Wednesday, July 01, 2020

Life and Death Under the Curse of COVID-19

"I was basically told that the government is willing to risk my life to save my life. Let me say that again, my government told me they're willing to let me die, which according to them is for my own safety ..."
"So six months later or so, time for surgery and boom, all non-essential surgeries postponed."
"Heart surgery, apparently considered non-essential. Now I know some say that's non-essential, but it's pretty goddam essential to me. Told me the surgery will bring me peace of mind and a fallback just in case something happens. Now I'm told today possibly could be a year or two?"
"So what, I'm just supposed to kiss my ass goodbye? I'm starting to freak out here. Wondering what I should do?"
"Sorry for the rant folks, just frustrated that the government gets to decide who lives or dies ... I'm willing to get sick and live than die and not get sick ..."
Jerry Dunham, 46, heart failure patient, Alberta

"I vowed to him on his death bed -- with our daughters sobbing for their daddy to wake up -- that his death would not be in vain. I promised him that."
"We're all alternating between feelings of profound sadness, disbelief and total rage."
"How many have had their health deteriorate beyond repair? Why couldn't each province have left some hospitals open to deal with essential surgeries and sickness unrelated to COVID?"
"Our oldest, Reydian, got up on the bed, hugging her dad, begging him, 'Please Daddy, please Daddy, come back to us. Please Daddy, it's Reydian."
Krista Lambier, ex-wife, mother of two daughters



A year and a half ago, 46-year-old Jerry Dunham, a construction worker, hockey player, musician, living in Palmerston Ontario, population 2,500 found he couldn't catch his breath. He was soon diagnosed with congestive heart failure and informed he might need a heart transplant, but in the interim, some tests were needed, he would be put on medications and would be fitted with a defibrillator. He was living there to be close to Kitchener where his ex-wife and their children lived.

When the date came around for his scheduled surgery he was living with his parents, because he could no longer work, as a result of his serious heart issues; his special commercial driver's licence to operate large trucks and equipment had been rescinded. The medication wasn't working as hoped to regulate his heart. No work, he was unable to function and lost his home, his truck and even his residence, returning to Alberta.

At his doctor's office, a nurse informed him that despite his racing heart, the surgery to implant a defibrillator would not proceed, as a result of COVID-19 taking up hospital time and space, since all 'elective surgery' was being postponed. Jerry Dunham didn't think of his impending surgery as 'elective' but necessary, to keep him alive, given his diagnosis and medical condition. He asked to speak with his doctor.
Surgery
Surgeries around the world are being cancelled due to the pandemic.
Image: Unsplash/Jafar Ahmed
He had a scheduled appointment pre-surgery with his doctor. There were no other patients during the time he sat in the doctor's office; no one coming or going. But as he sat in the office for 45 minutes, willing to wait until the doctor could see him, he was informed that the doctor was simply "too busy". It was while he was waiting that he wrote the posts above, on his Facebook page, in sheer desperation.

Two months passed. And on the seventh of June he was admitted to Medicine Hat Regional Hospital with a heart attack. He died of cardiac arrest on May 30, deprived of oxygen to his brain. A close member of his family advocated for the desperate need for surgery for Jerry Dunham, but never received any acknowledgement that anyone had taken his pleas seriously. The Medicine Hat Hospital was the closest location from his parents' home in Redcliff, Albert, a ten-minute drive away.

In the planning stages in Ontario in preparation for an anticipated tidal wave of serious respiratory cases brought on by COVID-19, modelling suggested that elective heart surgery cancellation would cause over 30 deaths by early May. But the cancellation proceeded, on the gamble that more lives would be saved coping with patients on respirators taking up hospital room in ICUs and physician time in caring for them, than devoting a part of the hospital to continuing surgery.

About 200,000 surgeries and other procedures -- cancer and heart surgeries included -- were cancelled while hospitals prepared for a deluge everyone was certain would eventuate, of COVID-19 patients. A spokesperson with Alberta Health wrote: "All urgent, emergency and cancer surgeries have been available throughout the pandemic. Albertans who need urgent surgery will get it. AHS has indicated that they are not aware of any deaths due to cancellations of scheduled surgeries."

When Jerry Dunham was taken off the ventilator his wife was informed that he would die within minutes or hours. He lived for another two-and-a-half days, before finally expiring. In the end, he had spent more time in intensive care following his deadly heart attack -- entirely preventable had his surgery proceeded -- than he would have done, with the implant of a defibrillator that was ultimately denied him.

Krista Lambier was asked did the family wish his death to be recorded as a COVID-19 death. "I said, 'no. He tested negative for COVID-19. That'd be a flat-out lie." She thinks now that perhaps the more than 8,560 deaths that Canada lists as being caused by the respiratory virus might be an over-inflated figure. On the other hand, since 80 percent of those deaths have been attributed to Canada's failure to adequately protect the health-vulnerable aged who lived in long-term care homes, perhaps not.

A chart from the COVIDSurg Collaborative study showing the projected global impacts the pandemic will have on particular elective surgery procedures.

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