After beating COVID-19, Vancouver physician Joseph Finkler explains how pandemic transformed emergency medicine

    1 of 3 2 of 3

      One of the tragedies of the novel coronavirus pandemic has been the impact on front-line workers’ health. Many have contracted COVID-19 and some have died.

      Dr. Joseph Finkler considers himself one of the lucky ones—the St. Paul’s Hospital emergency room physician is back at work after recovering from the disease and coming out of quarantine just over a week ago.

      He concedes that it sort of snuck upon him.

      “I didn’t recognize the symptoms because I had been working a whole bunch of night shifts,” Finkler told the Straight by phone. “I felt really crummy and tired.”

      The 62-year-old doctor said he had a persistent cough for months. But on March 26, he decided to stop working and get tested after feeling a fever, chills, and night sweats.

      After being diagnosed, he worried for a “fleeting moment” that he might develop lower interstitial pneumonia.

      That, he feared, could bring on a “cytokine storm”, in which immune-system cells attack other cells in the body, perhaps forcing him to go on a ventilator.

      According to the New Scientist, these cytokine storms are common complications of COVID-19 and other respiratory diseases.

      Fortunately, he avoided that fate but it still troubled him that he couldn’t help patients during his period self-isolation. He even had to remain at a distance from his partner and two daughters, who all amazingly avoided infection even though they live in the same house.

      One of those daughters, Laura, is a palliative care nurse at St. Paul’s Hospital. She was restricted from going into the community because she was also required to remain isolated.

      “My radioactivity not only resulted in their lifestyles being restricted for 14 days, but also they were stigmatized by their connection with me,” Finkler noted.

      He acknowledged that upon his return to work, some colleagues were not keen to be too close to him.

      “I understand it,” he said. “There’s a disconnect between what we know in science and what we might feel.”

      Finkler explained that because of the pandemic, it’s become far more complicated dealing with patients in the emergency ward.

      In early March, he said, staff were wearing gloves and sometimes wearing a surgical mask if they were swabbing patients.

      By the time he was diagnosed later that month, doctors and nurses were not only using surgical and N95 masks, but also wearing protective eye shields and disposable gowns over layers of clothing.

      “It’s like walking in molasses, or underwater,” he said. “It’s so crazy because it’s so restrictive. It really slows down the process.”

      Dr. Joseph Finkler says that treating patients has become more complicated during the pandemic because of all the protective gear that health workers must wear.

      At the same time, Finkler acknowledged that all this protective gear is necessary to prevent the spread of COVID-19 to patients and colleagues, even if it has slowed the delivery of health care somewhat.

      Patients often have to be separated when they arrive in the emergency room. Those who may be showing symptoms of respiratory problems or anyone who is critically ill is transferred to an area called "COVID", which has 12 beds where they can remain isolated.

      This keeps them away from other patients who might be suffering from acute mental-health issues or other problems unrelated to the novel coronavirus.

      Finkler said that there's a perception among some that if you contract COVID-19, it's a death sentence. In fact, the death rate is only a little over one percent in Canada if all the fatalities are divided by the number of positive test results.

      "But if we include a whole bunch of asymptomatic people [who have the virus] we haven't tested, it's actually way lower," he added. 

      Finkler applauded the way that everyone in the health-care system has “locked arms and come up with creative solutions” to the crisis.

      “Our planners did a ton of work—our department heads, operations managers, program managers, vice presidents of medicine, administrators, CEOs—they moved mountains to prepare us,” Finkler said. “Even though we’ve not had to deal with the tsunami [of cases], I think that was incredible.”

      Video: A Georgia Straight thank you to all frontline workers.
      Lucas Renzo Giovannetti
      For anyone concerned about visiting a doctor's office because of the pandemic, there's always the option of contacting a telehealth provider, which can put people in contact with physicians and other health-care professionals.