious to this physiological marker of her distress. All I could attend to were the numbers, which ideally are >92 per cent. Hers started at 93 per cent, then 88, 85, 78 … I realized the situation was tenuous and I lurched for the wall oxygen, cranking the dial to maximize oxygen delivery. To my complete horror, the numbers continued to drop … 75, 72, 70. Outside the room, I alerted the nurse and spoke with the senior medicine resident working that night. The room then exploded with activity. My senior told me to alert the ICU team and as I grabbed for the phone, I saw a flurry of nurses attaching monitors and moving the patient to an isolation room, a respiratory therapist switching her oxygen to a high flow system as her heart monitor began to show a dangerous arrhythmia. I relayed this information to the ICU doctor, who decided what medicine to administer. I could not believe how fast the situation had deteriorated. Thankfully, the patient eventually stabilized. We later learned that not only did she have COVID-19 but she also had multiple pulmonary emboli, blood clots in her lungs, that had contributed to her symptoms. A cacophony of noise had been harmonized with the help of the team.
It is only with a group approach that we can make a meaningful difference to patient health. A holistic approach considering the whole person includes more than simply considering both physical and mental health; it means considering how our patients live, where they live and why they live this way. It means knowing about vocational, social and environmental health. It has been shown time and time again that socioeconomic factors in people’s lives are crucial to their health and that those of lower socioeconomic status are more likely to have chronic conditions, including obesity, high blood pressure and diabetes.
Physicians are encouraged to structure their practice in this way; however, this attitude has not permeated into our society, as it should have. The same holistic approach must be applied to our approach to COVID-19. We must work together as a collective community, look beyond our own needs and think about the greater good so that we can establish a new normal.
This means we must consider our most vulnerable. We must consider the families in multigenerational homes; those without homes forcibly removed from parks during a global pandemic; the immigrant population that may struggle with communication in English; people with intellectual and developmental disabilities living in group homes. After all, if we do not drive COVID-19 from our most vulnerable, then this pandemic will continue to linger.
Quebec’s novel vaccine passport is a crucial step in the collectivist direction, one that values community and teamwork over the individual, providing a way to continue to re-open and ultimately keep the unvaccinated population safe at a time when the delta variant rages.
We have learned much during this pandemic and have developed tools to combat COVID-19. Now, we must use them and teamwork to make the tools effective. We must get vaccinated if eligible; we must wear masks indoors in public spaces; we must vaccinate our children if eligible; we must look out for our neighbours and arrange social gatherings that are safe; we must find compassion and empathy for others.
Only then will we find our new normal.