Paula Abramcyzk sighs at the unknown her day will bring. Odds are, in the heart of the Omicron wave, someone will die in the intensive care unit at Humber River Hospital in Toronto.

The ICU social worker is exhausted. ItB次元官网网址檚 9:37 a.m.on a Tuesday in January.

The 48-bed ICU on the sixth floor is quiet at the moment. Most of the patients are in induced comas; many are intubated. More than half have COVID-19.

AbramcyzkB次元官网网址檚 job is to support families once a loved one gets into the ICU. She guides them through the complex medical journey, including death.

B次元官网网址淚f youB次元官网网址檙e here, youB次元官网网址檙e dying. Very few people survive from COVID once theyB次元官网网址檙e here,B次元官网网址� she says quietly.

B次元官网网址淢y role has not changed (in the pandemic), just the intensity is ten-fold. The opinions from family members are much stronger B次元官网网址� people can accept dying of cancer, people canB次元官网网址檛 accept dying of COVID.B次元官网网址�

Numerous families have asked her to help them convince doctors to alter death certificates so that it doesnB次元官网网址檛 say COVID-19, she says.

B次元官网网址淭hey want autopsies because they donB次元官网网址檛 believe in COVID,B次元官网网址� Abramcyzk says, shaking her head.

Nearly two years into the pandemic, staff at the northwest Toronto hospital say they regained some semblance of normalcy in the fall when the Delta wave of COVID-19 abated.

Then the highly-infectious Omicron variant hit hard in December, leading to a dramatic spike in hospitalizations across the province and severe staffing crunches.

The Canadian Press spent 12 hours inside the hospital, talking to dozens of nurses, doctors and respiratory therapists about how the latest wave is impacting them.

With no end to the pandemic in sight, staff say they are barely hanging on B次元官网网址� they are exhausted, demoralized and frustrated.

Even brief reprieves are hard to come by. In a moment of calm on the sixth floor, Abramczyk dreams of taking a break, a short vacation.

Then she snaps out of her reverie when she gets word that a patient has died. (The Canadian Press later learned the patient did not have COVID-19.)

B次元官网网址淚 canB次元官网网址檛 take much vacation,B次元官网网址� Abramcyzk says. B次元官网网址淚tB次元官网网址檚 too busy.B次元官网网址�

She leaves to make some calls.

At 10:58 a.m., Tenzin Dhasel, sits down at her computer, which faces a window into her ICU patientB次元官网网址檚 room. Like other registered nurses, shemonitors the data spit out from the gaggle of wires and tubes connected to each patient.

Dhasel has just finished helping eight other colleagues flip a patient from back to front, a process called proning, which helps oxygenate the blood B次元官网网址� and is physically tiring for staff.

B次元官网网址淚tB次元官网网址檚 too much emotionally,B次元官网网址� Dhasel says, of the pandemic. B次元官网网址淚tB次元官网网址檚 not easy seeing people dying every day.B次元官网网址�

She is thinking about looking for a less stressful job because her mental health is in the dumps.

B次元官网网址淚tB次元官网网址檚 never been worse, I would say, but I cannot touch more on that because I get emotional,B次元官网网址� she says as a few tears fall into her mask.

ItB次元官网网址檚 12:07 p.m. and Suzi Laj has been in meetings much of the morning, part of her usual routine to understand who is in the ICU. She is the manager of the east wing of the unit.

There are 43 patients in the ICU on this day and five empty beds, Laj says. There are eight more ICU beds B次元官网网址� all full B次元官网网址� on the eighth floor.

Laj says 28 patients have COVID-19. Fifteen are unvaccinated or only have one dose of a COVID-19 vaccine, while 13 have two doses. None have been boosted.

B次元官网网址淲e are seeing vaccinated patients that are coming to the ICU, but many of them are immunocompromised or have other comorbidities,B次元官网网址� she says.

The major problem is staffing, she says. COVID-19, either directly or through an exposure, has taken nurses and doctors out of the rotation.

On top of that, several nurses have left the ICU during the pandemic, she says, for less stressful jobs. And a handful of nurses have retired.

B次元官网网址淚tB次元官网网址檚 emotionally exhausting to be there to support the patients, the families, but also the staff,B次元官网网址� Laj says.

There is a high percentage of staff who are spiritual, she says, so every day they gather for a small, non-denominational blessing.

