The Chronicle Herald (Provincial)
ICU capacity increased amid third wave
Nova Scotia has “maxed out” its normal intensive care bed capacity at the Halifax Infirmary and activated an “escalation plan” to increase the number of ICU beds available and transfer patients to other hospitals in response to a surge of COVID-19 patients requiring critical care.
As of Thursday afternoon, there were 93 COVID-19 patients in the province's hospitals. This includes 29 people in ICUS in the central zone, two people in ICU in the northern zone, one person in ICU in the eastern zone and one person in ICU in the western zone.
On any given day, the province has 98 beds designated for intensive care patients, according to Dr. Tony O'leary, medical director of critical care for Nova Scotia Health.
Speaking at a virtual press conference Thursday, O'leary said the province's “escalation plan” allows it to “escalate that (number) as we need across the province in terms of this pandemic” to about double that capacity “provided we have enough human resources, beds and ventilators.”
PROVINCE ADDS ICU BEDS
On a normal working day, O'leary said the Halifax Infirmary has 12 intensive care beds available. The province has increased that number to 15 and expanded into the Halifax Infirmary's coronary care unit with another eight beds.
“We have maxed out what we would consider as normal ICU capacity and we are opening new beds to function at critical care capacity within the Halifax Infirmary,” O'leary said.
“And we're also having to activate the escalation plan for the province, so that means we will be transferring patients out and that process is beginning for some of our patients now, so we have free capacity for the patients that need it within the central zone.”
PATIENTS TRANSFERRED OUT OF CENTAL ZONE
So far, less than five ICU patients have been transferred from the central zone to ICUS in other zones.
Patients who are “most stable” and can have their “needs met in another centre” are being prioritized for transfers and are being transported by both ground ambulance crews and EHS Lifeflight, O'leary noted.
“An appropriate patient is someone who can get the care they need at a different site when the Halifax Infirmary is over capacity. So if it's a NONCOVID patient, they could be transferred, but at the moment, it is COVID patients that we're having to transfer,” he added.
PEAK NUMBER OF PATIENTS BY END OF NEXT WEEK
Patients who require mechanical ventilation are staying in the ICU for an average of 10 or 11 days, followed by “rehabilitation” elsewhere in a hospital for about 10 days and in some cases longer than that, according to O'leary.
The age of COVID-19 patients in the ICU ranges from 20s to mid to late 60s, with the majority of patients being in the 40-plus age group.
“With wave three, we have seen people younger than would be expected in wave one or two and we know from looking at the other jurisdictions across the country that they've definitely experienced that younger age group requiring escalation,” he said.
O'leary said the province keeps “taking the data, reviewing where the peaks will be,” but expects that the province will see increased numbers of people requiring critical care in the coming weeks, with a peak number of patients in ICUS by the middle to end of next week.
“So certainly for the next three to four weeks, we're going to see an increased patient population coming to hospitals and coming to critical care, but we should hit the peak of those admissions according to the modelling, sometimes toward the middle or end of next week,” he added.
As a result, additional service reductions, including postponement of non-urgent surgeries both in the central and other zones, may be required so staff with the appropriate expertise are available to provide the required inpatient intensive care.
Since April 23, there have been roughly 1,600 surgeries postponed provincewide and about 176 of those have been rescheduled and completed, according to Carla Adams, a Nova Scotia Health spokesperson. While the majority of these would be related to third wave service reductions, other reasons include patients changing their minds or declining surgery.
EIGHT PATIENTS IN NON-COVID UNIT TEST POSITIVE
Nova Scotia reported 110 new cases of COVID-19 and 115 recoveries on Thursday, bringing the total number of active cases to 1,572.
Eight patients in a NONCOVID unit at the Halifax Infirmary site of the QEII Health Sciences Centre have been identified as positive for COVID-19. They have been transferred to a COVID-19 unit, according to a news release.
“Our infection prevention and control now is looking into that and trying to do contact tracing to see how that might have occurred. Those patients have been isolated," O'leary said about the patients in the NON-COVID unit who contracted the virus.