ICU chief contacts cosmetic surgeons, carpenters in search of supplies for COVID-19 battle

Dr. Michael Warner is preparing for battle.

He's head of the intensive care unit at the Michael Garron Hospital in Toronto, and he knows that any day he's about to be overwhelmed with critically ill patients infected with COVID-19.

"It's ominous. There's an air of foreboding," he said.

"This is coming. There are already ICUs in the Greater Toronto Area with patients with COVID-19."

It's also a battle he knows he can't fight without the necessary equipment.

"This is like D-Day. I'm on the boats and I don't know where the guns are," he said. "You don't know what the enemy looks like, and you don't know how long the battle will last.

"And you don't know if you have enough artillery and armour to protect you for the full battle."

One of the most critical pieces of armour is a simple disposable mask with a stamp that reads: N95. He knows there won't be enough of them.

Having that mask could be the difference between life and death for a patient, because doctors and nurses need to protect themselves from viral contamination before they can insert a breathing tube.

"I don't want to be in the position where I'm saying, 'Sorry, I can't help your father, mother, child because I don't have the personal protective equipment,'" he said.

"That's a personal nightmare for me."

'People want to do something'

Who else uses these special disposable masks? Carpenters. Construction workers.

So Warner started contacting people he knows in those industries asking for help. He said if they have any N95s, let him know, because he needs them for the hospital.

He didn't stop there.

He also knows there won't be enough ventilators — mechanical breathing machines that can keep critically ill COVID-19 patients alive long enough for their lungs to recover.

Who else has ventilators? Cosmetic surgeons.

Soon, Warner had prominent plastic surgeons organizing their network to start rounding up ventilators.

Veterinarians who treat large animals also use ventilators in their emergency rooms. So Warner sent some more emails.

Would animal ventilators work on humans?

"I don't know enough about animal ventilators to know, but I think at this point everything is on the table," Warner said.

Everyone got back to him immediately, pledging to do what they can to help.

"People want to do something, if there is something they can do," he said. "They just want to be told, and they'll do it."

Warner said it was the best use of his remaining time before the surge of sick patients begins.

"I can't wait for a shipment of N95 masks that might never come from the government."

Running out of time

Federal and provincial governments have announced measures over the past few days to increase the supply of hospital equipment, including masks. An interim order passed by the federal health minister on Wednesday will make it easier to import COVID-19 test kits.

But already the strains on supplies are starting to appear. Some regions are running low on nasal swabs used to test patients for COVID-19. And Canada is competing to buy masks with the U.S. and countries all over the world that are grappling with the global shortage.

Some Toronto hospitals could run out of some supplies within two weeks — and that's based on usage rates over the last month, not counting an increase in consumption rates expected as COVID-19 patients begin flooding hospitals.

That's why Warner is asking business leaders, manufacturers and innovators to come with rapid private sector solutions.

"We are going to need these supplies very soon," he said.

Warner said he knows governments are scrambling to increase supplies, but he's not sure they understand how critical a simple mask can be.

"I think they recognize that [personal protective equipment] is important. I don't know if they understand how quickly we could burn through it, and the catastrophic nature of that problem," he said.

"We can have all the ventilators in the world, but they will sit idle if you can't intubate a patient to put on that machine."

While Warner was reaching out to construction workers and veterinarians, Michael Hendricks was rummaging around the supply cupboards in his McGill University lab searching for N95 masks, boxes of latex gloves, and chemicals he uses to study the nervous systems of nematode worms.

Hendricks and researchers across Canada have received urgent emails from both provincial and federal health agencies asking them to donate testing chemicals, called reagents, and other laboratory supplies for COVID-19 testing.

With the supplies on back order, provinces are forced to ration their COVID-19 tests. But many research labs that study biological science would have the necessary reagents.

"These are reagents that are involved in isolating RNA from samples," Hendricks said. "And reagents are used for the amplification tests to see if the virus is there."

Hendricks piled up whatever he had for pickup.

"We had some N95 masks and about 100 regular surgical procedure masks. We have a ton of gloves — pick a size. We had recently ordered a bunch of boxes of gloves. We had thousands. We sent some of the RNA isolation kit materials as well."

Hendricks was happy to be contributing to the fight against COVID-19. He said the university research labs are quiet. All of the students have been told to go home. All of the research has been put on hold.

The Quebec Ministry of Health and Social Services is organizing the collection at McGill, while at McMaster University, supplies are being collected for the local Hamilton Health Sciences hospital.

Lesley MacNeil, an assistant professor of biochemistry at McMaster, was among the researchers gathering supplies. Even though she doesn't study viruses specifically, she was still able to contribute some personal protective equipment including gloves, face shields and eye goggles.

"Right now, the labs are shutting down. So we just gave them everything we had," she said.

At Humber River Hospital in Toronto, Dr. Michael Gardam said preparing for COVID-19 is taking up all of his time as chief of staff and infectious diseases consultant.

When he heard of Warner's scramble to find masks and ventilators, Gardam agreed the situation calls for such desperate measures.

"If the models are true, then yes, we need everything we can get."