HOSPITALS ON THE BRINK
Health-care system braces for surge in COVID cases
Ontario will close playgrounds, set up check points on bridges and at boundaries to Quebec and Manitoba and give new powers to police in an effort to control the growing COVID -19 crisis in the province.
“My friends, we are losing the battle between the variant and the vaccine,” Premier Doug Ford said during a late afternoon news conference in which he announced those and other new restrictions aimed at controlling exponential growth of COVID-19 in the province that is pushing the health system to the brink.
The province will also extend the current stay at home order from four to six weeks, put further restrictions on gatherings and capacity inside essential businesses and increase inspections and enforcement at businesses that remain open. Other outdoor facilities including tennis and basketball courts and golf courses will also close under the new orders. People can go out for exercise but cannot gather with people from outside their household, under the new orders.
The new restrictions come on the heels of grim new modelling that warns of a coming catastrophe in the province's hospitals, even with tougher restrictions.
Ontario's ICU beds could be full by the end of this month no matter what actions are taken to reduce transmissions of COVID -19 in the province, according to the modelling released by Ontario's science advisory table Friday.
It comes as hospitals are facing unprecedented pressure because of rapidly rising numbers of COVID-19 patients. In the past two weeks, hospitalizations for COVID-19 have grown by 67 per cent and ICU admissions by 51 per cent in Ontario. Patients from hard-hit Toronto area hospitals have been transferred across the province, including to Ottawa, to ease pressure on ICUs there.
Health Minister Christine Elliott said hospitals are being “pushed to the brink.”
It would take a six-week lockdown, tougher public health measures and at least 100,000 vaccines administered each day, or more, to bend the exponential curve of new COVID-19 cases in Ontario, according to the data from the science table. Without those actions, cases could hit 20,000 a day.
Ford said the province was following that advice by introducing new measures to restrict mobility and prevent people from gathering
But a catastrophe in the province's hospitals will likely happen anyway, acknowledged Adalsteinn Brown, co-chair of Ontario's COVID-19 science advisory table as the number of ICU patients reaches 1,000 or 1,500 in coming weeks. When asked by a reporter whether there was any way to avoid that scenario, Brown responded: “In the very short run, the answer is no.”
Brown argued that the province needs to do more, urgently, to prevent the already dire situation from getting worse and high case numbers continuing well into the summer putting even more pressure on the health system. That includes more focus on vaccinating in high-risk areas, something the province says it will do, and paid sick leave for essential workers, something the province has previously said it would not do.
According to models, those actions could see cases begin to drop by late May and bring them down significantly by summer.
But even that won't bring quick relief to overwhelmed hospitals, which have been preparing doctors to begin using a critical-care triage tool if there are more patients in need of critical care than there are resources as cases surge.
As of Friday, there were more than 700 people in intensive-care beds in Ontario hospitals and 4,812 new cases — both record highs during the pandemic.
“Our hospitals can no longer function normally. They are bursting at the seams. We are setting up field hospitals. Our children's hospitals are admitting adults. This has never happened in Ontario before. It's never happened in Canada before,” said Brown
The province was seeking relief from other provinces in the form of health workers. On Friday, Elliott said that could come from the Maritime provinces where cases have been lower than in the rest of the country.
Both The Ottawa Hospital and Queensway Carleton Hospital began taking unprecedented steps this week to be able to care for more COVID-19 patients.
On Thursday, The Ottawa Hospital said it was implementing a surge plan to be able to care for as many as 220 COVID-19 patients, which is more than double the number hospitalized across the city.
President and CEO Cameron Love said the hospital will create a temporary ICU in a space normally used as recovery for surgical patients. Staff from that unit will care for intensive-care patients.
The hospital is also asking staff to volunteer to take on different jobs to help with high numbers, and expected surges of COVID-19 patients, staffing is the biggest limitation to being able to handle growing caseloads, he said.
The Queensway Carleton Hospital on Friday tweeted that its “ICU is completely full with COVID-19 patients and we continue to surge into a temporary second ICU.” As of Friday, the hospital was treating 30 COVID-19 patients, 12 of them in ICU. The hospital's emergency department was also seeing more seriously ill patients coming in requiring isolation.
Queensway Carleton, like The Ottawa Hospital, entered the next stage in its pandemic surge plan, reducing the number of operating rooms to two — one for cancer surgeries and one for emergency surgeries — and postponing endoscopy and walk-in clinics so that staff can work in intensive care, emergency and elsewhere.
Both hospitals, along with Montfort, have received critically ill COVID-19 patients from the GTA this week. A total of nine are expected in Ottawa this week with more likely to come, said Love.
Elliott said the province has added 3,400 hospital beds during the pandemic and is working on bringing student nurses in their final years, retired nurses and international health workers in to assist in hospitals.
Ford said the province needs more vaccines to bring the curve down more quickly. The science table models included scenarios in which 100,000 people are vaccinated a day in the province as well as 300,000 people. With 300,000 daily vaccines and strong public health measures for six weeks, case numbers would decrease in time for a relatively normal summer in the province — something less likely with the current rate of vaccinations.