Sunita and Kamshad
With a second wave here, physician assistants Sunita Chera (L) and Kamshad Touri have again volunteered to join the COVID-19 care team at Toronto General Hospital. (Photo: UHN)

Kamshad Touri and Sunita Chera know what it's like to have work transformed by COVID-19.

Physician assistants (PAs) on the General Internal Medicine (GIM) Cancer Care team, when the pandemic was declared they, along with nurse practitioner (NP), Kirsten Lewis, became part of the first GIM COVID-19 care team at Toronto General Hospital (TGH).

"Our patient population was mainly cancer patients who had unscheduled admissions due to complications of their malignancies," Kamshad says.  "As the pandemic hit, fewer patients came to the hospital for non-COVID reasons, and we became the COVID team.

"Our patient population changed."

And, Sunita adds, that added a new set of challenges.

"We had a lot of patients being admitted with COVID-19 who are particularly vulnerable, including patients from long-term care homes and homeless shelters, and otherwise healthy people who contracted the virus in the community," she says.

Nov. 27 is National Physician Assistant Day in Canada, a time to recognize this group of medically-trained clinicians who are committed to providing high-quality medical care, expanding the reach of a supervising physician.

PAs work in a wide range of areas across UHN

Working within a medical team, PAs perform assessments, histories and physical examinations, order and interpret laboratory and diagnostic tests, review and order medications, coordinate patient care and transitions between hospitals, and perform procedures and assist in the operating room and clinics.

At UHN, PAs work in a wide variety of areas, including: bone marrow transplant, general, malignant and medical hematology, cardiology, GIM COVID-19 care team, Emergency Department and urgent cancer care, the Sprott Department of Surgery, gynecologic oncology, GIM cancer care team, outpatient medical oncology, the Ajmera Transplant Centre, neurosurgery, orthopedic surgery, plastic surgery – breast reconstruction, psychiatry, radiation oncology, thoracic surgery and urology.

Dr. Robert Wu, supervising physician of the GIM COVID-19 care team at TGH, is appreciative of all who volunteered to join his group after the pandemic was declared.

"There was significant fear in the first wave and significant concern for personal safety," Dr. Wu says. "Alongside our nurses, NP and attending physicians, Kamshad and Sunita worked tirelessly to provide care to our patients with COVID on weekdays and weekends.

"And now again, they have volunteered to be on our COVID team in this second wave."

Kamshad learned first-hand how serious COVID-19 can be, contracting the virus and eventually being hospitalized for eight days.

'Great multidisciplinary team that effectively worked together'

"It was an exceedingly difficult time both for myself and my family," he says. "The support I received from the GIM group during and after my hospital stay was enormous, that helped me to go through this very difficult time. 

"I really have to thank Drs. Paul Bunce, Mohammad Shafiee, Jessica Liu, Moira Kapral, David Hwang, Rob Wu and Peter Cram for their care and support."

Kamshad admits "there's always a possibility" he could get the virus a second time but adds "when you sign up for work in a medical field, you accept the risks as well."

Kamshad says despite the challenges of caring for COVID-19 patients, there's also been "real satisfaction knowing I'm part of a team that's come together quickly and done great work." 

Sunita, who was recently honoured with the GIM Citizenship Award for her hardwork, dedication, knowledge and compassion with patients and their families, says one of the biggest challenges in initially caring for COVID-19 patients was the evolving recommendations on medical management of patients, safety protocols and self-isolation guidelines at home.

"We knew so little about the virus," Sunita says. "The scientific community is continuing to learn more about COVID-19, which helps to inform us in treating patients and protecting patients, families, and the larger community, especially when we discharge patients from hospital."

Sunita adds one of the highlights of this work is being part of "a great multidisciplinary team that effectively worked together to respond to changes in guidance and provide excellent care for COVID-19 patients." 

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