Hospitals seek aid to curb strain
More government support sought as ICUs face worst-case scenario
As Ontario’s intensive care units swell under the pressure of COVID-19 cases requiring critical care, doctors are calling for better support to prevent a worst-case scenario in the province’s hospitals.
In a video posted to Twitter Saturday morning, Dr. Michael Warner, the medical director of critical care at Michael Garron Hospital, said a triage situation where doctors must decide who receives life-saving care could be imminent. He called for coordinated government efforts to pre-empt the strain on Ontario’s hospitals.
“If we find ourselves in a situation where they’re doing elective surgery in Halifax and we’re triaging patients in Toronto, that just can’t happen.”
Warner said that the federal government could get involved to co-ordinate transferring health-care resources from provinces less affected by the virus to those under strain. “We need ICU nurses here in the GTA to care for the patients that are coming and the patients we have already,” he said, calling on premiers to work together.
“Let’s break down the barriers now, let’s make the connections today and let’s start anticipating moving health-care workers to the more affected regions right away.”
Dr. Kashif Pirzada, an emergency physician in Toronto, said that though the idea to bring others in from different parts of the country is good, “it doesn’t seem feasible” as all provinces are seeing a surge. “They’re going to be busy with their own surges, they’re just maybe a couple of weeks behind us,” he said.
Pirzada said the current ICU system is becoming overwhelmed. Spaces in hospitals that would otherwise be used for other patients, such as those suffering heart attacks or surgery recovery units, are starting to take COVID-19 patients.
“We’re expanding the size of the ICU, but we don’t have the staff,” Pirzada said, adding that while nurses and physicians in other departments are being recruited to work in those areas, they don’t necessarily have the training they need to handle critical care. However, he noted staff are being brought up to speed.
Warner noted in the video that while Ontario should have about 2,300 ICU beds, the reality is that staffing means there are far fewer. “Eventually we will run out of places to move patients because we won’t have enough trained staff to care for them,” he said.
Usually, the ratio of ICU nurses to patients is one to one.
As many as 130 COVID-19 patients have been transferred from overwhelmed hospitals to other areas since April 1. On Friday, the Ontario government issued two emergency orders that could see health-care workers redeployed if needed and allow overwhelmed hospitals to transfer patients without gaining consent.
Closing schools in other GTA hot spots such as York or Durham Regions and better protecting workers would help mitigate spread, Pirzada said, suggesting essential workplaces equip staff with N95 masks and implement rapid testing to track possible outbreaks.
Adding additional lockdown restrictions if cases don’t improve, such as targeting and shuttering workplaces that aren’t properly protecting workers could help curb a worsening scenario in ICUs.
There are currently 585 COVID-19 patients in Ontario’s ICUs, according to data released by the Ontario government Saturday, an increase of 33 people. Of those, 384 people are on a ventilator, an increase of 25 since Friday. In Toronto, 285 patients are hospitalized and 96 are currently in intensive care. Of those, 68 require a ventilator.
Pirzada warned the weeks ahead will be “tough,” especially for the health-care system. “It’s going to be a strain that we haven’t seen before.” Despite the virus’s growing threat, he remains hopeful that a mix of better weather, school closures in certain regions and vaccinations will put the province in a good position.
“There’s a silver lining for everybody, and that’s not far away as long as we can get the fix right now.”
As many as 130 COVID-19 patients have been transferred from overwhelmed hospitals to other areas since April 1