Respiratory season arrives in Canada as head of emergency physicians group speaks

British Columbia’s Health Minister said 10,435 patients – a record number – were in hospital Tuesday night, many of them with respiratory illnesses.

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The head of a national group of emergency room doctors says he’s “disgusted” that provinces and territories generally haven’t planned for expected overcrowding in emergency rooms, especially as respiratory season begins to peak. in many areas.

Dr. Michael Howlett, president of the Canadian Association of Emergency Physicians, said governments and hospital administrators have failed to heed warnings from health care professionals charged with caring for more patients, including those who They often end up in hallways instead of the rooms where they would be. get better care.

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“It frustrates me that there are people who control the system and think they know more than many of us, with a lot of experience on the front lines dealing with patients,” said Howlett, who works in rural and urban emergency rooms for Oshawa-based Lakeridge Health. , Ont. He was also head of the emergency room there until last September.

“A lot of emergency physicians who have tremendous administrative and leadership experience across the country, many of them are in leadership roles, and in many cases they have a lot to offer. And no one wants to pay attention. “Everyone else thinks they know our specialty and they don’t.”

Howlett made the comments Wednesday as British Columbia’s health minister said 10,435 patients — a record number — were in hospital Tuesday night, many of them with a respiratory illness.

“It’s a big challenge,” Adrian Dix said, adding that 18,000 healthcare workers recently lost at least one day of work due to illness, putting additional pressure on the system.

Dix said it’s a “particularly challenging time” for the health-care system, but the province had administered 1.5 million doses of flu vaccine, the most in Canada.

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Emergency rooms in other parts of the country were also over capacity as rates of influenza and respiratory syncytial virus (RSV), which can be serious for infants and older adults, have steadily increased.

In Quebec, emergency rooms were at 137 per cent capacity on average, and Health Minister Christian Dube said about 1,900 people a day were visiting emergency rooms, double the number last year.

Dube said nearly half of daily ER visits are for non-urgent ailments that could be treated at a primary care clinic or doctor’s office, but it can be difficult to get an appointment.

“The system needs to offer better service for these (minor cases),” added Dr. Gilbert Boucher, president of the Quebec Association of Emergency Medicine Specialists and an emergency physician at the Montreal Heart Institute.

Bonnie Henry, provincial health officer in British Columbia, said the respiratory season was expected to peak next week as more people are likely to become infected with the H1N1 flu virus.

“That’s really one of the things that’s causing the greatest spread of disease now,” he said at a joint news conference with Dix.

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“H1N1 tends to affect younger people more and can still cause very severe illness and can make people more susceptible to having a bacterial infection after having had a flu infection,” Henry said.

Three children have died from flu-related deaths in British Columbia and all had secondary bacterial infections, Henry said.

“It is very sad and tragic to know that young people can be protected from these infections. But we know that any respiratory virus can cause inflammation in the lungs that makes you more susceptible to bacterial infections.”

Unlike viruses, bacterial infections can be treated with antibiotics, Henry noted.

Most children do not need to be hospitalized when they are treated in an emergency room, Henry said.

“But (flu) continues to put pressure on emergency departments and we encourage people to make sure they bring their children if they have any concerns. “We have also seen that emergency department visits have increased, particularly over the past six weeks, and the proportion of visits for acute respiratory infection has increased, particularly in children aged zero to 14 years.”

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Henry said there have been 24 flu outbreaks in long-term care homes over the past eight weeks, nearly half of them in the last week of December, making some people seriously ill.

Howlett said an increase in the number of emergency patients often means patients have to be placed on uncomfortable stretchers in hallways, increasing the risk of developing bed ulcers, especially for older people who cannot sleep. in noisy, bright areas with lots of people walking.

“There are a number of factors in emergency departments that contribute to it not being a stable area for people who come in.”

Howlett’s group met with provincial and territorial health ministers during their meeting in Charlottetown, P.E.I., last October to discuss how they could all join forces at a national forum this spring to find possible solutions to emergency room overcrowding.

So far, no jurisdiction has responded to the invitation, Howlett said, adding that doctors hope to start a meeting anyway.

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