'Collateral damage': Head emergency doctor fears toll of pandemic on health-care staff, non-COVID patients

Dr. Daniel Kalla knows many of his colleagues are going to get COVID-19 and he hopes to God none of them will die.

Kalla, head of the emergency department at St. Paul's Hospital in Vancouver, is on the front lines of the novel coronavirus crisis. He said it is not just the potential droves of coronavirus victims arriving at the hospital that worries him, but also the impact the pandemic is having on his co-workers.

"In emergency, we deal with a lot of scary and life-threatening conditions, but it is rarely our own," said Kalla on CBC's The Early Edition on Monday.

He said it is daunting to read the news and see how many health-care workers around the world have succumbed to the disease. In Italy, more than 50 doctors are counted among the dead.

Health-care workers are also facing a raft of psychological challenges.

A new study published in the Journal of the American Medical Association revealed the mental-health effects of the COVID-19 outbreak in China on frontline workers. 

It found that those who were involved in the diagnosis, treatment and care of patients with the disease had a higher risk of symptoms of depression, anxiety, insomnia and distress.

There's also the fear of bringing the virus home and passing it on to loved ones.

"That's an added burden that really plays with the mind," said Kalla.

Kalla said right now, despite a steady uptick in people being admitted due to COVID-19, the volume of patients at St. Paul's is still manageable.

"It's also terrifying," said Kalla. "The virus is four months old and we just know so little about it." 

He said the ultimate test on hospital resources will arrive in the next two weeks, and not just when it comes to caring for people with the illness. 

Kalla is also concerned about the impact it will have on patients who need care unrelated to the coronavirus. 

"There are the COVID victims and then there is all the collateral damage of COVID," he said.

"A lot of people are going to suffer, not just from COVID but from the impact on the health-care system."

'Wonderful' community support

Despite going to work every day anticipating "devastation and loss", Kalla said knowing health-care workers are in the hearts of British Columbians right now is a comfort.

At 7 p.m. PT every day, people across the province are taking to their windows and balconies to cheer and bang pots and pans to show their appreciation for essential workers who are putting their lives on the line right now.

St. Paul's is located in Vancouver's West End, where the applause ritual began, and Kalla said he has been able to steal a moment and step outside to listen.

"It's so wonderful. It's more than just feeling appreciated, you feel supported, like the community has your back," said Kalla.

The symbolic gesture also shows Kalla that many British Columbians are doing what they can, such as staying home and maintaining physical distance, to keep each other safe.

"If we all do our part we will come out so much better on the other side of it," he said.

Kalla, who has studied and written extensively about pandemic diseases, says they historically bring out the best and worst in people. 

And for those people not following public health orders necessary to reduce the spread of the virus, Kalla has a stark warning: "They are all ticking time bombs."