Every Canadian is now navigating the uniquely disorienting business of surviving a global pandemic: social distancing. Finding child care while still earning an income. Trying to stay healthy; trying to stay alive.

But health-care workers are struggling with these same challenges while also deploying to the front lines of this crisis, where they will soon face a crush of COVID-19 patients and the greatest test of their professional lives.

To better understand their realities, the Star spoke to three health-care workers — two doctors and a respiratory therapist — working in Toronto’s intensive-care units. (The Star also requested interviews with three ICU nurses but they were unable to get their employers’ permission by deadline.)

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They agreed to candidly speak about their fears, personal struggles, and plans for keeping themselves and their families safe. These interviews have been edited and condensed for clarity and length.

Ryan Smith poses at Sunnybrook hospital, where he is a respiratory therapist. He will be responsible for intubating and managing COVID-19 patients who require ventilation. (Andrew Francis Wallace)

Ryan Smith is a married father of three kids aged eight and under, including a daughter with special needs. As a respiratory therapist (RT) at Sunnybrook Health Sciences Centre, he will be responsible for intubating and managing COVID-19 patients who require ventilation.

Our specific profession has the unique joy of being in the most dangerous situations for any infectious patient. We’re 12 to 18 inches from the (patient’s) head for every intubation … Right where you don’t want to be.

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So that’s one of the scariest things for us. And not only are we in the scary situations but people might be timid to stand too close to us all the time. Even in our department, where we have our ventilators and our office, people will be very hesitant to hang out with us because we are at all of the crappy situations. We’re in the room where all the bad things happen.

Often people will say they don’t remember some or most of their ICU stay and that’s a good thing because it’s the worst time of their life probably … (But with intubation) the number one thing people remember and hate is being suctioned.

We actually take a suction catheter that’s already attached to the circuit and we push it down, and it goes right down to the bottom of the tube and you suck up secretions. If you can imagine choking on a little bit of water when you’re drinking your coffee or water — well, magnify that physiologically by, I don’t know, 40- or 50-fold … the sensation of needing to cough from that is tremendous.

Number two is pain. It’s our job to take away your pain, but we also need to be able to keep you awake to see if your brain’s working, right? So you’re sedated but we’re obliged to interrupt your sedation at least once a day to make sure your brain’s still working, that you can move your arms and legs, and that you’re still in there.

And almost every single patient gets delirium because they’ve lost their circadian rhythms, their days and their nights. At least 50 per cent of patients also unfortunately have restraints put on their arms so they don’t accidentally pull something out.

I think RTs have among the best — if not the best — compliance for personal protective equipment. We take it extraordinarily seriously, how to put this stuff on and take it off, because we are just in the crap of it so often. I have a complete set of clothing that I will leave in the trunk of my car — shoes, clothes, specific jackets, new underwear and socks (for) the end of my shift. And then I get home and those shoes, socks and jacket go into a bag in my garage and my car gets wiped down. So when I come into the house it’s all new, fresh stuff.

I also shower completely after every shift with the soap that we shower patients with, the really strong anti-bacterial soap.

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I’ve had a long talk with my wife and immediate family. If I were to test positive for COVID — which is fairly possible, compared to the average Joe on the street — I’ve made some plans for where I would go.

My daughter really needs to stay in our house; I’ve made a special bed for her because she’s special-needs and has her special things. So I can’t stay at home if I get COVID. Two friends have offered to give me their RV trailer so I would park an RV in our driveway, or my parents’ or in-laws’ driveway, for two weeks …

Everyone in my department is the same. We basically all have a fallout plan for if we were to get sick.

My daughter has a profoundly rare genetic syndrome, Kleefstra syndrome. She is seriously developmentally delayed; she’s five but she has a cognitive awareness of about a one-year-old. Her care isn’t too extensive but she’s lifetime in diapers and we had to rearrange our house — basically, all very baby-proofed. We have to carry her around.

If I had to pick the one thing I most worry about, it would be my daughter getting sick and having to go to Sick Kids. In the last few days, most hospitals have gone to zero visitors except for one parent who can only be swapped out once per 24 hours. You try and tell that to the parent of a kid who’s at Sick Kids — that’s devastating.

Dr. Michael Detsky with wife Lindsay, holding daughter, Blair, and sons and Lucas and Tyler. Detsky is an intensivist at Mount Sinai Hospital. (SUPPLIED PHOTO)

As an intensivist at Mount Sinai Hospital, Dr. Michael Detsky will be treating the sickest COVID-19 patients that pass through his critical-care unit. Meanwhile, he and his wife are figuring out how to run a household of three kids: two sons, aged seven and four, and a daughter who is almost two.

The moment I realized everything had changed was the night Tom Hanks tweeted he has the coronavirus, the NBA shut down and Trump gave that address to the union about coronavirus. Those things happened within a 30-minute period or something. I was at work (the next day) and realized, “OK, this is really escalating.”

Then speaking to colleagues in the U.S., who were describing how many patients they had in their ICUs already, I realized wow, we’re not that far behind. This is going to happen.

