As a nurse at Toronto Western, I thought I was ready for the pandemic. Then a Covid outbreak hit my ward
Veteran nurse Janet Pilgrim manages the Covid ward at Toronto Western Hospital. Here’s how she managed their outbreak in October.
As told to Isabel B. Slone
“I’ve been a nurse for more than 30 years. I work at Toronto Western Hospital, part of University Health Network, where I manage the general internal medicine ward and lead a team of 66 staff. I love building a human connection with people and helping them through their most vulnerable moments.
“In March, my ward was designated as the unit where all the Covid-19 patients would be isolated in the hospital. I was terrified—back then, there was still so much we didn’t know about Covid. I felt like I was being asked to walk off the edge of a cliff blindfolded. I also have a husband and two children, and I was worried about taking the virus home to them. That day, I had a morning huddle with my team to tell them the news. It was one of the hardest meetings I’ve ever had. My chest went tight, and I could feel my heart racing. I could sense the fear in the air. Some staff started crying; others’ faces just went blank.
“But I had been through this before, working on the front lines during SARS. I’d already experienced the shock and fear that comes with working at a hospital during a pandemic. I’d already pulled 12-hour days in an N95 mask. I was amazed at how it all came flooding back.
“In the first few weeks, we came up with strict protocols to keep our staff safe. At the height of the first wave, we were taking care of 30 patients. By the summer, when cases were low, we got to the point where we didn’t even have any Covid patients in the hospital. Like everyone else, I hoped the worst was over.
“It wasn’t. In mid-October, we learned that one of our team members had tested positive. Before I even had a chance to meet with my staff, I found out a second person had tested positive. I was devastated. I thought we’d done so well protecting ourselves from this virus. I was able to keep it together for the staff, but when I got home, I collapsed into my husband’s arms.
“We needed to test the rest of my staff, so the occupational health team set up a pop-up swabbing centre for my team. From that moment on, I didn’t have a minute to relax. I ran through every possible scenario in my head: what if so many people test positive that we can’t take care of patients? What if one of my staff dies?
“The wait time for results at UHN is only 12 to 18 hours, but every minute felt like days. I soon learned that another two staff members were positive. That morning, I greeted a colleague who was finishing up the night shift. They went to check their test result on their phone, and I watched as their face went ashen. The result was positive. I took the Covid-positive worker into a different room where we worked through next steps—together we contacted their family to come pick them up, and then called the Covid hotline to report their case.
“Within three days, we had five positive cases and two units on outbreak. Anybody who had set foot in these units—the medical team, occupational therapists, custodial staff, imaging staff, blood techs, patients on the ward—needed to be swabbed. That raised the number of people who had potentially been exposed from 66 to 300. In response, I went on autopilot—there was no time to feel upset or distraught. I immediately arranged a terminal cleaning of the unit, which involves removing patients from their rooms, cleaning and disinfecting each shared and individual space, disinfecting medical supplies in plastic packaging and discarding those in paper packaging, and changing all the curtains and linens. That week, the number of positive cases rose to seven.
“During the outbreak, I was working 12-hour days. I’d huddle twice daily with my day staff, then stay on to meet with the night shift as well. Then I’d go home and work for another six or seven hours, texting with my staff to make sure they were okay and communicating with the nurses. We had daily outbreak meetings to monitor the situation, and I went to every single one, including those on weekends. My husband was amazing. He took over all the household duties, covering meal prep, buying groceries and doing laundry so I could focus on work. I would come home and he’d have dinner waiting for me on the table. My fellow managers were also incredibly supportive, checking in to make sure I was okay, asking if there was anything they could do, or even just taking me for coffee and listening.
“The only way to get out of an outbreak is to wait. We were lucky that just one patient on the unit tested positive, and that the number of infected employees didn’t go above seven. If the number had been higher, we would have found ourselves short-staffed and unable to look after our patients. Thankfully, my staff have all recovered, though they still have lingering effects, like fatigue, shortness of breath and loss of taste.
“In late October, after 14 days with no new cases, the outbreak was officially over. It was one of the biggest challenges of my career. I’m happy to have survived it, but I don’t feel like I’ve come out the other end yet. After all, we’re not even halfway through the second wave. Another outbreak could hit us at any moment. The fear of contracting Covid hasn’t subsided—it’s something all hospital workers live with every day. And I don’t think that fear will go away until we have the vaccine.”