观点/评论：故意不接受疫苗而让医院不堪重负者是安省的耻辱

随着 Omicron 疫情风波在全省肆虐，安大略省的医院和重症监护室挤满了 Covid 患者。 一般住院患者需要医院提供的医疗设施，但重症患者则处于最危机的状态，需要消耗大量医疗资源——包括激进的药物治疗和医生、护士和医护人员团队的高强度护理。 截至 1 月 24 日，有逾 4000 名Covid患者住进安省医院，而至少 600 人被转入重症监护室，两者均创下历史新高。 虽然 Omicron 感染看似病情稍轻而住院时间缩短，但患者的大量涌入使本已高负荷的医疗系统难以应对，而药物和医护人员的短缺更加剧了医院的危机。




Ontario hospitals and ICUs are cramped with Covid patients as Omicron wave ravages across the province. While patients on a general medical floor need the hospital facilities' support, those critically ill are in the most vulnerable state, exhausting intensive medical resources – including aggressive drug therapies and constant attention from a team of doctors, nurses, and healthcare workers. As of Jan. 24, over 4000 patients were in hospitals with Covid, while at least 600 were in ICUs – both numbers were at a record high. The less-severe nature of Omicron appears to be leading to shorter hospital stays. However, the influx of patients has made the already stressed medical system struggle to cope, exacerbated by the shortage of drugs and healthcare workers.

全国范围内新冠病毒感染率的飙升导致大量医护人员离职，从而引发了一场迫在眉睫的“医疗系统危机”。 虽然一些被感染的医护工作者不得不隔离或请病假，但还有许多是因为不堪工作的高强度负荷被而被迫离职。 在失去知觉的病人耳边举着一个iPAD 以让他们听到亲人的声音和祈求会让许多护士黯然泪下，无法自持，而在竭尽全力以挽救病人的生命后，还是看着病人痛苦的离去是护士们最为难以接受的现实。巨大的内疚感是导致护士们不堪重负的另一个重要因素。Teresa Marini， 一名在安大略省南部一家医院重症监护室工作的注册护士向《环球邮报》表示：“当病人无法呼吸时，他们会歇斯底里，向你恳求对你施虐。你可以在下班时试图忘了这一幕，但你却绝不可能彻底将它抛在脑。”


 
Surging rates of Covid across the country has sparked an impending "public health crisis," which saw healthcare workers leave their position in droves. While some health workers infected are isolating or taking sick leaves, many others quit their profession because of burnout. Holding an ipad up to unconscious patients' ears while their loved ones plead for them to get better can take a heavy emotional toll on many nurses. The level of distress has soared as nurses face sad outcomes after all the exhaustive efforts to save patients' lives. The immeasurable feeling of guilt is another significant contributing factor to the high burnout rate. "When patients can't breathe, they become hysterical and start ripping at you and pleading with you. You can walk away from that at the end of the day, but you can't leave it behind any time soon," Teresa Marini, a registered nurse working at the ICU of a small hospital in southern Ontario, told the Globe.

长期人手不足、资源紧张、不断加班、不断超载的职业负荷让护士们长期工作于危险的工作环境中，使他们处于崩溃边缘。 2021 年春季，不堪负荷的护士比率达到 60-80% 的历史新高，较上年同期的 30-40% 大幅上升。 而在 ICU 工作的护士负荷最高，风险最大。

Chronic understaffing, limited resources, constant overtime, and accumulative occupational stress have created dangerous work conditions for nurses, pushing them to the brink. The burnout rate fetched at a record high of 60 -80% in the spring of 2021, a sharp increase from 30-40% a year earlier. Nurses working in ICUs were at the most significant risk.



但安省医院面临医护人员短缺的同时， Omicron 病例的激增使安省医院还面临着治疗重症患者急救药物的不足的紧急状况。由于医疗机构难以确保药品供应，许多医院的患者只能接受限量关键药品，而另一些病患甚至被完全剥夺了获得救命药物的机会。 Tocilizumab 或 sarilumab 是保护 Covid 患者免于上呼吸机甚至死亡的基本药物。在 德尔塔 浪潮中许多医院就已面临该药品缺乏的现状，而Omicron 病例的激增导致短缺危机进一步升级。同时防止病情进一步恶化的抗病毒药物瑞德西韦也供不应求。面临药品的严重不足，有些医院不得不采用病人抽奖的方式来提供药品分配的公平度。 Juravinski 的重症监护医师 Bram Rochwerg 医生说：“这种拿不到能救命药物的状况我以前从未遇到过。从此可以看出院内Covid 重症患者人满为患的紧迫现实。”

But as Ontario hospitals grapple with nurse shortages, the lack of critical drugs to treat critically ill patients amid a surge of Omicron cases has only fueled the hospital crisis. Many hospitals have seen patients on limited dosages of critical Covid therapeutics or even deprived of the chance to get the life-saving drugs altogether as healthcare facilities struggle to secure medicine supplies. Tocilizumab or sarilumab are the essential medicines to protect Covid patients from being ventilated or dying. After the Delta wave saw hospitals gripped by the drug shortages, the spike of Omicron cases has sent the shortage crisis soaring. The antiviral drug remdesivir, which helps prevent the progression of the disease, was also in short supply. The dire situation has forced hospitals to resort to a lottery-type system to ensure fairness in allocating doses. "I've never before faced a time where we didn't have access to a drug that saved lives. It's the reality of how many critically ill patients with Covid there are," said Dr. Bram Rochwerg, a critical care physician at Juravinski Hospital.

加国人士可以通过接种疫苗来为减少医院危机尽一份力。 安省政府新冠数据显明 Covid 疫苗能如何有效地降低住院和 ICU 入住率。 截至 1 月 24 日，未接种疫苗人口中的住院率达到每百万人 1115.2 人，而在接种两剂疫苗的人口中该数字仅为 202 人。 与此同时，每百万未接种疫苗的人中有 281 人进入 ICU，与两剂接种者中的 23 人形成鲜明对比。 那些故意不接种疫苗而使ICU病房不胜超载者是安省的耻辱。



Ontarians can do their part to help reduce hospital crises by getting vaccinated. Ontario Dashboard data has painted a clear picture of Covid vaccines' benefits in reducing hospitalized and ICU occupancy rates. As of Jan.24, the hospitalization rate reached 1115.2 per million among unvaccinated while only 202 among people with two doses. Meanwhile, 281 per million unvaccinated people were put into ICU, a sharp contrast to 23 among the two-dose recipients. It is a shame that those responsible for filling ICU beyond capacity have willfully chosen not to get vaccinated.