Ambulances outside the emergency entrance at Sunnybrook Health Sciences Centre are photographed on Sept. 22, 2020.Fred Lum/The Globe and Mail
The number of people hospitalized with COVID-19 in Canada’s two most populous provinces has jumped 44 per cent over the past seven days, putting renewed pressure on the health care systems in Ontario and Quebec.
Health-care experts in Ontario are sounding the alarm about the province’s exponential growth in new cases. They say the elderly are vulnerable to getting sickened with the virus as swelling ranks of younger people test positive. As of Monday, 82 people in Ontario were hospitalized with the virus, an increase of 86 per cent since Sept. 15.
“The trend line of the last week is very, very worrying,” said Anthony Dale, president of the Ontario Hospital Association (OHA).
Doctors in Ontario asked the provincial government on Wednesday for an infusion of funds to address a backlog of elective surgeries and other health care services delayed because of the pandemic. The Ontario Medical Association, which represents 43,000 physicians, called on the province to fund new pandemic units to house patients with COVID-19, expand capacity in the health care system to handle more procedures and services, and keep operating rooms open longer.
Along with Ontario, two other provinces are dealing with a resurgence of COVID-19 cases. The number of people hospitalized in Quebec with the virus has increased 30 per cent over the past seven days to 168.
In Alberta, a major outbreak at the province’s largest hospital has left three patients dead, infected another 17 and forced 114 staff members into isolation.
The outbreak began last Friday in the cardiac unit at Foothills Medical Centre. Alberta Chief Medical Officer of Health Deena Hinshaw told reporters this week that it is not known how the virus got into the hospital. But she said there is no “increased risk” to patients coming to the facility.
In all, 51 people in Alberta are hospitalized with the virus, well below a peak of 93 on July 22, but a 38-per-cent increase over the past seven days.
In Quebec, the hospitalization rate for COVID-19 patients has dropped sharply since the beginning of the pandemic. During the first wave, about 13 per cent of cases ended up in hospital. From Aug. 10 to Sept. 6, the rate was just 5 per cent. At a technical briefing on Wednesday, researchers and officials from Quebec’s institute of excellence in health and social services (INESSS) projected that the rate for COVID-19 patients in early September would fall again to 3.8 per cent.
The drop can be explained by the relative youth of Quebeckers contracting the virus in its second wave and their relative lack of comorbidities. By contrast, in the spring, the virus tore through long-term care homes in the province, killing 4,914 elderly residents.
As a result of this shift, Quebec will not exceed its hospital capacity of about 2,000 beds in the next four weeks, according to the INESSS projections. But officials warned that a faster spread of the virus caused by careless behaviour could still put pressure on the health care system.
“The capacity will be fairly good for the next four weeks, but it can change and it can change rapidly,” Luc Boileau, director-general of the institute, said in an interview.
At the same time, acute care in hospitals is overburdened. The waiting list for surgeries, built up because of pandemic restrictions in hospitals, is now 92,000 names long and emergency departments are operating at 130-per-cent capacity.
Patients waiting for beds on hospital gurneys is par for the course, said Dr. Bernard Mathieu, president of the Association des médecins d’urgence du Québec. “Unfortunately that’s the routine in Quebec. We tolerate things,” he said. “We need a crisis to act.”
Occupancy rates are hovering around 90 per cent at many of the large hospitals in Ontario. At Sunnybrook Health Sciences Centre in Toronto, occupancy has been just over 100 per cent over the past two weeks, said Ru Taggar, executive vice-president and chief nursing and health professions executive. “We are back at the same level of activity that we had before COVID," she said.
In anticipation of caring for additional patients with the virus, she said, Sunnybrook plans to expand its capacity by opening a new ward with 32 beds.
During the first wave of the virus, hospitals across Canada freed up beds in anticipation of an influx of COVID-19 patients by cancelling elective surgeries. As they brace for a second wave, they are still clearing the backlog of cases. The last thing they want to do, as a result, is cancel surgeries again.
“One of our greatest anxieties is ensuring that we don’t see a further build-up of delayed or cancelled scheduled care,” Kevin Smith, chief executive officer of the University Health Network hospitals in Toronto, said in an interview.
In British Columbia, hospitals have extended daily hours of operation and added weekends to the schedule for surgeries.
“We said we would catch up to surgeries lost to COVID-19 within 15 to 22 months,” Health Minister Adrian Dix told reporters last week. “We’re on track to do exactly that.”
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