On November 20 I came home to the news that the 10-day COVID-19 test positivity rate in Steinbach was a staggering 40%. Steinbach is a town of just over 15,000 people around one hour southeast of Winnipeg, and I was there for my family medicine rotation. The day before I arrived, a COVID-19 outbreak was declared at their regional hospital, and for the next month I had a glimpse of what life was like behind the 40%.

During my first ER shift, I was immersed in an atmosphere of stress and fear, as staff were already starting to feel the strain of the outbreak. All patients are screened as red, orange or green, meaning confirmed COVID, COVID suspect and no COVID symptoms, respectively. Although this labeling system works in theory, delays in testing led to many orange patients later becoming red once their test result would come back five days later. By that time, multiple healthcare workers would have already cared for that patient with inappropriate PPE. As a medical student I was mostly asked to see green patients, so I had a relatively normal ER shift. But listening to the conversations around me, it was clear that it was only the beginning.

By my second shift, this was all but confirmed. Two weeks after the outbreak began, the ER was essentially full of COVID red patients. I saw one orange patient whose test result had not come back yet. Around me, nurses were exhausted. Through cracks in the curtains, I saw patients struggling to breathe on 70L of oxygen. The anesthesiologist was on his way to do yet another intubation. Coughing was part of the constant background noise. I repeatedly refreshed the ER status board to see who was coming. Every single one was COVID red.

That weekend, a Hugs Over Masks rally occurred in Steinbach. Crowds of people gathered to listen to anti-mask rhetoric without any public health precautions. Honking trucks and cars lined up and blocked traffic down the main road for hours. I spotted signs that said, “Masks are child abuse”, “Freedom is essential”, “This is not North Korea”. All this occurred just two blocks down from a hospital buckling under the pressure of COVID-19. In clinic the following week, many patients were saddened by all the negative publicity the town received; most people who participated in the rally were not from Steinbach.

I spent a lot of time in clinic doing virtual visits due to COVID-19 restrictions. This is where I saw the reaches of the pandemic extending far deeper than just the hospital. Many patients were calling about the overwhelming stress of caring for their children at home because of school and daycare closures. Other patients who worked at schools and daycares were asking for work notes to protect their families at home. It wasn’t until I took a step back that I realized giving out more and more work notes to school staff would eventually make it more difficult for schools to stay open, which would simply exacerbate the childcare problem. How, then, do you advocate for both these patients when their needs contradict each other? A patient who worked at a personal care home with an outbreak asked for a work note due to their underlying health conditions. How do you advocate for this patient while also advocating for a healthcare system desperately in need of personal care home staff?

A young family came in one afternoon for a well-baby visit. After asking the standard questions, I asked how they were doing and found out that the couple was struggling financially. They were unstably employed even before the pandemic, making them ineligible for CERB. Now that the mom was prepared to work after giving birth, very few places were hiring. The social support services they had relied on previously were cancelled. Due to concern for their parents’ health, they were reluctant to have them help with childcare. Their first child had been taken away by Child and Family Services a few years ago. How do you tell them the same won’t happen again?

One afternoon I was with a doctor who had been practicing for many years at Steinbach Family Medical. At the end of the day, we talked about how COVID-19 was impacting the community. I saw him hold back tears as he talked about how difficult the last week had been for him. Multiple patients of his had died of COVID-19, patients he’d known for so long he thought of them as friends.

Every day we see the numbers. That day it was 40%. But there’s more to this pandemic than the numbers. There are people behind these numbers, and people that the numbers could never capture. And it’s important that we see them too.

By: Ms. Sara Wang, B.Sc. Winnipeg, MB