“We have entire families coming in with Covid”: This Scarborough ER doctor is working in one of the city’s raging Covid hot spots

“We have entire families coming in with Covid”: This Scarborough ER doctor is working in one of the city’s raging Covid hot spots

In few places is Ontario’s Covid crisis more evident than Scarborough Centenary Hospital, where there are dozens of patients in critical care. Scarborough’s large population of essential workers—who often live in multi-generational households—have borne the brunt of the virus, and the province has designated 11 Scarborough postal codes as hot spots. Jemy Joseph, an ER doctor at Scarborough Centenary, is one of many doctors using Twitter to spread information about the pandemic’s third wave. She says the situation in Scarborough highlights how the virus has disproportionately affected low-income and racialized communities, who continue to be underserved by provincial and federal Covid response measures. We spoke to Joseph ahead of an overnight shift in the ER.

Before we get into the bigger questions: you worked an overnight shift yesterday, and you’re about to do it again. How are you feeling?
I would say that my shifts these days are generally more exhausting, tiring and frustrating than usual. And quite emotional.

Describe the situation at the ER right now.
From the moment I start work, I can see how crowded it is. The waiting room is full. There are no beds to see patients anywhere. The hallways are full of patients brought in by paramedics. There are sick people all over, but there’s no space to see anyone. We’re now seeing younger, sicker people coming in, and they can crash on you quite quickly. There’s a chance you’ll end up doing CPR in the hallway.

Compared to, say, six months ago, what’s the situation like?
It’s worse. In general, when you have a ton of Covid patients, people who come in with other emergencies—heart attacks, trauma, lacerations, anything—are affected as well. The Canadian health care system is already fragile. We already had crowded hallways and long wait times. Now we have two problems piling up on top of each other.

Tell me about the challenges you’re facing in Scarborough that are specific to the population there.
In Scarborough and similar communities, like Peel, for example, there are more racialized and low-income individuals. We have entire families coming in with Covid. Our ICU has admitted seven husband-and-wife pairs so far. Most people in this community live in multi-generational households. These are your front-line workers. These are your essential workers. They don’t have the choice to work from home. These are the people who keep your factories running, who bring you Uber Eats, who work as nannies, who clean your house. They are very vulnerable. And not only that, but if they catch it, they’re infecting a large number of family members. We’re seeing a reflection of our community within the walls of our hospital.

On Saturday, you took to Twitter to speak out against Doug Ford’s new restrictions, which at the time included increased policing. Why did you feel the need to speak out?
I had a visceral reaction to those announcements. Science has been very clear about what needs to be done to curb this disease: stay home when you can, wear a mask, wash your hands, limit indoor contact, go outside. There is no science or evidence that increased policing is going to help eliminate Covid-19. I don’t know where they got that idea. We were sitting in high anticipation about what our premier was going to say, and we were disappointed: first because he shut down outdoor spaces, when we know that indoor space is where the spread happens, whether that means larger households or factories and grocery stores. But second, from a policing perspective, there’s already a history of racialized communities being targeted. These communities may feel cornered, and afraid of going outside. So as an Indian woman myself, I was devastated. Not just for myself, but for my community.

The vaccine rollout has been bumpy across the province, but at your hospital, you just had to shut down your clinic. What was that like?
We cancelled more than 10,000 appointments, in one of the communities that needs vaccines the most. That speaks volumes about how ineffective the rollout is. I think there has been a failure of vaccine procurement, and also in allocation of vaccines to the appropriate hot spots.

You’re one of a number of doctors across the province and country who’s using social media to broadcast your experience during the pandemic. Why now?
About two weeks ago, I was working at the vaccine clinic. I vaccinated a woman named Evelyn. The week before, she lost her brother to Covid. Two weeks before that, she lost her nephew; he died in his bedroom. He didn’t even make it to the hospital. Her sister-in-law had Covid, and was still in a coma at that point. There was one family member, a bank teller, who brought Covid home and infected the whole family. Evelyn begged me to communicate to as many people as I could how devastating this virus can be. I had a Twitter account that was mostly inactive, so I logged back on, and once I got there I was pleasantly surprised to see so many of my colleagues using the platform in the same way.

Do you feel a professional responsibility to share what you’re seeing?
I sometimes get the sense that communities that are not affected by the disease are not taking it seriously. Individuals from wealthy, high-income neighbourhoods are generally faring better with Covid, and there is a sense that people believe they’re protected from the disease; that it’s something that will affect people outside their neighbourhoods. And they are protected, in a sense—they can work from home and order their food—but that doesn’t mean the pandemic is over. This is why some of us are taking a stronger stance: you generally don’t hear doctors standing on street corners and yelling, so to speak. But some of us have hit a point where we can no longer remain silent. And I’m not generally a political person…

But this is a political issue. How do you feel about calls for Doug Ford to resign?
I don’t necessarily think resignation is a better solution than policy changes. Vaccine procurement is an issue. How we manage our borders is an issue. At the provincial level, not following scientific recommendations is an issue. I think accountability is needed: I was so proud of the people of Ontario for making the noise they did about shutting down playgrounds, because in 24 hours, that decision was reversed.

On Sunday, Justin Trudeau announced a series of measures to help Ontario, including bringing in health care workers from other provinces. He said this measure would strongly target the GTA. Will that help you?
We need more hands on deck. Yesterday, I was trying to contact doctors in other provinces asking if they’d like to do a stint in Toronto. But there are so many barriers for a health care worker moving province to province. The licensing process and the college registration usually takes weeks to months. Who’s going to pay for their travel? How are we going to accommodate these people? If the logistics of this take eight weeks, by then, this wave might be over. We need them today.

Many doctors have made public pleas for policies they think will help. What do you think is needed right now to prevent us from hitting the 18,000 daily cases that was modelled last week?
We need better restrictions on what’s shut down and what isn’t. The definition of “essential” is still far too broad. Everything that’s happening indoors that isn’t absolutely necessary to the bare-bones functioning of the city needs to be shut down. Indoor gatherings, like weddings, are not necessary. We need paid sick days. And our limited supply of vaccines need to be redirected to hot spots like Scarborough. We can’t wait for more political meetings to make decisions.

Covid has taken a huge psychic toll on health care workers. How are you taking care of yourself?
This type of trauma is different. I’m lucky to have a strong support system—I live with my mom and dad—but I’ve had days when I’ve completely broken down. I lost a family member to Covid just last week. I get a lot of support from my family, and from my church, but also from individuals who are part of the medical community. We recognize that we’re all soldiers in the same battle, and we can’t afford to lose any soldiers. After every shift, I go into the parking lot, take my mask off, and I just breathe. I don’t take a breath for granted at this point.