A Waterdown doctor working on the front lines of the COVID-19 response is warning people to stay home to slow the spread of the virus — and prevent it from overwhelming the health-care system.

Dr. Andrew Burkett, a respirologist and director of interventional pulmonology at the Grand River Regional Cancer Center in Kitchener-Waterloo, said physical distancing is the key to flattening the curve and helping the overwhelmed medical system, so more people can be saved.

“It’s so contagious that we’re not going to stop it at this point,” he said. “It’s going to run through our population at this point — the only thing we can change is the speed.”

“If everyone gets sick right away, we’re not going to be able to save very many people, but if we can slow it down to enough of a pace and build up capacity, we can do a lot better.”

Burkett, who lives in Waterdown with his wife and two young children, said he is currently seeing mostly young people admitted with symptoms.

“The other night on call, I did not admit anyone over the age of 50,” he said. “These people are incredibly sick.”

In fact, Burkett said he is “incredibly surprised” at how sick these younger patients are.

“These people are so sick — maybe on two hands I could count the people under 50 I’ve admitted in the last year,” he said. “Respiratory disease tends to be older people and now I’m admitting 20-year-olds and 40-year-olds.”

Burkett said as things stand now, they are sending home young people who, under normal circumstances, there is “no way” he would send home.

“But if they’re well enough to go, they go.”

He said when the coronavirus started, there was a narrative that older people would be killed by the virus, while younger people would experience effects similar to a cold.

“That hasn’t been true at all,” he said.

Burkett said older people have been doing a good job of physical distancing and self-isolating, but he feels many younger Canadians do not have the economic ability to do so.

He said there is no public health solution without an economic solution, because people cannot afford to social distance for an extended period. To that end, Burkett applauds the Canadian government's support of small business owners and other relief efforts aimed at keeping employees getting a paycheque.

While Burkett generally oversees lung cancer patients, he is now predominantly looking after COVID-19 and non-COVID-19 respiratory wards. In normal times, Burkett said he would typically spend 25 per cent of this time in hospital wards and 75 per cent in outpatient wards.

Now, he’s up to 50 per cent in-patient — a figure he expects to keep climbing over the next two weeks. Soon, he expects to only be working at the hospital.

“It's busier on those ward days and I'm home very late,” he said of the hospital work. “So more hospital-based acute work overall with longer days and sicker patients than usual.”

Burkett said while he does intubate patients, he isn’t currently managing the intensive care unit (ICU). While he may have to assist with the ICU at some point, he’s currently looking after the medical wards — including patients who are on oxygen and isolated. He said a typical day on the COVID-19 ward is similar to a regular ward, except everything takes five times as long — he has to put on all the protective personal equipment, take if off safely, then repeat the process for each patient.

“For this reason, we try to minimize going in and out of the patient's room and there are no visitors,” he said, adding he will speak to patients on their room phone while looking at them through a window, entering the room if a procedure needs to be done, or if a patient is worsening and needs to be examined.

Burkett added patients who are sicker take more time out of the day, as staff is constantly re-evaluating them to see if they need to be transferred to the ICU.

He said the whole team has been amazing — including doctors, nurse practitioners, floor nurses, allied health, the clerical staff, and the army of cleaners who tirelessly wipe every surface constantly.

However, he admitted that staff morale is an issue, like it is in any pandemic.

“You can imagine, people are scared,” he said. “We need nurses, we need porters to move patients, we need cleaners — we need more cleaners now — we continually clean every surface in the hospital.”

“So keeping morale up is an issue; that’s one of the other reasons why it’s so bad when a health-care worker gets sick,” he said. “People say, ‘It’s part of her job, she doesn’t come into work,’ but the problem is there’s one less nurse and a bunch of other nurses start getting scared.”

To that end, he said personal protective equipment for health-care workers is the biggest need.

“We’re already seeing doctors and nurses get sick and with the rush of people, if we don’t even have enough nurses to take care of the beds, we’re going to be in an even worse situation.”

