Quebec ICUs are counting on the lessons they learned in first wave of COVID-19

MONTREAL -- Quebec hospitals are fighting hard to keep COVID-19 patients alive in their intensive care units – and counting on lessons learned in the first wave of the pandemic.

During that first wave, the Jewish General Hospital's intensive care unit had a death rate about half that of an average hospital in the industrialized world.

Doctors there give some of the credit to their very modern facilities, built after the H1N1 outbreak.

"It was actually built shortly after H1N1, and we envisioned it as being an ICU that should be ready for the pandemic that nobody ever thought was going to come," said Dr. Paul Warshawsky.

In addition to the facilities, there was a lot of good advice from regions of the world hit earlier than Canada. There was also a good supply of equipment like ventilators, as well as expert staff, and the use of a lot of steroids.

There was also an aggressive lockdown that kept the ICU from being overwhelmed.

"There's a lot that we can do to help save people's lives, but a lot depends on how many people are going to come. Once the system starts to get overwhelmed, then the mortality goes up," said Warshawsky.

Quebec Health Minister Christian Dube said with strict infection controls and all the lessons learned in the first wave, fewer people are dying now, but the situation is still fragile.

"The death curve last time and the death curve this time, this is totally different. We are in a different environment. But I'm crossing my fingers that this will last," he said

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Because of lessons learned during the first wave, hospitals hope to continue to provide expected levels of care for non-COVID-19 patients through the fall and winter.

"But if the rates in the communities don't start going down," said Warshawsky, "we're going to have to start cancelling those things. And then those cancer patients and those patients waiting for surgery will be at a disadvantage."

Warshawsky said the most significant difference between then and now is that many people seem to have let guard down in recent weeks.

"Now is not the time to relax. Now is the time to follow what the government is telling us to do because if the hospitals become overwhelmed, we will not be able to provide the same type of care we provided in the first wave, and mortality will go up if we become overwhelmed," he said.