At-home COVID-19 patient program a boon to families and strained hospital system, patient says

Shaneen Robinson-Desjarlais's COVID-19 recovery is bumpy and ongoing, but the mother of three is glad she's been able to heal at home with her newborn as opposed to being separated from loved ones in a hospital hit hard by Manitoba's third wave.

Robinson-Desjarlais is one of 35 COVID-19 patients in Manitoba who are receiving daily remote care at home through the virtual COVID outpatient program (VCOP). She's one of sixteen on oxygen.

"I'm just so thankful that I can be home with my family and be monitored by health-care professionals every day," Robinson-Desjarlais said late last week.

"Every day they treat me with respect. They know my name. They're concerned. They make sure they're checking all my vitals."

Nurses and doctors do virtual check-ins daily, and in some cases they may get paramedics to visitor take the patient back to hospital.

Health-care staff have taught Robinson-Desjarlais how to monitor her blood pressure, temperature and oxygen levels.

They review those and her medication routines together to tinker as needed. They're on time and "super efficient," she said.

"I've got three kids and a newborn and I'm not feeling that great, and so it's super easy for me: just log on and chat with the nurse for 10minutes and then I'm out."

The program has supported 129 patients remotely since it was rolled out late last year to alleviate strain the health-care system faced during the pandemic's second wave.

Hospitalizations have been on the rise again in recent weeks, with the province forced to spin off additional methods of diverting patients from Winnipeg hospitals like St. Boniface,Graceand Health Sciences Centre.

WATCH | Lanette Siragusa on Manitoba's peak ICU capacity:

Lanette Siragusa on Manitoba's peak ICU capacity and lessons learned from the second wave

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Lanette Siragusa, chief nursing officer for Shared Health, said Monday the province will soon hit its second wave peak in ICU occupancy, and outlined how the health system is responding to the surge in COVID-19 patients.

Teens aged 17 to 19 requiring emergency medical care are being funnelled to the Children's Hospital.

High-risk seniors in hospital are seeing their personal care home placements expedited. About 270 placements have been sped up since April 20, with 63 between May 5 and 13 alone, according to a provincial spokesperson.

Even so, Manitoba is expected to exceed its second wave peak of129 critical care patients very soon nearly double the pre-pandemic critical care capacity in the province.

Alleviating pressure

But things are different this time around, said the chief nursing officer of Manitoba Shared Health.

Lanette Siragusa said vaccines have helped, and the at-home program has saved the hospital system 751 in-patient days so far. There are plans to expand it further.

"We have basically a whole medicine ward living at home," Siragusa said Monday during a COVID-19 news conference.

"The feedback from patients and families has been very positive; people like being at home and feeling supported in that environment. So, we will continue to lead the way on those innovative solutions."

That innovation isn't entirely unique to Manitoba. Ontario rolled out a suite of remote care programs late last year for similar reasons, including virtual monitoring of COVID-19 patients.

'Enormous service' to hospitals

It also took hospital systems being overwhelmed to trigger faster development of virtual supports that experts have been calling for since before COVID-19 emerged, said Dr. Philippe Lagac-Wiens

"I think the VCOP[virtual COVID outpatient program]is really one of the success stories of the coronavirus pandemic,"said Lagac-Wiens, a medical microbiologist and physician at the St. Boniface Hospital.

"It's really done an enormous service to the hospital system."

Lagac-Wiens, who isn't directly involved in the program but is familiar with how it works, said freeing up hospital space is just one benefit.

Keeping some COVID-19 patients at home means they aren't potentially exposed to hospital-borne infections while in a vulnerable state, he said.

They're also in a more comfortable space, instead of being largely alone in an unfamiliar hospital setting, and that could confer significant psychological benefits during recovery, said Lagac-Wiens.

Success of program

He believes the success of the program hinges on pre-selecting the right patients. They need reliable internet connection, appropriate support in the home and they can't be too sick, he said.

Robinson-Desjarlais's health has yo-yoed since testing positive around April 20, days after giving birth, when her lungs "basically shut down."

"Almost kicked the bucket," she said.

Her husband and three kids all got COVID-19, too, but the last of them surpassed the infectious period earlier this month.

Robinson-Desjarlais was discharged from hospital last on May 5. Shehas been reliant on the various oxygen tanks she received from the virtual outpatient program ever since.

This past weekend, her virtual care nurse told her to get to hospital again after learning her oxygen levels had sunk.

She remained in hospital on Monday but still considers the program a success.

"They assessed me properly and provided the care they needed to," she said via text message from hospital. "The doctor made a good call in my opinion. I definitely need to be here right now."