‘We’re still very much dealing with COVID’

For the vulnerable and those working in health care, the pandemic isn’t over

For many, COVID-19 is anything but over.

From the medically and economically vulnerable to those on the front lines of the health care system’s continuing and exhausting battle, the Star spoke with people this week who are very much still living through the realities of this health crisis.

These are their stories.

SIOBHAN MCKITTRICK

Physiotherapist

Siobhan McKittrick works with COVID patients who’ve only barely survived a severe infection.

The registered physiotherapist helps those who’ve spent months in hospital recovering from the virus, many on ventilators in a critical care unit, through their rehabilitation at the Bickle Centre, one of five Toronto Rehab sites.

“When patients first arrive, they need help with everything they do,” she says, describing the long hospital stays as having “deconditioned” their bodies, with some unable to initially swallow or walk on their own.

McKittrick says seeing the daily struggle of those trying to recover from a severe COVID infection has given her a unique perspective on the pandemic. The once-daily — and now weekly — Ontario data on COVID infections, hospitalizations and deaths has a different meaning for her, especially the figures that track those who’ve recovered.

“Some of those COVID-recovered were our patients, and working with them, seeing what they went through, they didn’t feel recovered,” says McKittrick, also an interprofessional educator at the Bickle Centre, a part of University Health Network.

She understands “that strong push to return to how things were before,” and why some already feel as if the COVID crisis is over. But she also knows, after seeing the number and the range of patients that are severely affected, she can’t yet accept living right now as though the pandemic has ended.

BELLA HAEFELE, 13

Andrea Haefele’s teenage daughter, Bella, has been out of full-time school for almost three years.

Her parents pulled her after first hearing about the novel coronavirus in the winter of 2020, knowing that Bella would be in danger of getting dangerously ill if infected.

Bella has many varying disabilities and complex medical needs. She is visually impaired, is on the autism spectrum, and has been diagnosed with a rare genetic neurological disorder called Pitt-Hopkins syndrome.

“She is13 years old, but cognitively at the level of a one-year-old,” says Haefele, while describing her daughter, who communicates with the aid of an iPad and uses a wheelchair to go long distances.

Keeping Bella home from school was a huge shift for the family, and for Bella herself “socially, emotionally and physically,” Haefele says. (Bella is back this September, but only part time.) COVID also caused the community and hospital services she relies on to scale back or shut down.

“If I were to compare her to my son, someone who is non-disabled and has definitely had disruption in their day-to-day life, I would say for someone like Bella, who has various disabilities, the pandemic disruptions are amplified times 100.”

Haefele makes it clear that she’s always had to advocate for her daughter to be included. But COVID has made it even harder, from not prioritizing services and spaces for those in the disabled community to dropping mask mandates in public spaces, shifting the infection risk to the most vulnerable.

“Different people need different things in order to be part of a community. What works for one does not work for all.

“And I think that starts from who is making the decision, why they’re making the decision and how they’re making the decision. Because in the end, it’s always the people who are marginalized, who are impacted the most.”

VIRGINIA PARRAGA

Long-term-care resident

Throughout the pandemic, avoiding COVID has been top of mind for Virginia Parraga. At 82, with underlying health issues, including a heart condition, Parraga is concerned that if she contracts the virus, the effects could be devastating.

As a resident of Kensington Gardens, a long-term-care home in Toronto, the risks to Parraga and her 350-odd fellow residents are very real. Long-term-care homes have been among the hardest hit settings, particularly during the virus’s first deadly wave that killed some 1,500 residents. And even though the number of fatalities among residents has gone down with the arrival of the vaccine and antiviral treatments, those with existing health conditions can see their quality of life dramatically reduced by a COVID infection.

“It’s not over yet,” says Parraga, who has lived in long-term care for seven years and is worried for herself and her fellow residents that a return to a world with no public health precautions could spell disaster.

Parraga has avoided a COVID infection. She’s worn a mask, kept six feet away from others and been vaccinated. She spent much of the worst of the pandemic isolating in her room, a terribly difficult strategy to be sure, but she’s stayed safe. It’s a situation she said she doesn’t want to return to should another wave arrive in Ontario this fall.

