More hospital beds no fix for COVID
What’s really happening with hospital beds in Ontario? The provincial government keeps announcing additional beds, including another 500 this week. In 2020, the government funded 3,100 new hospital beds at a cost of $2.5 billion. And yet, Ontarians have been repeatedly told the hospital system is on the verge of collapse.
Something doesn’t compute here. How can Ontario add so many hospital beds, many of them explicitly for COVID patients, and not gain any significant hospital capacity? It’s a critical point because one of the main arguments used to justify a province-wide lockdown is the fear that an increasing COVID caseload would overload the province’s hospitals.
despite the apparent bed expansion, Ontarians have been told for months that all the hospitals in the province, combined, can only accommodate 150 COVID patients in intensive care without hampering other hospital activities. At 300 patients, surgeries start being cancelled and system-collapse warnings begin. These are remarkably small numbers in a province of 14.7 million people.
Back in April, Premier doug Ford announced the first 2,500 new beds and said Ontario was prepared for a COVID surge. Nine months later, the government seems anything but prepared and instead has resorted to the blunt instrument of a lockdown, with all its attendant economic and psychological damage.
As of Thursday, Ontario had 388 COVID patients in intensive care. Chief Medical Officer of Health david Williams says t he province has to get the ICU number down to 150 before the lockdown can end. No one can predict when that might be.
doris Grinspun, CEO of the registered Nurses’ Association of Ontario, says the government’s bed expansion is “smoke and mirrors,” designed to make it look like it’s doing something when it’s not.
There is some truth to that. A health ministry spokesperson said “the majority” of the 3,100 beds promised last year “are reported to be in operation.” An exact number was not available. However, the government did say it had hired 481 nurses during the pandemic. That’s across the entire health sector, not just in hospitals.
There are significant staffing challenges that come with expanding health-care capacity, ones that might be insuperable in the short term. Every part of the health sector is short of qualified people. Hospitals and longterm care homes all need nurses. Hospitals are hiring them away from other hospitals and care homes. Shortages are so bad that some long-term care homes can’t administer the rapid COVID tests because they lack qualified medical staff.
Further complicating things is the fact that expanding intensive-care capacity requires doctors and nurses with specialized training. A bed announcement won’t make them suddenly appear. Even rookie nurses are in short supply. The pandemic has delayed clinical placements for new graduates, reducing the supply of newcomers.
Far from having the ability to add more staff, hospitals are struggling to maintain the status quo. Many hospitals are “reporting (job) vacancies at historically high levels,” according to Anthony dale, president of the Ontario Hospital Association. While it takes all the resources hospitals have to do their job in normal times, during the pandemic their role has expanded dramatically, dale points out. Hospitals
are being relied on to run COVID testing centres, help long-term care homes and administer vaccinations.
While hospitals say they just can’t get enough people, Grinspun says the government has not been effective at linking available nurses to open positions. She estimates that there are at least 500 unemployed nurses available to work in Ontario now.
The real story behind Ontario’s purported bed expansion is complex, somewhat murky and not particularly encouraging. It might best be summarized as “We’re trying to do a bit more and hoping for the best.”
That is not exactly the message Ford has been giving the public. Curiously, he alternates between hope and despair. The premier’s recent statement that the health-care system was “on the brink of collapse” wasn’t reassuring, given that he’s the one ultimately responsible for it. At the same time, he would have people believe that thousands of hospital beds have been added for pandemic patients.
While less than entirely frank, Ford’s approach is perhaps understandable. People desperately want to believe that government can control the pandemic and help will be available if they contract the virus. A cure in the form of a rapidly expanded health system is not realistic. Instead, Ontarians are being offered a placebo, the illusion that such a system exists. Maybe that’s better than nothing, but let’s call it what it is.