B次元官网网址淲e do whatB次元官网网址檚 called a temperature check and see how everyone is doing,B次元官网网址� Laj explains.

Up on the eighth floor, Julie Bourque slinks into a chair in the empty visitors area. It is 3:35 p.m.

She is the charge nurse of the east wing of the respiratory unit, where many COVID-19 patients who are in slightly better condition than those in the ICU receive treatment.

But those patients can crash and die quickly.

Bourque says she stopped counting COVID-19 deaths when they hit 60 in the first six months of the pandemic.

B次元官网网址淚t really just destroys your morale,B次元官网网址� Bourque says.

She commutes everyday from Barrie, Ont., which is about an hourB次元官网网址檚 drive.

B次元官网网址淚 spend a lot of rides home crying with stress,B次元官网网址� she says.

The job is so demanding that finding time to drink water in the break room is difficult. She says they arenB次元官网网址檛 allowed water or cups near working stations during the pandemic.

B次元官网网址淎 lot of us have had problems with having chronic bladder infections because we donB次元官网网址檛 have time to drink, to pee, to hydrate ourselves,B次元官网网址� Bourque says.

Many are also living with the trauma of the pandemic, she says.

B次元官网网址淵ou canB次元官网网址檛 prepare yourself for watching people suffocate to death,B次元官网网址� Bourque says.

B次元官网网址淲eB次元官网网址檝e seen very young people gasping for air until their last breath and weB次元官网网址檙e the only ones there because family canB次元官网网址檛 be.B次元官网网址�

In addition to Omicron-related staffing issues, sometimes outside factors wreak havoc.

The recent storm that dumped 55 centimetres of snow on the city left BourqueB次元官网网址檚 floor with little help. It took her six hours to get to work that day.

Nurses had to extend their 12-hour shift, which ends at 7:30 a.m., until noon because few could make it into the hospital, she says.

For several hours, she says, there were two nurses taking care of 32 patients. Once she and a few others got in, there was about one nurse for eight patients.

B次元官网网址淲e were just hoping that we donB次元官网网址檛 miss something, that someone doesnB次元官网网址檛 die because we couldnB次元官网网址檛 get to them fast enough,B次元官网网址� Bourque says.

Thankfully, she says, no one died during that time.

But on any given day during the fifth wave, she says, the crew on the eighth floor is so busy that the priority is B次元官网网址渓ife and limbB次元官网网址� over comfort.

B次元官网网址淲e didnB次元官网网址檛 come into this profession to leave people soiled, to let people struggle and feel uncomfortable, but some days we have no choice,B次元官网网址� Bourque says.

TheyB次元官网网址檒l often save someoneB次元官网网址檚 life, she says, then get yelled at by another patient for being inhumane.

Bourque needs a break.

She managed to get six consecutive days off recently: two vacation days tacked on to a weekend and two Christmas statutory holidays.

But then she caught COVID-19.

She wasnB次元官网网址檛 too sick, but she had to take care of several other sick family members.

It wasnB次元官网网址檛 much of a break.

B次元官网网址淚B次元官网网址檓 running the halls here and IB次元官网网址檓 short of breath and getting chest pains and feeling dizzy and alone,B次元官网网址� she says.

B次元官网网址淚tB次元官网网址檚 not sustainable.B次元官网网址�

In the break room on the ICU, Joy Turner sprawls into a chair at 4:46 p.m., all four limbs splayed out like a starfish.

The nurse woke with a start at 2 a.m., stressed about her 7:30 a.m. shift.

B次元官网网址淚tB次元官网网址檚 coming back in,B次元官网网址� she says, her voice cracking. B次元官网网址淵ou have to mentally prepare for the challenges youB次元官网网址檒l face.B次元官网网址�

Turner read the bible this morning. It helps. She hopes to one day hug her family again B次元官网网址� she has limited herself to phone calls and driveway visits the entire pandemic, afraid of giving them COVID-19.

B次元官网网址淟ook at my eyes,B次元官网网址� she says. B次元官网网址淭heyB次元官网网址檙e red and theyB次元官网网址檙e watering, but IB次元官网网址檓 not crying, IB次元官网网址檓 just exhausted.B次元官网网址�

About 20 minutes later, a patient with COVID-19 dies.

A nurse walks out of the room, her head bowed, as she slowly pushes a bed. A sheet covers the patient, who is headed to the morgue.

Liam Casey, The Canadian Press

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