Dr. Lerly Luo reflects on what COVID-19 has meant for her medical residency and patients.

By Sherry Kaniuga

A 60-year-old man is close to dying in a palliative care hospital bed. His wife, sister, and mother are by his side – using up three out of the four available visitor allowances for dying patients during the COVID-19 pandemic. However, the patient has two sons and an uncle who wished to be there too.

The family approaches you in distress, asking for an exception to the visitor limit. At the same time, you are aware of COVID-19 outbreaks in nearby healthcare settings, and the visitor restrictions have already been increased to four visitors for end-of-life patients. What do you do?

This situation was one of many difficult scenarios medical resident Dr. Lerly Luo has faced since COVID-19 landed in Manitoba this spring.

“It was really challenging and heartbreaking,” recalls Dr. Luo, a University of British Columbia medicine grad who began her combined Public Health and Family Medicine residency in Winnipeg the summer before the pandemic started. ​“Those restrictions are needed to protect all other patients and staff – but at the same time, it didn’t feel humane or culturally sensitive. Imagine asking families to choose who can be present at a loved one’s death? I could see both sides so clearly, but there is no right answer.”

Dr. Luo has seen firsthand the emotional and physical toll the pandemic and constant change has taken on physicians, nurses, and other healthcare workers in the multiple hospitals she’s worked in these last few months – and she’s felt the pressure herself.

She is used to change. Her family immigrated to New Zealand from China when she was five. They moved multiple times including to Australia, then made Canada home when she was 18. She studied a Bachelor of Science with honours in physiology before pursuing medicine at UBC.

“I was drawn to medicine because I feel it’s one of the most meaningful ways to make a difference in someone’s life,” Dr. Luo says. ​“You meet patients in some very vulnerable moments – it’s an honour to be there, to walk alongside someone and be able to offer guidance in those moments.”

She’s since won multiple awards including the Canadian Medical Association Award for Young Leaders, founded a global health conference, and spent a summer in Kenya researching how to expand the scope of primary care in Nairobi’s slums using digital health. She has also been involved with public health advocacy across Canada and at the World Health Organization.

Adding ​“pandemic physician” to her resume wasn’t something Dr. Luo expected. During Manitoba’s first COVID-19 wave, she was redeployed to work with the Medical Director of Public Health at the Winnipeg Regional Health Authority. She has also taken on a quality improvement project, studying the benefits and shortfalls of virtual visits, in hopes to further guide and develop virtual care during and after the pandemic.

“I’m impressed – and grateful – for how quickly our system has adapted to incorporate virtual care into healthcare delivery, allowing many patients to receive care safely during the pandemic. As clinicians, there are certainly limits when you can’t examine or build rapport with a patient in person, which supports the need for expansion to include video options. Not all care can be delivered virtually, but having access to virtual care is essential – both right now and increasingly in the future of healthcare,” she says.

Completing a medical residency has been tough on Dr. Luo and her peers, who face not only higher risks of COVID-19 exposure and what that means for their families, but the potential of redeployments, added work burden, compromised training opportunities, licensing exam challenges, and a loss of social cohesion. COVID-19 has added inefficiencies in care, increased work burden in an already busy healthcare system, and taken a toll on physicians’ health and well-being.

“We’re the ones on the front lines, and it’s exhausting. But there are some moments that ground me – realizing among the chaos that this is why we became doctors, laughing with friends, or going for a run and looking up at the sky. I am privileged to be able to do what I love,” she says.

“It’s the people who get us through residency,” she adds. ​“Our interconnectedness makes all the difference. Talking to others about the losses, the difficulties, and the challenging cases, you realize that we’re part of a well supported community and that residency truly is a shared experience,” she explains.

“Above all, my peers inspire me – their drive, compassion, intelligence, ideas, and humour. Even before but perhaps especially during a pandemic, we’re a madly resilient group.”