Ontario appears to be avoiding worst-case COVID-19 triage in intensive care, but concerns remain – fr

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Ontario appears to be avoiding worst-case COVID-19 triage in intensive care, but concerns remain – fr


TORONTO – Ontario appears to have avoided a devastating scenario in which doctors in the province’s intensive care units (ICUs) could have been forced to choose who gets life-saving care and who doesn’t.

Less than a month ago, an Ontario Health official warned that reaching 900 COVID-19 patients in the ICU could result in a triage protocol that would prevent some of the oldest and sickest patients from receive the highest level of care available.

On Tuesday, Ontario Health Minister Christine Elliott told CP24 that arrows are starting to point away from this worst-case scenario, despite the number of intensive care patients near this threshold.

“As far as the triage protocol goes, this is something that hasn’t been activated in Ontario, and luckily – from what medical experts are saying – it looks like we won’t need it, this which is very good news for everyone.

The statement comes as Ontario reports 886 COVID-19 patients in intensive care units. That number has remained relatively stable over the past week, with the number of cases rocketing above the 900 mark on May 1 before dropping back down.

In early April, Ontario Health Executive Vice President Dr. Chris Simpson told CP24 that if the number of COVID-19 patients in intensive care exceeds 900 and community cases continue to grow, “then we will likely be in a territory where we need to start thinking about other ways, either increasing capacity or activating the triage protocol, but it has to be and we are determined that it will be the last resort.

The triage protocol was developed in January. The paper says patients who are expected to live 12 months or more after treatment should receive more attention and care in scenarios where healthcare resources are too limited.

Since then, a number of emergency measures have been taken by the provincial government, including cancellations of elective surgeries and the transfer of patients to hospitals that have more capacity than other hospitals located in hot spots.

Health officials and intensive care doctors across the province say they were able to breathe a sigh of relief this week after receiving reports that the province may be able to avoid a triage situation entirely by intensive care.

“I think for everyone it’s a bit of a breath and a sigh of relief,” Dr. Christie Lee, interim ICU site manager in Mount Sinai, told CTV News Toronto. “Over the past few days, we’ve been gaining information in particular from our Ontario Intensive Care Command Center, which suggests that new science table projections that may be released in the next few days suggest that we are not. ‘may not achieve those same lofty goals we thought.

“While the numbers are still pretty high, if we don’t meet those projections it would probably suggest that we might be able to avoid having to institute or implement some sort of triage protocol. “

Dr. Mark Soth, director of intensive care at St. Joseph’s Hospital in Hamilton, says there have been tough decisions like transferring patients, but these have helped avoid leaving patients without. the care they need.

“I think we’ve done a really good job of dispatching patients across the province to use all of the critical care capacity, we have to do that because you really want to use everything you’ve got before you consider anything. or like sorting. Soth said. “I think unfortunately we’re in a situation where that’s the best option – that we have to do it, rather than having areas under so much pressure that they can’t handle it. “

If Ontario is able to mitigate the spread of the virus in the community and vaccinate those most at risk of infection, Soth said the province should be able to avoid further pressure on hospitals .

The president and CEO of the University Health Network, a hospital system that includes Toronto General, Toronto Western and Princess Margaret, echoed this statement and that it is essential that people continue to monitor health metrics public and get vaccinated against COVID-19 to ensure the number of patients in the intensive care unit continues to decline.

“Fortunately, I would say that as long as we’re full our growth rate is changing slightly, so it’s not increasing,” Dr. Kevin Smith told CTV News Toronto. “We are also seeing rejections, which is good news.”

“I’ll temper the good news by saying that it could absolutely go the other way if we step back one iota on necessary behaviors – getting your vaccine, following public health measures, keeping distance, socializing only with who you are.” reside, all of these things that we know we have to do. “

PEOPLE WAITING FOR SCHEDULED CARE COULD SOON TURN INTO EMERGENCY CARE

While hospitals may not need to use the triage protocol developed in January, doctors fear more non-COVID-19 patients may end up in an emergency due to a lack of scheduled care.

“I think we all feel like we can do this job in three or four weeks. But if we don’t really follow the rules and get them under control and become able to do our intended job again outside of COVID, (it) raises concerns about what it would mean for patients awaiting treatment. another important intervention.

Smith added that the highest priority non-COVID-19 patients still receive care at UHN – identified as patients who need care within 14 days – but others are urged to wait for staff to be redeployed to help with pandemic efforts. For cancer patients, for example, Smith says the time between diagnosis and treatment can be critical.

Some of these patients may need to be treated in an emergency room.

Once the number of COVID-19 patients in Ontario’s ICUs drops and emergency measures are lifted, Smith says it will take time to deal with the long list of people who will need treatment. care. This will add further strain to the overburdened health care system as frontline staff who have worked throughout the pandemic continue to catch up.

“It’s a straight ball,” Smith said. “If you can’t squeeze one place and not have a pop in another, it will. We really need to maintain this balance between those who need COVID care and those who have other critical care needs.

The government has not indicated how long its directive on canceling elective surgeries and transferring patients will last.

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