Ontario Health says healthcare less likely to affect current COVID wave

TORONTO – Modeling shows Ontario’s intensive care units could treat around 200 COVID-19 patients in January, but the head of the health system watchdog says service cuts across The whole province is unlikely to happen during this pandemic.

Dr Chris Simpson, medical vice president for Ontario Health, told The Canadian Press that the trigger point where hospitals will be ordered to ease non-urgent procedures is currently close to 250 or 300 intensive care patients. .

This is higher than the 150-patient threshold the government cited a year ago as the point at which canceling surgery and other measures may need to be taken to keep the system running. medican.

Such measures have been enacted during the pandemic in Ontario, most recently in April as the hospital system responded to a particularly deadly third wave.

The intensive care work has now hovered around 130 patients for weeks, with 137 people in intensive care as of Wednesday. But despite some strain on local hospitals, “it really hasn’t had any negative effects that we can detect from a systemic level,” Simpson said.

“The number is now probably 250 or 300 (patients) before we start to see some systemic effects, and that is a strategic direction to start to ease routine procedures,” Simpson said. across the province.

That’s due to a number of factors, including greater investment in capacity and lessons learned in managing spikes through patient transfers and other means, Simpson said. Vaccinations also help prevent more people from becoming seriously ill with breakthrough infections.

Currently, healthcare workforces are the biggest “rate-limiting step” to critical care capacity that can overwhelm hospitals, as facilities compete with staffing, Simpson said. low, and those who stay exhausted and miserable.

Recent projections from Ontario’s COVID-19 Scientific Advisory Panel highlight uncertainty about the trajectory of the increased infection curve in the province, which began late last month when capacity limits fell in many zeroes. public spaces and cold weather, forcing people to mingle indoors.

Hospitalizations and critical care admissions are seen as lagging indicators following the rise in COVID-19 cases. The specialist team’s models put the intensive care capacity at around 200 patients in January, with 250 patients also within the capacity range.

Simpson said variables like booster doses for more people and vaccinations for younger children will need to be monitored as trends unfold, noting again that vaccinations can keep people from getting very sick at this time.

“You plan for the worst, but I think there’s some reason to believe this won’t have as much of an impact as previous waves, but an impact on the ICU,” he said.

Simpson said it is more likely that surgery cancellations will be localized and rescheduled within weeks, as opposed to provincewide cancellations without a set schedule date, which represents a “different kind of pressure” than with earlier in the pandemic.

Some hospitals are already facing stress from a rise in COVID-19 cases and have signaled that canceling procedures may be necessary. Ontario Hospital Association executive director Anthony Dale pointed to facilities in Sudbury, Sault Ste. Marie and parts of southwestern Ontario are experiencing “extraordinary, heavy pressure due to the large number of COVID-19 patients”.

“Mitigation actions, including patient transfers in some cases, are being taken by these organisations,” he said in an emailed statement.

Dale said acute care hospitals in Ontario are reaching an average 90% occupancy rate and can provide care for hospitalized COVID-19 patients in “relatively stable conditions” in most areas. all regions.

He said hospitals will monitor the situation throughout the winter, saying that “hospital capacity, especially ICU capacity, is not something we can take for granted during a pandemic, because the number of cases can change at lightning speed.” Dale asks everyone to get vaccinated and follow public health guidelines.

The systemic strain has emerged in several Canadian jurisdictions, which have struggled with a spike in infections following the availability of a vaccine. The fourth wave of COVID-19 in Alberta resulted in the cancellation of 15,000 surgeries and a call for the military to help this fall.

Saskatchewan is still in the process of restarting hundreds of healthcare services that were halted in its deadly fourth wave, including organ donation and home care.

Simpson said such situations show how COVID-19 cannot impact health services even during this pandemic period.

“The COVID numbers, if they go north to the point where we have a lot of COVID patients in the hospital again, it will have an impact. We’ve seen that it did last time and it’s going to do it again,” he said. “We have to say what we say today with a lot of caution.”

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