TORONTO – Models suggest Ontario’s intensive care units could be treating about 200 COVID-19 patients in January, but the head of the agency that oversees the health system says a reduction in those is less likely to occur. services throughout the province during this wave of the pandemic.
Ontario Health Vice President Medical Dr. Chris Simpson told The Canadian Press that the trigger point at which hospitals would be ordered to cut back on non-urgent procedures is now closer to 250 to 300 intensive care patients.
That’s higher than the threshold of 150 patients that the government cited a year ago as the point at which surgery cancellations and other measures may need to be taken to keep the healthcare system running.
Such measures were already enacted during the Ontario pandemic, most recently in April when the hospital system responded to a particularly deadly third wave.
Ontario hospitals address ‘staggering’ surgical backlog caused by COVID-19
Intensive care occupancy has hovered at around 130 patients for weeks, with 137 people in intensive care as of Wednesday. But despite some stress on local hospitals, “it really hasn’t had any negative impacts that we can detect from the system level,” Simpson said.
“The number is now probably more than 250 or 300 (patients) before we started to see some systemic impacts, and by that, I mean a strategic direction to start reducing procedures that are not urgent at the provincial level,” he said Simpson.
That’s due to several factors, including more investments in capacity and lessons learned about managing the surge of cases through patient transfers and other means, Simpson said. Vaccines also help prevent more people from getting seriously ill with breakthrough infections.
Now, health human resources is the largest “rate-limiting step” for intensive care capacity that could overwhelm hospitals, Simpson said, as facilities face under-staffing and burnout and the anguish among those who remain.
Recent predictions from Ontario’s COVID-19 Scientific Advisory Board highlighted the uncertainty about the trajectory of the rising infection curve in the province, which began late last month when capacity limits were lowered in many public spaces and the Weather got cold, causing people to mingle indoors.
Test Numbers Flat, Positivity Higher as COVID-19 Cases Rise in Most Ontario Regions – Modeling
Intensive care admissions and hospitalizations are considered lagging indicators following increases in COVID-19 cases. The expert group’s models placed intensive care occupation likely at around 200 patients in January, with 250 patients also in the range of possibilities.
Simpson said variables like booster doses for more people and vaccines for younger children will need to be watched as trends develop, noting again that vaccines can keep people from getting so seriously ill this time.
“You plan for the worst, but I think there is some reason to believe that this will not be as shocking as the previous waves in terms of impact on ICUs,” he said.
Simpson said surgery cancellations are more likely to be tracked down and rescheduled within a few weeks, as opposed to cancellations across the province without a rescheduled date set, representing a “different kind of pressure” than before in the pandemic. .
Some hospitals are already grappling with the stress caused by the surge in COVID-19 cases and have signaled that cancellations of procedures might be necessary. Ontario Hospital Association Executive Director Anthony Dale pointed to facilities in Sudbury, Sault Ste. Marie and parts of southwestern Ontario that are experiencing “unusual strong pressures due to large numbers of COVID-19 patients.”
COVID-19 Vaccine Appointments for Ontario Children Ages 5-11 Can Be Booked Starting Tuesday
“These organizations are taking mitigation measures, including patient transfers in some cases,” he said in an emailed statement.
Dale said Ontario’s intensive care hospitals average 90 percent occupancy and can provide care for inpatients with COVID-19 in “relatively stable conditions” in most areas.
He said hospitals will monitor the situation during the winter, saying that “hospital capacity, particularly ICU capacity, is not something we can take for granted in a pandemic, as the number of cases can change with the lightning fast”. Dale asked people to get vaccinated and follow public health guidelines.
The system-wide strain has manifested itself in some Canadian jurisdictions that fought spikes of infection long after vaccines became available. A fourth-wave COVID-19 surge in Alberta prompted 15,000 surgery cancellations and a request for help from the military this fall.
Saskatchewan is still in the process of restarting hundreds of health care services that were halted during its fourth deadly wave, including organ donations and home care.
Simpson said such situations show how it is not impossible for COVID-19 to affect health services even at this stage of the pandemic.
“The COVID numbers, if they go north to the point where we have a lot of COVID patients back in hospitals, it will have an impact. We saw that he did it last time and he will do it again, ”he said. “We have to say what we say today very cautiously.”
See link »
© 2021 The Canadian Press