The pandemic has meant higher stress and few breaks for those on front lines
At 7 a.m. Christmas morning, Dr. Lisa Richardson will start her day helping COVID-19 patients at Toronto General Hospital in what could become a 12-hour shift.
"I was actually thinking ... OK, I need to find one of those ugly Christmas sweaters or holiday sweaters ... so that I can try and add some cheer in some way," said Richardson, a general internal medicine specialist at the downtown Toronto hospital.
She and her team will be looking after 25 in-patients all day, until the next shift arrives at 5 p.m. But if a patient isn't doing well, Richardson said she'll often stay later, which might mean that she won't make it home in time to eat with her family on Friday.
"None of us like to leave one of our patients if they're unwell and clinically deteriorating," she told The Current.
"You don't want to sort of say, 'Sorry, I've got to go for my Christmas dinner.' So it's just unpredictable in that way."
With COVID-19 visitor restrictions in place, Richardson is worried about hospital patients who won't get to see their families at all.
Being a witness to that loneliness has been one of the hardest parts of the pandemic.
"When you're hospitalized, you're acutely unwell, and to be alone is very, very hard," she said.
The spike in cases has taken its toll on front-line health-care workers. Richardson said it's exhausting "that this has been going on for so long, and that we're continuing to see the numbers rise."
"We don't have that energy that we had initially," she said.
Mounting stress fuels staff shortages: paramedic
The holiday period is one of the busiest times for health-care workers in "a normal year," said Vancouver paramedic David Leary. Now, that pressure has been exacerbated by the pandemic and is fuelling other issues, including the opioid crisis.
"The strain and stress, it's compounding the mental health issues with our paramedics and dispatchers — at levels we've never seen before," said Leary, a spokesperson for the Ambulance Paramedics of BC (APBC).
He said the stress is leading to a staffing crisis, as APBC members "have to take time off work to recover and recuperate."
Leary said he worked through half his vacation earlier this year to help cover that staffing crisis. He'll take Christmas Day off but otherwise will be working through most of the holidays this year.
"Time off is important, but I feel it is important that we do step up," he said. "And most of my co-workers feel the same way."
Richardson agreed that it's been very difficult to get time away. On a recent free weekend, she received a page telling her a patient's condition had worsened and went back to the hospital to help.
"There are so many crises all the time, so for those of us who are on the front line and also have leadership roles, you cannot disconnect," she said.
An ongoing study at the University of Alberta in Edmonton is assessing the toll of the pandemic on 5,000 health-care workers in Alberta, British Columbia, Ontario and Quebec. Initial data suggests high levels of anxiety among the workers, with the highest numbers among physicians.
Lead researcher Dr. Nicola Cherry told CBC News last month that "more than half the doctors now have these very high levels of anxiety that give us concern about how they're going to cope long term."
Amid the stress, Richardson said the pandemic has "also taught us a lot around our resilience, around how we can support one another."
Recently, she was moved when a patient took the time to ask her how she was doing.
"I literally almost cried," she said.
"The idea that our patients are thinking about the toll that this is taking on us as well was really moving for me."
She now has some time off booked over New Year's and hopes to see extended family via video call.
Missing family at Christmas
Like Richardson and many Canadians, Leary will be having a smaller Christmas this year, forgoing time with grandparents and extended family.
"We'll just be keeping within our bubble, and we feel it's important to protect ourselves — but not only ourselves, the rest of the public," he said.
Even so, he is worried about the stress of isolation at "a time of year where it can already be lonely for people."
As a nurse working in COVID-19 units, Naveed Hussain has chosen to limit interactions with his family not just during the holiday season but since the pandemic began.
"My father's over 70; my mother is over 60. My father does have medical ailments and I prioritize their health," said Hussain, a registered nurse at McGill University Health Centre in Montreal.
Hussain will also work through the holidays and hasn't "had time off in a long time."
"It's been tough emotionally and mentally, you know, being away from family and friends," he said.
"But it's also a sacrifice we chose to take, right? It's just like a firefighter running into a fire in a building."
Risk of catching virus
Hussain contracted COVID-19 at work in April, suffering the common symptoms of malaise, body aches and fever, as well as difficulties with his liver. He also inadvertently passed the illness on to his girlfriend.
Despite lingering symptoms that took six months to shake, he said it's given him "the ability to care more closely."
"You understand symptoms and how to manage those symptoms better," he said.
"It gives you a different perspective on how to care for patients and how to have empathy for those who are affected."
The University of Alberta study is also looking at how many front-line health workers have contracted COVID-19, with a view to improving safety measures.
"If a health-care worker is sick and not able to go to work ... that's going to very much affect all of us in the community," Cherry, an occupational epidemiologist at the university, told CBC News.
Light at the end of the tunnel
As case numbers have climbed over the fall, Hussain said he struggles when he sees misinformation about the vaccines or people who refuse to wear masks to help limit the spread of the virus.
"It's discouraging because we end up seeing more and more patients coming in, and then we hear the rhetoric coming from the other side," he said.
Dr. Alexander Wong, an infectious diseases physician at Regina General Hospital, said he's seeing the virus affect the most vulnerable more and more in the second wave.
They include "those in long-term care settings, as well as our inner-city vulnerable populations as well, so it's been exhausting, it's been tiring," he said.
Wong said he hasn't taken "any meaningful stretch of vacation basically since the beginning of March."
When his daughter was born in August, he took a few days off but then resumed work while technically on leave. He expects to take half of Christmas Eve and Christmas Day off, and then "be back to my usual sort of craziness."
But there is light at the end of the tunnel. The first Canadians received the Pfizer-BioNTech vaccine last week, after it was approved by Health Canada. A second vaccine, from Moderna, was approved on Wednesday.
"I'm one of the privileged few; I actually got my COVID vaccine [on Sunday]," Wong said.
"It stung a little bit, but, you know, I'm feeling great."