“It’s very uncomfortable because I’m a fun-loving person and that doesn’t make me feel as if I’m contributing to anything,” says Parraga, currently president of Kensington Gardens’ residents council.

ARAVIND JOSEPH

Community worker

Aravind Joseph would like the general public to know that anything that makes the pandemic last longer makes his already vulnerable and disadvantaged clients even more isolated.

As lead for personal support services at St. James Town Community Corner, which serves thousands of people in one of the most ethnically diverse neighbourhoods in Toronto, Joseph has seen first hand the physical, psychological and economic tolls the pandemic has taken on some of the city’s poorest people.

“We have a lot of people with mental-health problems, we have a lot of seniors, we have people facing a lot of isolation,” he explains.

Just one of the Community Corner’s services that had to be suspended because of the pandemic was the seniors program every Wednesday and Thursday that provided an opportunity for older residents to get together, play games and have lunch. The program has resumed but only for five or six seniors at a time, whereas pre-pandemic it could accommodate as many as 40.

Similarly, meals could no longer be served communally. As a result, the Community Corner was forced to deliver some 13,000 meals over a period of about seven months, mostly to vulnerable seniors.

“It just aggravated their isolation and that basically aggravates their mental-health situation as well,” Joseph laments.

ENZO RISI

Organ transplant patient

For more than two years, Enzo Risi managed to dodge COVID-19.

He diligently wore masks, avoided crowded spaces and often only met friends and family outdoors.

When his doctors advised it, Risi would get another vaccine. The 71year-old has had five. He also rushed to get the COVID prevention drug Evusheld after it was approved last spring to ensure his body had antibodies to fight the virus.

Risi was right to be careful. As an organ transplant recipient, he’s among those at highest risk of getting severely sick from COVID. The anti-rejection drugs he must take after receiving a new kidney five years ago — a donation from his wife — suppress his immune system, making him especially vulnerable to infections.

Despite his caution, the Richmond Hill resident tested positive in June, shortly after the province’s remaining mask mandates expired June 11.

“I don’t know where, I don’t know how; it didn’t come from my family. And I always wear my mask everywhere.”

Risi quickly received an antiviral to help him fight the infection. His team at St. Michael’s Hospital’s Transplant Program has rallied around him and other transplant patients to make sure they are as protected as possible. Before vaccines, about one in five of St. Mike’s kidney transplant patients who caught COVID died.

“It’s really hard to tell a transplant patient they have to live with the virus, because they just can’t,” Dr. Darren Yuen, a transplant nephrologist at the hospital, told the Star in May.

While he didn’t need hospital care, Risi says COVID hit him hard and the after-effects have lingered.

“It was terrible, it’s still terrible. I can’t have a deep breath because it’s painful.”

The recent talk of the pandemic being over has him worried. For himself because he doesn’t want to risk another infection, and for others who are vulnerable, including transplant patients, the immunocompromised and the elderly.

“I don’t think it’s time for us to stop being cautious,” he says.

CARLY REBELO

Manager of infection prevention and control at UHN

Walk into any store, mall or sporting complex and you may see a few people wearing masks. But other than that, there’s very little evidence of a pandemic in our day-today lives. Unless you work in a hospital. The setting where Carly Rebelo works is like a different world.

While much of society seems to have moved on from COVID, it remains a threat for hospital staff and patients.

“We’re still very much dealing with COVID within the hospital system and managing outbreaks and trying to balance COVID within the hospital,” says Rebelo, adding that the last two years’ legacy of surgical backlogs, surging volumes in the emergency department and human resource shortages has only added to the challenge facing her team.

While the hospital is dealing with fewer COVID outbreaks than at the peak, she notes they still occur and require the same diligent and immediate response.

Complicating things is the anticipated surge of both COVID and influenza cases this fall.

She notes that things outside the hospital’s doors may have changed, but precautions will remain inside. That means continued universal masking mandates, testing of patients and more stringent returnto-work policies — measures Rebelo expects to see at other hospitals, too.

As for any notion that the pandemic is officially “over,” that’s simply not the case, says Rebelo.

“It doesn’t mean that COVID is gone, that it’s no longer a threat.”