Expect patient transfers as COVID cases surge

Patients in Ontario hospitals that are struggling with unprecedented COVID-19 admissions are more likely to face transfers to other hospitals as the Omicron surge comes to a head.

A directive signed Friday by chief medical officer Dr. Kieran Moore clears the way for more widespread use of the practice, common in the pandemic’s third wave last spring when intensive care units rapidly filled, leading to 2,000 critically ill patients being transferred to other cities and away from their families.

“It’s sending a very strong message to the system that the functional integrity of the health-care system is in danger,” said Dr. Chris Simpson, a cardiologist at Kingston General Hospital and executive vice-president of Ontario Health, a provincial agency overseeing health care.

“Without a specific intervention, the health-care system might not be there for somebody who really needs it,” he added, citing situations such as stroke, heart attack and trauma patients needing immediate attention.

But patients have the right to refuse transfers, which was not the case under an emergency order from Premier Doug Ford’s government that took effect early last April and expired in late June.

“Patient consent is required for transfer,” confirmed Simpson, who noted doctors usually tried to get approval last year when it wasn’t required. “When explained in context to people, most are OK with it.”

In a memo sent to hospitals Friday afternoon and obtained by the Star, Moore said the directive is necessary to “maintain health care for as many patients as possible.”

“Increased hospitalizations are expected throughout January,” the chief medical officer warned in the directive, noting the problem is compounded by nurses, doctors and other staff sick with COVID-19 or isolating at home.

Moore’s move came with the province reporting record hospitalizations for the eighth day in a row. Another 184 COVID-19 patients have been admitted, pushing the total to 3,814 — well above last April’s record high of about 2,300 patients.

Unlike the tense situation when intensive care units were pushed to the breaking point last spring, this time patients on hospital wards — not just the sickest patients in ICU — could find themselves being transferred to less crowded hospitals with better ability to care for them.

“Whether the biggest challenge is the wards or ICU will become clear in the next seven to 10 days,” said Dr. Peter Jüni, scientific director of the science table of experts advising Moore and Ford. “We might have a problem at both.”

Simpson said ICU capacity seems “just fine for the moment,” but cautioned that can change quickly. There were 527 COVID-19 patients in intensive care Friday, an increase of 27 from the previous day, and 517 beds still available despite another 1,337 adults in ICU for other illnesses and injuries.

“The crunch is going to be at the ward level,” he predicted.

It’s difficult to forecast which hospitals are more likely to have to transfer patients elsewhere, Simpson added.

“It changes a lot day-to-day who is busiest. This time we’ve got Omicron on the rise in every public health unit. There’s no hospital that’s not experiencing difficulty.”

‘‘ “It’s sending a very strong message to the system that the functional integrity of the healthcare system is in danger. Without a specific intervention, the healthcare system might not be there for somebody who really needs it.

DR. CHRIS SIMPSON EXECUTIVE VICE-PRESIDENT OF ONTARIO

HEALTH