| Effects of the COVID-19 pandemic on hemodialysis care and routine |
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Effect on hemodialysis care
I, well not really very greatly, I mean there’s very little difference. (P5, man) No, it didn’t, there was no disruption. (P7, woman)
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Change in their routine
Yes, before COVID, like I’m situated at…, and we are patients here that come from the North, because we don’t have access to these facilities that we get here in Montreal, we don’t have access to those … Like in my community, we don’t have a dialysis clinic, so I had to be sent here and there’s about eight or nine of us from my community, so we are all situated here. And before the COVID, they went to different dialysis clinics … So, they were all different, different areas where they went, but ever since the COVID happened, we have, we’ve all been placed at the same time, at the same hospital … And there is some of them that went to different clinics that say: When are we going back? They want to go back to their old routine, you know? ’Cause their routine has been changed and they miss where they, where they usually went before the COVID. (P10, man) They don’t want to send people to different clinics because, you know, of contamination or whatever, you know? They don’t want people. If somebody has it, they don’t know right away, so if somebody has it and gets sent to another clinic, they could be spreading it at that other clinic, you know? So, they wanted to keep us all in the same place, same time, you know? So, it will, it’s better if somebody does have the COVID, they know how to trace it, you know? Who we had contact with, it’s easier to track. (P10, man) They switched me to a completely different center because there was a special center for those on dialysis who had COVID. (P19, woman) I requested the change because I didn’t feel safe. (P21, man)
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Change in their routine regarding their mode of transportation
But since March or April, I’ve been getting there myself by car, and I make sure to be in the outdoor parking lot to avoid being in the elevators. (P6, man) I’ve stopped taking the metro because you have to wear a mask in order to get into the metro, you know like to get past the turnstiles, but once people are inside, a lot of people take their masks off once the ticket taker doesn’t see them anymore, people take their masks off, they sit in this train with the same air circulating inside with no masks, so I avoid the metro. (P9, woman)
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Switching from in-center dialysis to home hemodialysis
No, I have no desire to switch, even if a war broke out, the choice is easy, I would choose: if I can get to the hospital for treatment, perfect. (P2, man) No, no, no, I don’t think I had never imagined doing that. I think the biggest unfortunate aspect is that I don’t live in an apartment large enough to accommodate hemodialysis at the home, but I live so close to the dialysis clinic, I don’t know if it would be a big advantage or not. (P4, man) No, not at all, because for me, since my illness began, I have refused to bring my illness home. (P19, woman) Danger of infecting yourself at home. Well, I prefer going to the hospital even if we’re in the middle of a COVID-19 pandemic than doing this at home and risking getting an infection. (P22, man)
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Effect of COVID-19 infection risk and mitigation measures
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Concerns related to their own infection risk
I was, I wouldn’t say afraid, I wasn’t in fear, but I was, you know, uneasy that I may catch the coronavirus. (P4, man) If I see somebody, if the elevator door opens and there’s somebody standing there with no mask, I let them go by, by themselves, I don’t go in with them. So, if they’re not prepared to protect themselves, you know, I protect myself. (P9, woman) I knew a person that got the COVID while at the hospital … so that became you know, added a little bit more paranoia for my part. (P10, man). I’m always afraid, wherever I go, anywhere I go, I’m afraid of the virus. I try to be careful as much as I can and I know, and I don’t go anywhere unless I have to. (P13, woman)
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Risk management in the hemodialysis unit
Appropriate measures
Oh yes, they’re necessary, they’re absolutely necessary, I understand why it’s being done, but it’s an inconvenience for the patients, that’s all. I understand that it’s for our protection, but it’s an inconvenience. (P9, woman) Yes, I think they are appropriate, they were really taking care of us good. (P13, woman)
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Mixed feelings
I thought it made no sense that if a nurse takes you from the inner door because you have an emergency, yes you can go. But if you ask to go, you can’t go. Oh no, the access is closed, while they go in and out, I don’t understand. I’m already on dialysis, I’m finishing my dialysis, so I’ve followed all of the precautions, all of the stuff—hand washing, mask, and everything I’ve been asked, temperature and everything—why can’t I go to the ER? I have to walk around the hospital from the outside to go when I’ve finished four hours of dialysis. (P19, woman) I don’t understand why now with the COVID and we have to be screened outside the waiting room, instead of waiting in our chairs which is separated with the plexiglass and everything, and we’re definitely you know x amount apart. They fill up the waiting room screening everybody and then they let everybody go in. It would seem better to me if, you know, everybody could just go sit in their chairs. They’re not in the way, they are distanced, they don’t have to worry about anything, and the person doing the screening can still screen anyway. I don’t see what the difference is between being screened in the waiting room to come into your chair, you know? It just doesn’t make sense. (P21, man)
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Prohibition of visitorsBut, but it’s better because they come from outside, it might be them who are most at risk, because there’s a bunch of sick people, many, many people, even if there’s 2 meters, because then if you spread it to your family, that’s no better. (P7, woman)
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Fear of infecting their loved ones
That’s what, that’s what I’m worried about, but thank God at least, I told you, as I told you, I get to have my safety measures, so as long as you know you keep yourself, you know, protected, so yes, but it’s still scary, yes. (P8, woman) I stay away from them, we talk on the phone, but there’s, there’s no physical interactions at all. (P9, woman) Yes. It really scares me when I go to my community. (P11, man) No, I very rarely see my family, so I don’t have to worry. (P16, man)
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Effect of COVID-19 pandemic on relationships
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Interactions with health care workers
The doctors, we hardly ever see them. Unless there’s a new patient, and then they come, otherwise, not at all. (P1, man) COVID requires them to do other tasks that they would not have normally done. (P2, man) The doctors would not come in; we spoke through the window. (P7, woman) Even the doctors when they pass, at least they don’t approach you like that, they keep their distance. (P8, woman) It’s hard, you know, to see their faces and the interaction you know is like when you interact with your nurses you know there’s the facial expressions that you see. (P10, man) So, we no longer have contact, they do everything they can to avoid being closer to you, even if they still have to get closer because when they have to connect you, they can’t keep a distance of 2 meters and connect you, they would have to get closer to connect you, but still well protected. (P3, man) The staff is kind of freaked out. (P21, man)
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COVID-19 pandemic and isolation from loved ones
I would have really liked to reach out to people, I would have really liked to see my colleagues, I would have really liked to be happy with everyone, but instead, we’re wary, we keep our distance from each other, all that … It’s not … it’s not very pleasant, it’s often said! (P3, man) It’s obvious that we feel really isolated. (P7, woman)
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