Surge pushes Cornwall hospital to the limit

Hospital is one bed away from full capacity as post-holiday cases surge into grey zone

Cornwall Community Hospital has had to cancel some in-patient surgeries this week as it manages a sudden post-Christmas surge of COVID -19 cases.

The COVID-19 situation across the Eastern Ontario Health Unit deteriorated quickly over the past month with Cornwall at the centre of the region's rapid growth in cases. The Cornwall hospital now has only one empty bed despite already expanding its patient capacity.

“We're looking at where we find more beds — and we do have contingency plans for that,” hospital president and CEO Jeanette Despatie said in an interview. “But that means impacting other nonCOVID services when we do that.”

Already, the hospital has expanded its capacity by more than 10 per cent to 188 beds. For several days this week, the hospital has had 187 patients, including 12 COVID -19 cases.

“We're usually sitting with five to seven patients in the emergency room, looking for beds,” Despatie said. Typically, patient discharges free up space, she said, but

COVID-19 patients tend to have extended hospital stays and that has slowed the hospital's normal turnover rate.

“What we do know is that over the last few weeks, that ratio of admissions to discharges has been very high,” Despatie said, adding that she's never before seen this kind of pressure for acute care beds in Cornwall.

Expanding hospital capacity still further would mean moving beds into clinical space, she said, and imposing more limits on non-emergency surgeries. Contingency plans exist to expand the hospital in stages to 230 beds.

Cornwall's critical care unit (CCU) has already added three beds, and some CCU patients have been moved to hospitals in Ottawa.

Despatie said she's hoping the current stay-at-home order will stem the region's flash flood of COVID-19 cases. “We're hoping that once we get beyond the 14 days following the Christmas and New Year's break, it will subside,” she said. “But we know the spread will continue for awhile.”

The Cornwall hospital serves as the region's main COVID-19 treatment centre. The Eastern Ontario Health Unit, which encompasses Cornwall, Winchester, Hawkesbury, Alexandria and Clarence-Rockland, has a seven-day rolling average of 151.9 cases per 100,000 residents, according to provincial statistics. Ottawa's seven-day rolling average is 91.8, according to figures released by the province Friday.

Cornwall has 227 active cases and nearby Akwesasne has another 55. There are 13 institutional outbreaks, including one at the Tsiionkwanonhso:te long-term care home on Cornwall Island that has killed five people.

The Eastern Ontario Health Unit reported 66 cases during the past two days after recording 141 cases last weekend. The health unit now has 629 active cases. At the beginning of September, it had only two.

“Hopefully, we're peaking right now,” said Dr. Paul Roumeliotis, the unit's medical officer of health. “Our numbers are not even red: we're in the grey zone. We're much higher than Ottawa right now, and it's very concerning.”

The grey zone is at the extreme end of the province's colour-coded COVID -19 response framework; it means local hospitals and intensive care units are at risk of being overwhelmed by sick patients.

Eastern Ontario's COVID-19 numbers remained low and stable for most of the pandemic, but then shot up alarmingly, Roumeliotis said, starting in October. Incautious holiday gatherings, he said, further propelled the spread of the virus as people failed to respect physical distancing or mask-wearing guidelines.

The region recorded 339 COVID cases in October, 324 in November, and 685 in December. Already in January, the health unit has reported 374 new cases.

“What our data has shown is that two-thirds of our cases are what we call close contacts,” Roumeliotis said.

Contact tracing has revealed that whole families are being infected by individuals who contract COVID-19 after being careless at work or social gatherings. “I call it the multiplier effect: that's what we're seeing,” Roumeliotis said.

“We've had families with four, five or six people all testing positive.”

Mohawk Council of Akwesasne Grand Chief Abram Benedict said they only had a few cases of COVID-19 heading into December, but experienced a steep rise over the past month-and-a-half. COVID-19 vaccinations began Friday at the Tsiionkwanonhso:te long-term care home, he said.

“We're running thin on staff at this point,” Benedict said.

Cornwall Mayor Bernadette Clement said this week's COVID -19 numbers are worrying. “Hearing the hospital say they're reaching capacity really drove it home for all of us,” she said.

Clement said the sudden rise in COVID-19 numbers underscores the need for a better understanding of community transmission — and how such a rapid spread can occur. “It is much more urgent because the question of many people is: How did this happen? Why was it so sudden? The community needs data, and an understanding of what the risky activities are in our community.”

The mayor hosted an online meeting Thursday with other Eastern Ontario politicians to discuss with the region's four hospital CEOs whether there's anything municipalities can do to support the local health-care system.

“Mayors want to know, `What is it that we can do?' ” she said. “The next few weeks, the next month is critical.”

COVID-19 vaccinations began this week in the region with residents, staff and caregivers in longterm care homes at the front of the line. Local paramedics and nurses from the public health unit are administering the vaccines.

What we do know is that over the last few weeks, that ratio of admissions to discharges has been very high.