“Once more unto the breach, dear friends” – Reflections on the novel coronavirus disease and emergency medicine in Canada

摘要

References to war abound, as our leaders describe the tollthat the novel coronavirus disease (COVID-19) hastaken on the world. With over 300,000 deaths worldwideand no vaccine in sight as of this writing, the UNSecretary-General has described this pandemic as thegreatest threat to the world since World War II. In barelytwo months, the United States lost more people toCOVID-19 than in the Vietnam war and, by summer2020, the losses to COVID-19 will outnumber all oftheir soldiers who died in battle during World WarI. Canada, perhaps less accustomed to war metaphors,is nonetheless embattled with thousands of new casesof infection per week and over 6,000 deaths.1 The majority of Canadian fatalities have been in Quebec andOntario, predominantly among the elderly in long-termcare facilities; but, as we all know too well, COVID-19spares no region or demographic entirely. It has beenremarkable to witness the widespread adaptation ofemergency departments (EDs) in response to the pandemic, with the advent of hot and cold zones, testingtents in hospital parking lots, the institution of new protocols, and the fundamental changes in practice. Emergency physicians across Canada now wear personalprotective equipment (PPE) for the entirety of theirshifts, have had to revise their approach to resuscitation,and use phones to take histories. Many shower at workand change clothes before coming home, worryingabout the risk to their families.