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In the ‘hot zone’: Behind the scenes of the COVID-19 battle at B.C.’s biggest hospital


“It’s feels like you’re under water — like scuba-diving.”

It’s a comparison Dr. Donald Griesdale never thought he’d make 13 years into his career as one of the intensive care physicians leading the COVID-19 charge at Vancouver General Hospital.

“It’s surreal,” he says, describing the now-complex ordeal of donning personal protective equipment. “You’re wearing your visor, your face-mask, your respirator, your gowns and your gloves; you literally have that barrier between you and the outside world.”

That armor is to protect them from the patients they know are coming. 

VGH, the biggest hospital in B.C., is one of 17 facilities province-wide that has morphed into a primary treatment site for coronavirus patients.  (Vancouver Coastal Health)

VGH, the biggest hospital in B.C., is one of 17 around the province that has morphed into a primary treatment site specializing in treating coronavirus patients.

As one of the front-line physicians handling those incoming patients, his team is notified of suspected COVID-19 cases even before they arrive, most with typical flu-like symptoms: cough, fever, shortness of breath.

When the nurses come out of the hot zone, they’re drenched in sweat and you can see their mask that’s outlined on their face.– Dr. Donald Griesdale, VGH intensive care physician

The first line of defence is the team in the ER department, which does an initial assessment. If the patient needs critical care, they’re transferred to a section of the ICU that has been hived off as a dedicated ward. 

Dr. Don Griesdale is pictured outside Vancouver General Hospital where he’s worked as an ICU physician since 2007. (Maggie MacPherson/CBC)

Hot zone vs. warm zone

The COVID-19 critical care unit is divided in two: the warm zone and the hot zone. 

The hot zone is where the infected patients themselves are examined and treated. The warm zone is a buffer area that acts as a staging zone for health-care workers.

Each team spends up to three hours making the rounds inside the hot zone before peeling off their personal protective equipment, washing their hands like lives depend on it, then rotating and swapping out. 

The COVID-19 unit is divided into the hot zone, where patients are treated, and the warm zone, which acts as a staging area for health-care workers. (Vancouver Coastal Health)

“When the nurses come out of the hot zone, they’re usually drenched in sweat and you can see their mask that’s outlined on their face,” said Griesdale.

“Then in the warm zone, if issues come up … we have a really good two-way system so we’re easily able to communicate with the staff inside the hot zone.”

The warm zone is also where all of the experts involved — from physicians, nurses, and respiratory therapists to dietitians and pharmacists — convene and communicate. As a team, they discuss all of the issues for each patient and come up with individual care plans for the day.

Watch doctors and nurses treat patients in the dedicated COVID-19 unit at VGH:

A dedicated treatment unit for patients with COVID-19 has become the front line for Vancouver General Hospital’s battle against the illness. 0:59

‘They’re scared when they come in’

Nurses are the main point of human contact for patients. And there’s an underlying uncertainty on both sides that’s hard to describe. Mostly, it’s fear of the unknown.

“It’s scary,” said Jess Donald, a registered nurse who’s worked in the emergency room at VGH since 2007. 

“They’re scared when they come in, they’re scared of getting a breathing tube put in, they’re scared of what’s going to happen. And we’re scared for them, to be honest.”

The biggest challenge, she said, is finding ways to have personal interaction. FaceTime has become a lifeline, a way to communicate with family forced to remain on the outside. Despite technology’s best attempts, the feeling of isolation never really goes away. 

“The best we can do is reassure them, make sure they know they’ve got a really great team behind them and that we’re here to care for them and help them get them home …That’s our priority.”

Jess Donald is a registered nurse at Vancouver General Hospital in the Intensive Care Unit, where she’s worked for 13 years. (Maggie MacPherson/CBC)

Griesdale echoed that, adding they often take for granted the intrinsic role the family plays in caring for the patient. 

Usually, they’re at the bedside, engaged in care, communicating. But in the new COVID world, that in-person interaction with loved ones has been replaced by a unique bond between near-strangers. 

He gave an example of a young woman he was treating who became quite ill with coronavirus. 

“It was really hard because every day I would phone her husband who was at home sick himself with the kids and have to say, ‘Well, your wife isn’t doing well,’ or ‘She’s getting worse,'” Griesdale recalled.

“I put myself in that position thinking what would it be like if that were my wife in there … I found it emotionally quite difficult.”

‘The most fulfilling time in my career, bar none’

But ask the doctors and nurses about the pressure and responsibility of serving as the front-line fighting chance against this virus? They say it’s not about them.

It’s about everyone: a caring community that’s become an unexpected inspiration, the support of a province, the most pleasant surprise of all. 

“[People] have been so great sending us food, making masks — it’s the kindness that really permeates through when we’re feeling isolated,” smiled Jess Donald. “There’s this whole ‘we’re in this together’ movement, and I really feel that.”

“We see it on the front-lines, absolutely, but I certainly understand the sacrifices the public is making as well,” said Griesdale. “It’s been really heartening and it’s certainly been the most fulfilling time in my career, bar none.”

The gratitude, on both sides, like clockwork: at precisely 7 p.m, the collective chorus of cheers rises from the city, a moment that still brings tears to their eyes, and smiles to their faces. Every single night.

Messages of gratitude hang in the critical care COVID-19 unit at VGH as a reminder of the community support health-care workers hear every night with the 7 p.m. cheers. (Vancouver Coastal Health)



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