Spring 2022 (Volume 32, Number 1)
Dispatches from the COVID Ward
at Vancouver General Hospital
By Kam Shojania, MD, FRCPC
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Vancouver General Hospital COVID-19 Rheumatology Volunteers:
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Alice Mai, Ann Marie Colwill, Antonio Avina, Brent Ohata, Daniel Ennis, David Collins, Diane Lacaille,
Fergus To, Hyein Kim, Jason Kur, Jennifer Corpuz, Jennifer Reynolds, Jonathan Chan, Kam Shojania,
Kun Huang, Mohammad Bardi, Natasha Dehghan, Neda Amiri, Raheem Kherani, Shannon Galway,
Shahin Jamal, Wendy Wong
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In March 2020, and for the next 23
months (and still ongoing), there has
always been at least one rheumatologist
working on the Vancouver General
Hospital COVID-19 ward. Think back to
March 2020, when we were all worried
about COVID. How was it transmitted?
What would happen here? Would we end
up like New York or Italy? What was the
COVID ward going to look like? I had visions
of hallways full of sick and dying
people, limited oxygen supplies, and
scarce personal protective equipment.
Vaccines were only a dream. During this
uncertain and frightening time, these
22 rheumatologists collectively answered
a call for help from the internists and
administration at Vancouver General
Hospital (VGH). For a week at a time, we
worked alongside internists, other subspecialists, nurses,
and other allied health members taking care of very sick
COVID-19 patients.
At the beginning we were sifting through online sources
but eventually we were able to develop our own treatment
algorithms and we published papers on COVID-19 cytokine
storm treatment. Some of us even had to “borrow”
tocilizumab from private offices and bring supply to the
intensive care unit (ICU). Seeing the rheumatologists as
the first group to step up was an inspiration to other specialists
in the hospital who also subsequently volunteered.
A few of us were infected with COVID-19 — but all recovered.
In addition to working on the COVID-19 ward, some of
us also sat on the COVID-19 therapeutics committee, and
others provided advice and wrote provincial directives on
COVID-19 vaccines in immunosuppressed patients.
Raheem Kherani (left) and Kam Shojania
(right) in the "air lock" behind the VGH
COVID ward (December 2020).
In retrospect, our biggest fear was that our internal medicine
skills would be too rusty and that our care would be
sub-par. The opposite turned out to be
true as we each realized that we were
more than capable of treating these
patients. It is true that to be a good
rheumatologist you need to be a good
internist. All of us were comfortable
taking care of unstable patients with
multiple medical problems including
COVID-19. Dare I say that it was actually
energizing to work closely with
internists, infectious disease specialists,
respirologists and intensivists. It
was difficult to manage the emotional
toil of caring for sick and sometimes
dying patients without their families
present. We participated in many difficult
bedside video conferences with
distraught family members who could
not attend in person due to emergency
isolation requirements.
On October 26th 2021, there was an appreciation dinner
for these brave physicians. We received letters of gratitude
from our Premier, our Minister of Health, the Mayor
of Vancouver and the VGH CEO. There were lots of laughs
and a few tears as we talked about how working on the
COVID ward changed us. As I looked around the table, I
knew that I would never forget how immensely proud I am
of my wonderful colleagues who, in the early months of the
pandemic, heroically “ran towards the fire” to help when
there was so much uncertainty.
Kam Shojania, MD, FRCPC
Head, Division of Rheumatology, Vancouver General Hospital
Medical Director, Mary Pack Arthritis Program
Clinical Professor, UBC Division of Rheumatology
Vancouver, British Columbia
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