Canadian Medical Association

As an emergency physician, I have witnessed first-hand the repeated treatment delays, physical and mental exhaustion among my fellow health workers and general distress caused by COVID-19 and its variants among the public for close to two years now.

The lingering pandemic compels me to draw parallels with what I experienced as a humanitarian doctor following the 2010 earthquake in Haiti. While some may think this comparison is exaggerated, I believe that the situation in Quebec and elsewhere in the country requires the same kind of robust and organized response we would have to muster if we were dealing with a natural catastrophe.

Regaining control of the situation

There is no denying that Omicron has thrown us a curve ball. We could rehash all of the mistakes that could have been avoided, but I have come to understand that in an emergency it is better to focus on the things we can control and on what we can do.

I have learned some important lessons since my first humanitarian intervention. Firstly, every emergency is divided into four phases: preparedness, response, recovery and mitigation. We have failed the first phase because we were not able to adequately anticipate the threat. We are now in the midst of the response phase, which is also experiencing its share of difficulties—but we do have some potential solutions, which I will share below. Lastly, recovery and mitigation will be crucial steps that we will be able to act upon. We will eventually have to ensure the system recovers, once this viral tsunami has passed. We can start today by thinking about how we can get first-line care (the point of entry to the health system) back on its feet for priority groups and, in the longer term, anticipate and prepare for the next crisis.

The five S’s teach us that in order to adequately respond to the current crisis, we have to simultaneously bring together (ensure the synchronicity of) the following key elements: staff, stuff, space, and systems. If any one of these elements is subpar, our emergency response will be inadequate and the results will be negatively affected. So far, these elements have not been brought together—which is part of the reason for the cataclysm we have been experiencing.

Using the means available to us

Considering the difficulties in bringing together the four key elements required for optimal emergency response, we must considerably reduce the entry of new patients into the system to limit harm. This effort hinges in large part on public compliance with health measures, especially vaccination. Vaccination is the most effective tool we have to mitigate the effects of the crisis.

Every day, I see patients with COVID-19 who are suffering and seriously ill admitted to hospital. Most of them are unvaccinated. Right now in Quebec, unvaccinated patients are overrepresented in hospitals compared to their proportion of the general population: they are 7.5 times more likely to be hospitalized than people who have received two vaccine doses. That’s a huge difference!

It disheartens me to see patients who would otherwise be healthy make such a choice. We are privileged to live in a G7 country with access to vaccines. Choosing to get vaccinated makes sense, for ourselves as well as for our seniors, our children and our health care workers.

Dr. Abdo Shabah

Emergency physician and Canadian Medical Association spokesperson

This open letter was originally published in La Presse+

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