This Canadian doctor is treating COVID-19 patients in Bolivia, where hospitals are full
TORONTO -- ICU beds are filling up in several provinces, with doctors in B.C. warning that hospitals could be overwhelmed by May, Ontario is redeploying 1,000 nurses to staff additional ICU beds, and hospitalizations in Quebec are rising as well.
One Canadian doctor knows well what that could mean: Dr. Ivar Mendez has spent the last four months in Bolivia, where full hospitals have left some COVID-19 patients receiving care in their homes.
Taking a leave from his usual work as the provincial head of surgery at the University of Saskatchewan and Saskatchewan Health Authority, Mendez has returned to his home of Bolivia to lead an initiative to provide remote, virtual care.
“We've implemented a system by which people with a cell phone or a tablet can communicate with their decision, and the cell phone or tablet can also communicate via Bluetooth technology to pulse oximeters, that you put in the finger and you monitor oxygen saturation of the patient, thermometers and digital stethoscope,” Mendez told CTVNews.ca in a phone interview on Wednesday.
With hospitals overwhelmed, patients have nowhere left to go, so their families take care of them.
“You are at home, you're taking care of, for example your dad, but you're in contact with a physician directly,” he added.
One of the issues that Bolivia has faced throughout the pandemic is a shortage of liquid oxygen, but oxygen generators that pull oxygen from the air have helped with that issue and patients can have them in their homes.
“You can have physicians directing the care of the patients at home with these oxygen concentrators,” he said.
All the patient requires is a smartphone or tablet and Mendez and his colleagues provide what he calls peripherals: the pulse oximeters, thermometers and digital stethoscopes.
“This relatively simple technology has saved a lot of lives,” said Mendez.
With the pulse oximeter, physicians can remotely monitor a patient’s oxygen level and virtually adjust their oxygen concentrator. A digital stethoscope allows the doctor to listen to the chest and heart from kilometres away. And a digital thermometer will allow a physician to see if a patient’s temperature has changed.
“Three simple peripherals have made a huge difference,” he added.
Preliminary data shows that home care may have even better outcomes for some patients.
“You have your family members that are continuously taking care of you, and you're not exposed to other diseases,” he said.
This isn’t Mendez’s first foray into remote care. His research on the topic began in Canada.
“The reason I went to Bolivia is because of the work that I did in Saskatchewan and Halifax, where I was before, on remote care to distant, under-serviced populations,” he said.
Mendez and his team used robotics early on in the pandemic to provide care to pregnant women in remote First Nations communities in Saskatchewan. To prevent parents from having to travel all the way to the city for prenatal care, robotic ultrasounds were performed with the patient in a remote community and the person guiding the robotic arm and interpreting the ultrasound being in Saskatoon or Regina.
“We are able to provide complex diagnostic imaging totally remotely,” he said. “Expertise is in the city, the interpretation of the radiologist is in the city, but the patient doesn't have to move from the community.”
And he uses that same idea in Bolivia. Patients don’t have to travel to get medical care, their smartphones bring it to their homes.