A surge in COVID-19 cases driven by the rapid spread of the Omicron variant is being felt broadly across the health care system, with staffing shortages impacting a range of services, including home care, laboratory testing and emergency response.
In provinces including British Columbia, Alberta, Ontario and Quebec, a shortage of paramedics has meant fewer ambulances on the road. Troy Clifford, president of Ambulance Paramedics of B.C., said that for more than a year 20 to 30 per cent of ambulances across the province have been out of service because there have not been enough people to staff them. Over the holidays, that climbed to 40 or 50 per cent in some communities, he said.
“In some smaller rural and remote communities we have two, three ambulances down to one ambulance, and in some of those communities we’ve been having no ambulance,” Mr. Clifford said. “In the Lower Mainland, we have approximately 120 transport capable ambulances from Hope to Pemberton. We’ve got, at peak times over the holidays, 50 out of service.”
B.C.’s emergency response system had faced staffing shortages and high call volumes long before Omicron. At the height of last summer’s heat wave, some callers to 911 reported busy signals and waits of more than 10 hours for ambulances to arrive.
BC Emergency Health Services was unable to provide data on how many paramedics and dispatchers are off sick with COVID-19. Sick-leave numbers for six days in early January showed 334 paramedics and dispatchers called in sick from any illness, compared to 211 over the same period in January, 2021. This does not include counts from rural stations, which use a different scheduling system.
On Jan. 8, the union representing Toronto’s paramedics tweeted that there was a “code red” – a situation where no city ambulances were available to respond to calls. City officials later said this was a serious but common issue. Ambulances are dealing with more patients than they have in the past, and are bringing them to facilities where large numbers of medical staff are calling in sick, the officials explained. In such situations, ambulances can start to queue up.
“In-hospital wait times, commonly referred to as offload delays, are the most significant factor contributing to Toronto Paramedic Services ambulance availability,” Toronto Fire Chief Matthew Pegg said. On the day of the code red, there were times when more than 50 ambulances were waiting to transfer patients to the care of hospitals, he said.
But city officials added that they field more than 100 ambulances during peak times and that paramedics are offloading non-urgent calls to firefighters. In crunch times, paramedics can also come into Toronto from adjacent municipalities as needed.
The Health Sciences Association of Alberta (HSAA), which has posted daily about ambulance shortages, wait times and short-staffing, is calling on the Government of Alberta and Alberta Health Services (AHS) to disclose the true impact of Omicron on health care staff. The union says that while AHS does track staffing levels, the union only has access to voluntary reports.
“AHS needs to tell us the number of health care workers unable to work due to COVID-19,” HSAA president Mike Parker said in a statement.
“All of us have the right to know just how devastating these next few weeks might be and demand government action based on that information. … Ambulances responding to emergencies from Hanna to Calgary, or from Lloydminster to Edmonton, are not signs everything is okay.”
The staffing crunches extend into hospitals, where scheduled surgeries have been postponed as doctors and nurses work to care for a surge in COVID-19 patients while also falling ill themselves.
In the past week, physician shortages have led to temporary overnight closures of emergency departments, including at B.C.’s Nicola Valley Hospital and Saskatchewan’s Porcupine Carragana Hospital. Alberta’s Rocky Mountain House Health Centre was unable to provide obstetrical services for three days and directed patients to a hospital 80 kilometres away.
On Monday, Hamilton Health Sciences in Ontario is closing its West End Urgent Care Clinic for up to eight weeks so it can redeploy emergency-trained physicians, nurses and other staff to emergency departments and other high-priority areas.
B.C.’s seniors advocate, Isobel Mackenzie, said home support services have also been disrupted as a result of staffing shortages, requiring some communities to begin triaging these visits.
“Those [disruptions] are quite significant, because the person that is receiving the visit, it may be because the person is coming to make sure they take their medication, or the person is coming to get them out of bed,” Ms. Mackenzie said. “Some home care clients can only be toileted when somebody arrives to assist them.”
The Ontario Community Support Association has reported a similar strain on non-profit groups who help seniors and chronically ill people live independently in that province.
“This is a sector supporting a lot of people in Ontario,” said Deborah Simon, chief executive of the umbrella group, which includes entities such as Meals on Wheels. The rising infection rates are hitting clients, she said, and keeping volunteers away, too. Organizations facing staff shortages are trying to make do by sending their office workers to care for clients.
“Programs that were volunteer driven are now being shored up by staff,” Ms. Simon said.
In B.C., LifeLabs, Canada’s largest medical laboratory network, has temporarily closed 11 locations and reduced hours at five others, “due to the spread of Omicron and related protocols, which have resulted in severe employee impacts.” The closures are expected to last at least two weeks.
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