Prince Rupert doctors push for stringent COVID-19 measures

A group of Prince Rupert doctors has expressed written concern to the City that without more public diligence and increased measures controlling COVID-19, there will be heightened stress on the hospital system.

The seven letters posted on Mayor Lee Brains web page on March 20 cite repeated concerns that the spread of COVID-19 will detrimentally affect Prince Rupert and it’s medical resources, such as staffing and equipment, if stringent measures are not immediately put in place by the City to lock down the transmission of the contagion.

“It is prudent that we realize that this viral illness could completely overwhelm health care resources in our town,”Dr. Gillaume Coetzee, who has had a private medical practice in P.R. for 10 years, said.

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“Based on a population of 12,000 people, 7,200 will contract this virus if it is allowed to spread,” Coetzee said, “Of those, 20 per cent which equals 1,440 people will need to be admitted into hospital. Prince Rupert has 26 beds in our hospital.”

Of the 1,440 admitted, five per cent or 72 people would required intubation, which is the insertion of a breathing tube. There are only two ventilators in Prince Rupert, Coetzee said.

Prince Rupert faces some unique health care challenges as a remote rural community, Dr. Kevin Browne, specialist of internal medicine in P.R. said in his letter to City Council. With single individuals in physician positions of internal medicine, general surgery, paediatrics, obstetrics and gynaecology as well as psychiatry, health care service would become extremely vulnerable with the loss of one of these doctors should they become exposed to the virus.

“Our hospital, strictly speaking, does not have an intensive care unit, rather it has two beds that are designated for ‘higher acuity’ patients. In theory this means that when a patient becomes so severely ill that they would be intubated then they need to be transported out to a higher level of care, i.e. to an institution with a designated intensive care unit - thus they need to be flown out, ” Browne said.

The number and availability of nursing staff is also a concern for local doctors.

“Another important factor is that we have limited nursing staff who are comfortable with, and can provide care for patients who are intubated and ventilated,” Browne said.

“In the event that one or more of these nurses becomes unable to work because of significant COVID-19 infection, the impact is far greater than in other hospitals who may have a lager pool of nurses with this training to draw from.”

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Another worry for Browne, is shortages of appropriate medical supplies and personal protective equipment.

It’s estimated that for every day there is an intubated and ventilated patient at P.R.R.H. who needs respiratory precautions, such as those required for COVID-19 infections, 40 sets of personal protective equipment per day will be required, including masks, gloves, gowns etc.

“In effect this means that families of patients in ICU will not be able to visit them in person… this will be extremely troublesome to our indigenous population for whom as you know the importance of family relationships provides the backbone of the social and cultural fabric and this becomes even more important when patients are critically ill and in danger of dying,” Browne said.

“I think my civic duty, and my duty as a physician is to inform people that this is how bad it could get. And that it is in our control to some extent, not letting it get there, by following some simple recommendations the British Columbia Centre of Disease Control (BCCDC) has made to the public in general,” said Coetzee.

“I think the biggest myth that I want to dispel, I think is number one, ‘it’s just a flu’, because it’s not quite just a flu. The second thing I would like to make sure people are aware of is, even if the threat might be perceived as low, the implications of when it hits could be…disastrous.”

Coetzee has a dual role as a private physician. He is also chief of staff at Prince Rupert Regional Hospital. He spoke to The Northern View as a local private physician and not as a representative of Northern Health.