Sunday, January 29, 2023

Rise in COVID-19 hospitalizations could lead to further shortages in care, doctors warn

As COVID-19 cases threaten hospitals in many parts of Canada, a doctor is warning that hospitalizations in some provinces are hitting record highs, which could further reduce general hospital care for the foreseeable future. .

Dr Tasleem Nimji, physician lead for the COVID-19 emergency response at Toronto’s Humber River Hospital, told CTV’s Your Morning on Tuesday that his hospital is already “very stretched”.

“The number of patients we are recruiting every day is very, very high. We have days where we are admitting an average of 20 patients a day and you can imagine at some point that is no longer possible,” Nimji said.

She explained that the “flow” of a hospital’s ability to function and provide effective and efficient support can become “very tight” if there is a sudden surge of patients who need care.

Nimji says Ontario’s hospitals are filling up at an alarming rate. Two weeks ago there were 480 people in hospital because of COVID-19, according to provincial figures. As of Monday, there are about 2,500 patients in hospitals.

Nimji said hospitals have “used every liver we have to try to build capacity” to no avail amid this surge in hospitalizations. What will help now, she says, is the “injection or boost” of health care workers such as military aid.

However, federal officials have said that may not be possible.

Faced with this record-setting increase in cases, Infrastructure and Communities Minister Dominic LeBlanc told reporters during a press briefing on Friday that the federal government expects increasing requests from provinces and territories in the coming weeks and will respond. They will do everything for it, but ultimately health care is the provincial jurisdiction.

“As a government we have to efficiently use the federal resources we can bring in to fill the gaps we are identifying with provinces and territories,” LeBlanc said. Canadian life.”

LeBlanc said the federal government would speak with all of Canada’s prime ministers this week to discuss next steps and coordinate the expected onslaught of requests for support.

“It should come as no surprise to anyone that this is not an unlimited number of federal health care resources that we can tolerate,” he said.

Because of this, Nimji said Canadians should expect further cuts in hospital services.

“Unfortunately, you’ve seen a decrease in surgical volume, and I know it affects patients in a very real way. But I expect that to actually increase because I don’t see how the system would cope otherwise,” she said. said.

“You’re going to see further reductions in kind and further I think general access to care decreases while we move all of our resources to manage this boom.”

Nimji acknowledged that this tension is being felt in the health care system, affecting not just people working in hospitals, but other first responders affecting paramedics.

In previous waves of the COVID-19 pandemic, Nimji noted that provinces would borrow health care workers from areas that were not as hard-pressed. However, she says it will be “more difficult this time” with Omicron’s influence being felt across the country.

He said that if several provinces request military aid, there will not be enough members to help every hospital. Nimji said this could lead to a reduction in care in hospitals.

“We are doing things like asking family members to support us as essential care workers when we are younger nurses,” she said.

The Canadian Medical Association (CMA) issued a statement on Tuesday urging federal, provincial and regional governments to work together to mitigate the impact of the current wave of COVID-19, amid concerns that Omicron infections may increase. Could leave the system unable to repair.

“We know Canadians are tired and frustrated. Physicians, nurses, respiratory therapists, pharmacists, laboratory technologists and other health care providers are just exhausted. And we need to stabilize our health systems to care for COVID patients. All hands-on decks are needed and all others require care,” CMA President Dr. Katherine Smart said in the statement.

Who is being hospitalized?

The increase in cases comes amid the spread of the new Omicron variant. While more permeable than the previous delta version and thought to be able to evade some vaccine protection, there has been evidence that it may cause less severe disease and reduce the chances of hospitalization.

However, Nimji says that Omicron still poses a huge threat to the unaffiliated.

“When you start looking at ICU volumes, and certainly when you look at people who have serious consequences, or complications, they are getting disproportionate to non-vaccinated,” she said.

But not all hospital admissions are directly related to COVID-19. Nimji explained that someone coming in for a scan or routine procedure can test positive for the virus and be asymptomatic. While someone in that condition is unlikely to be admitted for a long time, Nimji said it still puts pressure on the hospital.

“If someone is coming into the hospital and it is found that they have COVID, their hospital stay is usually longer than the fact that they have COVID,” she said.

In addition, Nimji said she is also seeing more Canadians recruited with only one or two doses of the COVID-19 vaccine. While his symptoms are less severe than those of unvaccinated people, Nimji said he may still need hospital care for a few days.

“The challenge here is that… people who have had just two vaccines, for example, don’t necessarily have a booster, they are still being admitted. And they may not have a longer admission. , but they are still being admitted. Hence the less serious consequences, but still… increasing the capacity of the hospital,” Nimji said.

Chief Public Health Officer Dr. Theresa Tam said on Friday that serious diseases due to the Omicron version are not growing at the same “explosive rate” as case numbers. However, she noted that hospitalization rates are rising because of “the sudden acceleration of the omicron and the sheer volume of cases.”

While the increase in cases has led to increased testing capacity, resulting in an underestimation of the number of cases, Tam said public health agencies across the country are working on laboratories to monitor overall disease activity and its impact on hospitals. using other indicators such as test-positivity rate.

“All we can do is help by narrowing down our contacts to get through this difficult time so fast,” Tam said. “It may sound like a double marathon we didn’t sign up for, but despite feeling exhausted, we should have a sense of accomplishment for the ground we’ve covered so far.”

With files from Rachel Aiello of


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