what is hidden by the low numbers of COVID-19 hospitalizations in Quebec – .

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what is hidden by the low numbers of COVID-19 hospitalizations in Quebec – .


The health system still bogged down by the backlog of surgeries and staff exhaustion

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During the peak of the second wave in mid-January, 1,523 Quebecers were hospitalized for COVID-19, 230 in intensive care, many of whom were breathless on ventilators. As of Sunday, those numbers had fallen to 75 and 22 respectively – a remarkable sign of progress in the pandemic.

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But the latest hospitalization figures are somewhat misleading, experts say, as Quebec hospitals have never been so understaffed as they are today, with record numbers of healthcare professionals suffering from burnout. professional and a huge backlog of elective surgeries that will take at least the next two years to clear.

“The battle against COVID is under control, but our hospitals are in bad shape,” Dr. François Marquis, head of the intensive care unit at Hôpital Maisonneuve-Rosemont, told the Montreal Gazette.

“Our hospital is now only functioning at 50% of what it should be. We’re not even close to getting back to the surgical volumes and efficiency we had before COVID, and it’s going to take years to overcome and it will require a real investment from the government.

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“The surgeries are canceled every day,” added Marquis. “We are trying to do wonders to get people to have surgery. And I’m not talking about elective (or elective) surgery. These are cancer and aneurysm cases, and these are things that are going to kill you if we don’t fix them right away.

Marquis’s harsh assessment is corroborated by the Ministry of Health’s own statistics, which showed that more than 148,000 Quebecers had been waiting at least a year for surgery as of March 31, up more than 33,000 since before. the pandemic.

The reasons for the surgical backlog are twofold: Hospitals voluntarily reduced elective surgeries in waves one, two and three while more than 4,000 experienced nurses left the profession during the pandemic, according to union leaders. (The Ministry of Health says the profession saw a net gain of nearly 2,500 nurses during this period, but the Quebec Interprofessional Health Federation disputes the government’s calculations.)

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For Marquis, there is no doubt that Maisonneuve-Rosemont experienced an exodus of nurses and respiratory therapists during the pandemic.

“The second wave caused more and more workers to flee the hospital,” he explained. “At this time, stress in the hospital is unrelated to COVID-19. Stress is purely a matter of a lack of nurses. Half of my beds are not available, the operating theater is not even working at 50% and we are having problems in the emergency department and in the wards because we do not have enough staff.

Dr Lawrence Rosenberg, Executive Director of the Central West Montreal Health Authority, confirmed that the Jewish General Hospital is also struggling with staff shortages, even though its employee retention rate is one of the highest in the city.

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“The fallout from the pandemic is something we have to deal with, for sure,” Rosenberg said.

“We certainly want to make sure that people who may not have had the best access to care that they wanted or needed receive the care they need now. It’s getting better week by week. Staffing is always an issue, and the challenges may be more apparent in other institutions than ours, but it is still a challenge for us.

On Thursday, the opposition Parti Québécois called on the Legault government to act quickly to resolve staff shortages in hospitals. PQ health spokesperson Joël Arseneau blamed the fact that some emergency rooms reduced their opening hours to a lack of planning from the Ministry of Health.

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Health Minister Christian Dubé unveiled a plan last month to reduce wait times for operations to a maximum of six months by 2024. Under the plan, health workers have been allowed to go on vacation this summer (which they were denied in 2020) and the government will increase surgeries in the fall. But the plan does not seek to hire more staff, only to increase the efficiency of hospitals.

The plan also does not address the burnout of hospital workers, leaving individual health authorities to help staff with limited funds. The Central West Montreal Health Authority, for example, has recorded more than 50,000 calls to its COVID-19 helpline for employees since March 2020, more than 500 of which deal with psychological issues.

With the acute care system so vulnerable in Quebec, hospital administrators fear a possible fourth wave this fall driven by the ultra-contagious Delta variant. Even though the cases of COVID-19 have dropped to less than 100 per day and approximately 45% of the Quebec population is adequately vaccinated, there is not much room for maneuver in the system in the event of a fourth wave.

“What we are all hoping for is that the fourth wave will be small enough that it is not a burden on the health care system,” said Marquis.

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