It will be a ‘long time’ before hospitals can return to normal
They will need to keep some space open for potential future surges
Hamilton’s hospitals are starting to look at rescheduling some postponed surgeries and other cancelled care but they won’t be back to providing the same volume of services as before COVID-19 any time soon.
“I think it’s going to take a long time for us to get back to normal,” said Rob MacIsaac, CEO of Hamilton Health Sciences (HHS).
“As long as this virus is in the community there will be the continued chance we’ll see spikes,” he said. “We will, for a considerable period of time, have to ensure that we have some capacity to deal with sudden surges in activity because of the virus.”
Hamilton’s normally overcrowded hospitals have drastically reduced services to open up hundreds of beds for COVID-19 patients.
At HHS, surgery is down 80 per cent for pediatrics and 60 per cent for adults, with some specialties hit harder than others.
Diagnostic imaging is half as much as normal for outpatients while only 17 per cent of clinic activity remains on-site.
It’s a similar story at St. Joseph’s Healthcare.
These temporary cuts increase wait lists and significantly affect patients’ lives as they sit in limbo potentially in pain, disabled or stressed about what a delay means to their prognosis. As a result, hospitals are starting to plan for how they would gradually ramp-up services.
“We’ve certainly turned our mind to it,” said MacIsaac. “We’ll be looking for some provincial direction before we act on it. We’re a big place and we need to be very deliberate and plan before we do something like that.”
The province released a framework Monday that provides a road map to reopening the economy and slowly relaxing physical distancing.
At the same time, it’s creating a plan to bring back elective surgery.
“Once we get through this peak of COVID-19, we’ll be able to get things back on track with the people who need those surgeries,” Health Minister Christine Elliott said Monday. “I’d say cancer surgeries have to be top of the list.”
For the most part, cancer surgeries haven’t been postponed in Hamilton so it’s uncertain what that means here.
What is clear is that hospitals need to keep some space open for potential future surges.
“We can now start to look at how do we bring back the rest of the health-care system,” Matthew Anderson, CEO of Ontario Health, said April 20. But “we need to maintain some of this capacity as a buffer.”
Both Ontario’s framework and the Canada-wide guidelines being created by the federal and provincial governments include health system capacity as one of the main conditions to any relaxing of the current rules.
It means Ontario’s hospitals can’t bring back all the services they did before and end up in their usual state of having more patients than funded beds. This overcrowding is known as hallway medicine because patients are sometimes put in unconventional areas like hallways, sun rooms, family rooms and closets.
For the foreseeable future, a number of hospital beds need to remain available at all times, including space in intensive care units with ventilators. There also needs to be sufficient personal protective equipment.
“We need that capacity so we can start to look at how do you bring different parts of the economy back online and we have some safety there to ensure if something does go a bit awry we have some capacity to be able to absorb it,” said Anderson.