As a result, he said those who are on the COVID-19 ward are given a wide berth by other hospital staff.

“You come off the COVID ward and everyone thinks you’re a leper,” he said. “Even my wife — we take extreme steps to make sure we’re not cross-contaminating anything.

“That being said, it’s kind of a moot point. The whole hospital is about to become a COVID ward,” he said. “We’ve already maxed out our beds on the COVID ward and we’re trying to retrofit more and build more, but we’re already having to admit COVID patients to the rest of the hospital.”

A front-line nurse, who expressed fear of reprisal from their employer for speaking with the media, said the situation has been stressful. The Review has agreed to withhold their name.

“We are fighting an invisible enemy and it is our job to find that enemy,” the nurse said. “We protect ourselves with (personal protective equipment), hoping it will be enough.”

Personally, the nurse is proud to be contributing, but is very concerned over the challenges the next month will bring. Nonetheless, they are determined to overcome the challenges.

From a health-care standpoint, the nurse said it feels like they are going to war.

“This is the calm before the storm; I am almost tired of waiting,” said the nurse. “Being front line over the next month, frankly, scares the hell out of me.”

However, they — and many of their co-workers been in the field for decades.

“We aren’t about to walk away now.”

Personally, Burkett said he is concerned about the virus, but said working as a doctor, he has been struck by the randomness of life and that all of the time we have is essentially borrowed.

“In terms of me feeling more scared or more worried about stuff in the COVID era — not overly,” he said. “An issue all health-care workers have to work with though, is how they’re going to interact with their families.”

While in some cases, medical professionals have moved out of their home or segregated themselves in a different part of the home, Burkett said he hasn’t done so, despite having two young children. Burkett, whose wife is also a physician, said the couple did talk about him moving out during the pandemic, but they decided to do their best and stay as a family, as there are mental health concerns to consider — and he doesn’t want his children to be any more scared than they have to be.

He is changing clothes and cleaning everything at work and showering immediately at home.

“But if I couldn’t have seen my family through this time — especially because I can get sick at any point — I’m very reassured by the fact that children are very rare to get it or even show symptoms — and if they do, the outcomes are very, very good.”

Meanwhile, Dakota Love, a personal support worker at Hamilton’s Shalom Village who lives in Waterdown, said while COVID-19 is scary because it is something the system has never faced before, she faces germs and things they don’t want to bring home to their families on a daily basis.

To that end, she said she is still taking the same day-to-day precautions, but to an extreme — including washing her hands and changing clothes when she gets home.

Love said the sanitization efforts at the facility have been ramped up in the face of COVID-19.

“We’ve definitely buffed up our PPE,” she said. “We’re ready for it to come.”

Love said a lot of her nurse and PSW friends are more concerned about the situation, and while she was more nervous at the beginning of the outbreak, she said the CEO and leadership at her workplace have been “incredible.”

“Our managers have been incredibly supportive of us and our needs and keeping us all healthy,” she said. “It’s definitely a worry, but I just try to stay positive.”

Moving forward, Burkett said he hopes COVID-19 is a wake-up for the public about the seriousness of properly equipping and funding the health-care system — something he said didn’t happen in the aftermath of SARS or H1N1.

“I hope that even after this, it really shifts that focus and that we have a way to ramp things up,” he said. “The health system went from 100 per cent use to 900 per cent use overnight, and it's going to keep getting worse.”

“If we’re already running at 100 per cent, how are we going to have the capacity? And if we’re always going to be figuring it out on the fly, that’s not great.”

Burkett added the pandemic shows the importance of having elected officials who are scientifically literate to understand the warning signs early.

“I don’t think any western country took this seriously enough and the scientific community in every country was screaming at the top of their lungs that this was going to be terrible.”

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STORY BEHIND THE STORY: The Review wanted to see how local health-care workers on the front line of the COVID-19 pandemic are feeling — and what the situation is like on the ground.