Seite - 467 - in VULNERABLE - The Law, Policy and Ethics of COVID-19

467A View from the Front Lines of a COVID-19 Outbreak mile wide. He greeted me cheerfully, told me he felt fine, and wanted a coffee. Billy makes friends instantly with everyone. He remembered the fever but now felt as good as ever. On Wednesday night he had a fever again and became short of breath, with low oxygen satura- tion in his blood. We started him on oxygen. But Thursday morning he looked good again. He wanted to get rid of those annoying nasal prongs. This would become a pattern. High temperatures and short- ness of breath in the evenings—then perking up in the morning to charm us as we made rounds. He was the definition of resilience. I felt confident that Billy was going to make it through this infection—and he did. Wednesday evening, I had at least four phone calls with the nurse on duty. He was worried about Helen. She was short of breath and couldn’t stop coughing. They were struggling to keep her oxygen saturation near 90%. On top of COVID-19 infection, Helen had heart failure. She was on a high dose of diuretics. Neither she nor her fam- ily wanted her to go to the hospital. She hated hospitals. The family wanted her kept comfortable. I decided to prescribe hydromorphone to help the laboured breathing and settle the agitation. But I discov- ered there were no narcotics on site. It was almost midnight. We opted to try lorazepam to settle her. I reviewed what I would need to do if Helen died in the home. I slept lightly, worried I would be heading back to PHM at some point in the night to pronounce a death. To my surprise and relief that call never came. Somehow Helen made it through the night. Thursday would be the worst day of the first week. I was pull- ing into the parking lot at PHM when I received a couple of texts from Jen who was the charge nurse that day: “Helen is on 6L and sats are 84–88%. We don’t have a plan for air hunger. I don’t know that we have meds for it either.” Then a minute later: “Can you come see Stuart right away?” There were two residents with severe shortness of breath. Each was getting 6 litres per minute of oxygen. We hadn’t yet acquired oxy- gen concentrators, so we were using small mobile tanks. Jen calcu- lated, at that rate, each of them would use a tank an hour. I walked into the building, ready to kick into action, determined to procure medications to help with the agitation and shortness of breath. I went directly to the purple pod where Nurse Jen was watch- ing over Stuart. I donned personal protective gear and went in. I’d been checking Stuart every day. He sat in his wheelchair, coughing