Northern, rural Ontario sees ‘dire situation’
Sudbury, Algoma and St. Thomas have recorded highest COVID infection rates in the province
As Ontario prepares for another pandemic winter, some hospitals and health-care systems in rural and northern regions are already struggling to cope following recent local surges in COVID-19 cases.
This week — and for the first time in the pandemic — the Sault Area Hospital opened a COVID ward for patients sick with the virus after cases skyrocketed in the Algoma region.
In Sudbury, Health Sciences North this week announced it is partnering with local long-termcare homes and retirement homes to open 40 new patient beds by the end of November. Earlier this month, the hospital was caring for 27 COVID patients — a peak during the pandemic.
And in southwestern Ontario, the St. Thomas and Elgin General Hospital on Nov. 12 warned residents it faced “a dire situation,” noting COVID cases were climbing at an unprecedented rate in the community with the number of critical care patients in the hospital at a pandemic high. The hospital confirmed to the Star on Thursday that four patients from its intensive care unit have been transferred to London Health Sciences Centre.
“What we’re seeing now is that areas that haven’t historically been hit hard by COVID are now finding themselves under some very heavy pressure,” said Anthony Dale, president and CEO of the Ontario Hospital Association. “The virus is continuing to take advantage of the vulnerabilities in the province.”
In previous pandemic waves, dense urban areas saw the largest influx of COVID patients crowding into hospitals. In the spring, overwhelmed hospitals in Greater Toronto transferred critically ill patients hundreds of kilometres to areas with lower infection rates, including hospitals in London, Sudbury and even Sault Ste. Marie.
Now, parts of northern Ontario and areas in the province’s southwest are seeing concerning spikes in COVID cases, straining local hospitals.
Though the province has high vaccination coverage overall — as of Nov. 18, about 86 per cent of the eligible population is fully vaccinated — some communities lag behind, creating opportunities for COVID outbreaks. Experts say lower vaccination rates, combined with a population with little prior COVID exposure, leading to fewer people immune from the virus, is likely behind recent surges in rural and remote communities.
Algoma Public Health and Public Health Sudbury and Districts are this week recording the highest COVID infection rates in the province. As of Nov. 17, Algoma had an infection rate of about 147 per 100,000, while Sudbury’s rate was about 213 per 100,000, according to Public Health Ontario. For comparison, Peel Public Health and Toronto Public Health posted infection rates of 33 per 100,000 and about 30 per 100,000, respectively.
Though hospitals in large centres, such as those in Sudbury, Timmins and Thunder Bay, can care for a significant number of critically ill patients, smaller, more remote hospitals have limited ICU capacity, said Dale.
Northern Ontario’s geography and long distances between hospitals make patient transfers between institutions difficult, especially in the northwest and northeast regions, Dale said, noting winter weather adds another layer of complexity to transporting patients. Provincial and hospital leaders are closely watching COVID trends in northern Ontario and will assist should any area risk being overwhelmed, he said.
“The North in particular is quite vulnerable. We’re not there yet, but if there is a need to transport large numbers of patients to other centres, that would be the first significant challenge (to the province’s hospital system) since the spring.”
In a statement to the Star, Health Sciences North said the Sudbury hospital, which has Ontario’s highest patient occupancy rates, has increased bed capacity throughout the pandemic to meet demand. In October, it reduced “surgical activities to 85 per cent of pre-pandemic levels” and will open 40 new patient beds this month by partnering with long-term-care and retirement homes, CEO Dominic Giroux said in a statement.
The population testing positive for COVID in Sudbury has changed throughout the pandemic, with industrial workers, miners and international travellers making up the most cases in the first wave, for example, Giroux said. Now, as in the third wave, the hospital is seeing patients acquiring COVID in the community, “including patients admitted to HSN for other symptoms who get swabbed … and have a positive result for COVID-19.”
Though the Algoma region has a high percentage of its eligible population fully vaccinated — 87 per cent have had two doses, while 91 per cent have one dose — COVID is finding the unvaccinated in the community, said Dr. Lucas Castellani, director of infection prevention and control at Sault Area Hospital.
COVID cases are so high in Sault Ste. Marie that the hospital is struggling to keep pace with testing at its assessment centres and now must ship specimens to other labs, increasing turnaround times for results, making it even harder to slow the virus’s spread, Castellani said.
“We didn’t have to do that before,” he said. “Our hospital lab is running until four in the morning. People are working all day and then staying on their own, out of their own goodwill, to finish … But it’s still not enough when we have this big surge.”