THE NEW NORMAL
Plan could triple intensive care beds, and hundreds of ventilators are on hand
The ByWard Market was like much of Ottawa on Friday, nearly a ghost town as residents stayed home. Many of the ways we interact will change and necessary measures to fight the COVID-19 pandemic could be required for months, not just weeks.
The Ottawa Hospital has a plan to triple the number of beds in its intensive care unit if and when the COVID-19 pandemic demands that level of emergency response, a senior doctor says.
Dr. Dave Neilipovitz, head of the department of critical care, said The Ottawa Hospital has been planning for a pandemic since the SARS outbreak in 2003.
“We’re getting prepared to increase the number of beds we have available,” Neilipovitz said in an interview. “We’re working diligently to make that happen.”
The hospital’s General campus has a 28-bed ICU that specializes in respiratory, thoracic and cancer care, while the Civic campus has another 28-bed ICU that specializes in neurological, vascular and trauma care. The Civic campus serves as the region’s main trauma centre.
Neilipovitz said the hospital has a plan to increase both of those intensive care units to more than triple their current size. “We’re trying to get to 100 ICU beds at both campuses of The Ottawa Hospital,” he said.
Intensive care units treat patients with life-threatening injuries or illnesses. This city’s ICUs will treat the most severe cases of COVID-19, and their limited capacity is at the heart of strict measures now in place to curtail the spread of the coronavirus and flatten its growth curve.
Neilipovitz said the hospital has a tiered pandemic response plan with four stages that “will ramp up and increase depending on what the future holds.”
The upper tiers of that response plan would see the hospital use other sites and other parts of existing facilities to increase its overall patient capacity and its ability to deliver intensive care.
“The way we’ll respond is not the way we run on a daily basis,” Dr. Neilipovitz explained. “We’ll be adapting. We won’t have a lot of elbow room, let’s put it that way.”
Neilipovitz also serves as the critical care lead for the Champlain LHIN, the regional health network. He said hospital officials from across Eastern Ontario have been working together to prepare for COVID -19; key officials visited The Ottawa Hospital on Friday to view its preparations.
“We never know what we’re going to get,” Neilipovitz said of the pandemic. “But are we better prepared than Italy and China? I certainly think so. We’ve had the luxury of learning from their mistakes.”
He said the hospital has access to 300 ventilators along with 100 disposable ventilators designed for use in a pandemic. The hospital is trying to acquire another 200 disposable units but it needs the permission of Health Canada to make that happen. Other hospitals in the region have about 100 more ventilators at their disposal.
Some of the ventilators that the hospital will put into service are not standard ICU devices, “but they’ll certainly serve the purpose in this situation,” Neilipovitz added.
The Ottawa Hospital and others in the region, in keeping with recommendations from the Ontario Ministry of Health, are now starting to postpone or curtail non-urgent surgeries, medical procedures and outpatient programs.
Reducing activity in operating rooms and other parts of the hospital will allow officials to open beds for COVID-19 cases and remake some areas — such as the postanesthesia care unit that normally receives patients after surgery — into makeshift ICUs.
“We’re getting prepared and we’ll face it,” Neilipovitz vowed.
Earlier this week, a group of Toronto-based researchers released a report that suggests Ontario could face a critical shortage of ventilators and ICU beds within two months — even with a controlled spread of COVID-19 and an injection of new hospital resources. That projection assumed hospitals would be able to double the size of their ICUs and acquire 600 new ventilators across the province.
Critically ill patients with COVID-19 often need mechanical help to breathe because the disease attacks the lower respiratory system. The availability of ventilators — they push air into a patient’s lungs — has become a critical issue in countries hard hit by COVID-19.
A study of Chinese COVID-19 patients, published in the New England Journal of Medicine, revealed that five per cent of those with the coronavirus land in intensive care, and about half of those require mechanical ventilation. aduffy@postmedia.com