The urgency is quiet.
So are the most vulnerable.
Pruning unconscious patients so that their lungs can expand.
It's a relentless routine to help those heaving for breath
while a health care system struggles to catch its own.
I have two empty beds
but it's going to be filled because I have one patient in emerg waiting to come up
one patient upstairs not doing well and needs to come down
so by today, it will be full, most likely.
Two years in crisis mode.
The cracks are now craters.
Hospitals already under strain
carrying more with every wave.
At Humber River Hospital the people holding it up
like nurse Kimisha Marshall are trying so hard not to crumble.
It is endless it is endless
as soon as they come in some die
then we get a replacement yeah
it's just endless yeah
a lot of nurses are sick with COVID themselves
so shorter staff working hard just to get this patient better.
I need it to be over
I just want it to go away right just go away yeah.
The pandemic hasn't gone away
but thousands of nurses have left the profession since it started.
Chronic staff shortages have gone from bad to worse
exhausted many felt expendable too by low pay and wage caps
the load for those left, Ashley De Lumen says, keeps getting heavier.
We're always short that's the hardest part
because instead of having one patient
we're getting two unstable patients.
How hard is that for you to manage?
You have to keep up with drips
make sure your patient's stable
you have to be on top of things for two unstable patients
so that's hard.
The turn to urgency can come with little warning.
Omicron may be a milder variant but it's still a cruel one.
The sheer volume of cases means the proportion of critically ill patients is higher too
most COVID patients in the ICU here are unvaccinated
treating them can be an exercise in futility and frustration.
Is it frustrating in a way?
To be honest yes, because this could have been
I can't say right but most likely this could have been prevented
but because you know they have their freedom to choose
what they want then there's repercussions
which is this.
And it almost seems like this is our new norm you know.
I want to be honest with you that you know her right now she's very fragile and frail.
The calls to loved ones are never easy
neither is working on a constant brink
and every surge forces glaring questions
on how best to survive this wave and any other.
If her breathing gets worse it means her body is failing.
ICU doctor Sanjay Manocha says the perpetual present has lessons in it
I think what's helped what we've learned over the last two years is
you have this critical care command center
which actually manages the system and so
the ability to move patients from one hospital to another
to allow them to continue their care
and also allow the local hospital to to manage with the influx of patients
has been tremendous.
But omicron has made every maneuver tighter
because every hospital is under pressure
making access to all care even worse.
Now, we're in a position where we cannot offer effective and timely treatment
to other individuals like we used to
for other issues, surgeries have to be canceled
people are waiting for
critical surgeries investigations intervention to carry on with their lives
and you know that's a huge toll
and what impact will that have down the road.
It's a looming question so is the way out
hospital admissions are lagging indicators
it means any reprieve comes later
and sometimes with resentment too.
Vaccines have been so accessible for a year
social worker Paula Abramczyk says those who don't get a shot keep putting everyone at risk.
They think it's just their right, their body
they can do what they want
but the effect is huge
it is sad that people can't have surgeries now
because of the selfishness of others
it's overwhelming that it seems to be never-ending
that's the frustrating part
there's no light at the end of the tunnel
especially in the ICU
maybe other places in the hospital because those people actually get better they go home
but these people are just not getting better
so we don't see a big light at the end of the tunnel here.
Even outside of the ICU any light can be hard to hold on to.
Are you ready to go home? y
Emilio Perrone is going home he's vaccinated that helped him survive COVID.
Julie Bourque is happy he's leaving but says it's harder to let go of the
trauma of the last two years.
It's actually a huge relief to be able to send people home.
Sorry, we've seen more death in two years than most people see in their careers a
nd it's hard to get past it's hard
to not let it get to you
because you don't come into this profession to watch people die
you come to watch them get better and go home.
There is a real fear that the constant trauma will lead to even more burnout
that there will be more variants, more waves, more sick people and fewer to care for them
every potential COVID case is a stark reminder that reform is critical.
Your oxygen is looking much lower than I would like it to be.
Dr. Tasleem Nimjee leads Humber's pandemic response
and is the hospital's Chief Medical Innovation Officer.
We really need to strengthen the community resources and support integrations of care
so that for a patient you're not feeling like if I need something and I need something quickly
the only place I know to get it is to go to an emergency department.
Okay take a big breath for me, the better we get at preventative medicine
the better we get at predictive medicine t
he less likely patients will need to come into an acute care center because they're in crisis.
Investing in community and even remote care would lessen the chronic burden on hospitals
would make the next public health emergency
she says less catastrophic.
To create the kind of change that we need
we're looking for really big sort of system disruptive ideas.
And you're optimistic that those will come?
I am I am, I mean what's the alternative, right?
There will always be patients that require a health care system that can support them
there will always be a burden of illness
there will always be people that are drawn to medicine because we want to treat patients
and so the more efficient we can make the system
the better we do at treating patients ultimately
and that's why we're here.
That commitment to care it's still going through a devastating test
if change comes from this crisis it can't come soon enough.
Ioanna Roumeliotis, CBC News, Toronto.