Ontario hit new high for COVID ICU patients – and experts say it’s not even near the top

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Ontario now has a record 369 ICU COVID patients – the highest number so far in the pandemic – as hospitals in hard-hit areas stretch before holiday gatherings are even expected .

Dr Michael Warner, medical director of intensive care at Michael Garron Hospital in Toronto, said Monday’s summit (reports show figures from the day before) of 369 patients in intensive care units across the province did is “not even near the top”, which he thinks will reach 600 or more.

“Nobody knows how bad it will get, but I can say for sure that it will get worse now,” he said, adding that he didn’t want to stir up fears and just wanted people to know about them. facts.

“Right now, in the hot zone hospitals, it’s bad.”

The figures come from Critical Care Services Ontario’s daily report, which also shows 45 patients were admitted to the ICU on Monday. They differ slightly from the provincial total of 352, due to differences in reporting. Either way, this is a record high, surpassing spring highs below 300 and previous holiday highs.

Some hospitals in the hard-hit red zones of Toronto, Peel Region, York Region and Windsor have already made the decision to cut back on scheduled surgeries and had to transfer patients because they just didn’t have enough space. Mackenzie Richmond Hill Hospital is among those taking such action. Joseph Brant Hospital in Burlington has just opened a 16,000 square foot field hospital specifically for patients with COVID-19.

The impacts are felt beyond the GTA. The Windsor Regional Hospital announced Tuesday that area staff will begin transferring patients to Chatham and Sarnia due to a lack of beds, and in London, Ont., A hospital system has run out of room for them. bodies in his morgue and is now temporarily storing them in a mobile unit, a spokesperson confirmed to The Star.

It’s “doubly unfair to the people who live in these areas,” Warner said, with more COVID there and other care also affected, such as postponing scheduled surgeries. The Ontario Intensive Care Services report sets the baseline for ICU beds at 2,136. Although there are beds available in places like Thunder Bay and Kingston, Warner said they are not. not evenly distributed throughout the system. According to the report, in Toronto, for example, 347 beds are occupied out of 407.

He is yet to see any patients presenting to his intensive care unit with COVID following the Christmas gatherings due to the time it takes for the disease to progress. But he said hundreds of people were tested over the weekend at the hospital’s assessment center, and around 60 to 70 percent of those admitted to congregate during the holiday season.

“Holiday gatherings are a huge problem,” he says. “It’s a nightmare for us.”

The new mutated variant of the coronavirus, dubbed B.1.1.7, which is “almost certainly more transmissible, will have an impact on the spread, especially if it is ubiquitous in the community, which is not yet known, and which coincides with the holiday gatherings, ”he added. So far, six cases of the new variant have been reported in Ontario.

Already, every day in the province, patients are transferred from hospitals where intensive care units are full to those who still have room. Full intensive care units also require more nurses to come from other units to help, which means surgeries are being canceled, Warner said.

The ratio of intensive care beds to nurses is usually one to one, but that is already stretching and “it increases the chances of things going through the cracks.”

“Everyone’s cup will eventually overflow. You can only fill every intensive care unit so long and everyone is full, ”he said.

“There is elasticity in the system, but none of it is free.”

On Jan. 1, the province sent a note to hospitals, he added, telling them to prepare for intensive care units to be at 115 percent of capacity under surge plans.

“For my hospital, we had to go from 17 to 19 beds in our intensive care unit. Today I have 17 patients in my intensive care unit, which is 100% capacity, ”he said. They will have to figure out “how to take nursing capacity out of other programs.”

The Scarborough Health Network is at 98% of its intensive care capacity, spokeswoman Leigh Duncan said in an email. They have two beds left in intensive care.

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“Some non-emergency surgical hospitalizations have been postponed. Surgical cases are assessed daily and every effort is made to avoid cancellations, ”added Duncan.

Day procedures, urgent and emergency surgeries, regional service and cancer surgery will continue.

At the University Health Network, which includes Toronto General and Toronto Western Hospitals, spokesperson Gillian Howard said in an email that the beds in the intensive care unit are full and about 25% of those patients are affected. of COVID.

The team there “is working on what we may have to cancel if the number of patients with COVID-19 continues to rise,” she said. “It hasn’t happened yet – but it probably will be soon. “

She added that this should not affect the rollout of the vaccination, which is led by their family health team.

Warner added that in the first wave, many of the victims were essential workers, or people who lived in overcrowded homes, who could not escape their risks. But he is now seeing people who have been infected with COVID because they have chosen to come together with other people.

“Almost all of the patients in the intensive care unit have acquired COVID from a member of their household,” he said, adding that the disease “will eventually find the host vulnerable.”

What the public doesn’t see behind closed doors is the “impossible situation” many families find themselves in, when loved ones come to the end of their lives, but they can’t be there because they have to be. isolate as they may also be infected.

It’s “overwhelming” to have to see them watch Zoom while their loved ones die.

“If your mother is dying and you live with your mother or if you visited your mother during the holidays, you are supposed to isolate yourself for two weeks,” he said. “It means you can’t come to the hospital and hold her hand while she’s dying.

The only way to regain control of the situation is to support people with COVID so that they do not have to expose their families and “carry the vaccine to as many weapons as possible”.

The deployment so far, he said, has been far too slow.

“Why are we not like Israel? Why aren’t there vans going through communities like Thorncliffe Park to vaccinate people? Warner asked.

The program is only successful if every dose of vaccine has been given and the province waits for more doses from the federal government, “everything else is a failure,” he said.

“It’s so urgent.

May Warren

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