I haven’t been back in the hospital (in several days) … normally we’d be meeting together in a group, we’d be getting together on Tuesday to talk about the cases. But our mindset is we’re planning for a marathon here and we kind of have to pace ourselves and protect ourselves from each other so that we’re not in contact.

Usually there’s two of us on at the time, two staff physicians, and if one of us gets exposed it will probably be two of us getting exposed at the same time. So that’s two of the six (ICU doctors) going down. So, we don’t have a ton of wiggle room here.

All of a sudden we’re in this totally different world. A huge element was when the schools announced they were shutting down for two weeks … My kids go to Jewish school, which was shutting down for three weeks but then also two weeks after that for Passover, so we were like, oh my God, this is so long! But now I’m sitting here thinking: it’s going to be way longer than that.

Now it’s like: What’s the summer going to be like? Is there going to be a start to the new school year? What is actually going to happen here? It’s such an unknown.

This whole week has pretty much been locked down. I’ve taken the kids for walks into the park and we’ve seen people, but sort of staying two metres away from each other. My parents are at their cottage so we ended up driving to go to their house, just to give a different scene for the kids so it felt like they were actually leaving the house.

For the foreseeable future, we’re not going to have playdates for them because we don’t want to contribute to the spread of the virus through families. But you can see that they truly do crave interacting with their own friends; you can see they miss them. It’s hard and I don’t really have a solution at this point.

I’m not so worried about the kids getting sick. You look at the data for kids, it’s very mild. Thank God — it’s a huge source of relief that based on what we know today, if I brought this home we don’t think the kids will get critically ill. I’m more concerned that they could serve as vectors for getting other people sick.

I’m worried for my parents for sure. My (68-year-old) dad still works as a physician. He’s actually going on service in April to look after patients in the hospital, too, so he’s going to be exposed to this a bit. I don’t know. I told him, “I don’t really know if you should do this.” But he was the physician-in-chief during SARS so he’s definitely been through something similar to this. He’s concerned obviously but not panicked.

(The lowest points so far) are when I see reports coming out of Italy, reading how horrific it sounds in these situations in other parts of the world. And having text and phone discussions with friends in the U.S, describing how bad it is there.

For me, it’s not that I’m dealing with that myself right now. It’s the anticipation of dealing with this in the coming days to weeks to potentially months. Somebody used this term “pre-traumatic stress.” You know? It’s like, you’re anticipating it. And I’m sitting at home feeling sort of helpless; I’m not there doing the work yet, I’m in the queue waiting to get involved. That is, to me, the hardest thing right now.

Dr. Barbara Haas, a trauma surgeon and critical-care doctor at Sunnybrook Health Sciences Centre, with her 20-month-old son. (SUPPLIED PHOTO)

Dr. Barbara Haas is a trauma surgeon and ICU doctor at Sunnybrook Health Sciences Centre who is also a single mom to a 20-month-old boy. She just finished a week at the hospital and isn’t back on the schedule until the end of April but knows she will likely be called back to work much sooner.

A couple of weeks ago, watching the news, it was clear that this was coming for us in Canada. I just finished a week in the intensive-care unit and from day one, it really hit me — the way that we’re doing business is going to be very different for quite a while.

I am a mom, a single mom. And my son is just over one and a half. I get a lot of help from family and friends and a nanny … but right now, to keep everyone as safe as possible, I’ve asked my nanny to stay home and not expose herself to public transportation and other things in public.

I’m still in the middle of trying to figure (child care) out. Both of my parents are very fit and active people but they’re older, and of course my biggest worry is about getting them sick. My parents are in their late 60s and live in Quebec, an eight-hour drive away.

I may actually send my son away to be with his grandma and sort of plan on not seeing him for a few weeks while I’m working and afterwards. Not because I don’t want him to get sick necessarily but because I don’t want his nanny or his grandparents to get ill. So if he’s with them, and I’m away from them, that’s probably the safest thing to do.

The nice thing about a toddler is that he doesn’t quite understand what’s going on. He’s blissfully playing with his (Lego) Duplo and reading “Goodnight Moon,” so we’ve just been going for walks and playing around the house.

For me, it will be hard. I think for him it will be OK. I’ve talked to some of my colleagues, who went through SARS, and they did similar things. They said, you know, the kids don’t even remember so that makes me happy.

He already understands what it means when I say Mummy is going to work. So he understands Mummy’s going to work and that she comes back — and that she always comes back. I’ll tell him I’m going to work, I’ll give him a kiss. I might have a little cry in the car on the way to work but he will be OK. And I think when he’s bigger, he’ll either not remember this or he’ll understand what Mummy did, what she had to do.

(This next stretch) will be incredibly stressful. I think every ICU doctor and indeed every doctor in the city right now is worried about our city (turning into) what we’re seeing on the news in Italy, where there’s clearly not enough medical equipment, not enough ventilators, and doctors are having to make some really difficult choices about who lives and who dies. That’s what’s scaring me the most.

I think what most of the health-care providers are hoping for is that people will make the sacrifices that they can in their own life. Stay home, stay away from other people, and really slow this virus down so that we can take really good care of the people who do get sick and not have to make those tough decisions. And we can get through this, and to the other side.