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Ontario has asked thousands of family health care workers to work evenings and weekends to help ease the burden on overwhelmed children’s hospitals, a government memo obtained by The Canadian Press shows.

Nadia Surani, the director of the primary health care branch in the Ministry of Health, said in the note to family health teams that the “difficult and complex” respiratory illness surge predicted by health care workers has materialized.

The flu, respiratory syncytial virus, or RSV, and COVID-19 are circulating in all parts of the province, Ms. Surani wrote in the memo sent Monday.

“This scenario is contributing to pressures on our health care system, particularly in the pediatric sector, and we are expecting high-volume pressures across our health system now and through the winter,” Ms. Surani wrote.

“I am writing to call on your support and requesting your organizations to offer clinical services 7 days a week, including evening availability, until further notice, to meet the needs of your patients. Please advise your patients of this availability so they may seek care in the appropriate place for their health concerns.”

Extended hours will help “alleviate pressure on emergency departments,” she wrote.

Pediatric hospitals across the province are well beyond capacity with children flooding emergency rooms and intensive care units with the flu and RSV.

Major pediatric hospitals in Toronto, Ottawa, Hamilton and London, Ont., have cancelled surgeries in order to redeploy staff to overflowing intensive-care units, emergency departments and general wards.

Many clinics across the province already offer extended hours to deal with the onslaught of patients with respiratory illnesses, the Association of Family Health Teams of Ontario said in a note to its members.

The government memo was not a directive to work seven days a week, the association said.

“In discussions with the ministry, this memo was not intended to be directive nor prescriptive but was a request to communicate to your patients about how to access care, especially for sick children, with a focus on receiving care through their primary-care teams first so that your patients do not seek care in the hospital if not needed,” the association wrote.

The government memo upset Dr. Michelle Cohen, a family physician who works at the Lakeview Family Health Team in Brighton, Ont.

“In my opinion, we’ve gone above and beyond like all primary care and all health care has, and this is pretty offensive,” Dr. Cohen said.

Their clinic is already working extended hours, she said, and it’s been 2½ years of flat-out work.

“My evening clinic last night was packed full of sick kids with infections,” Dr. Cohen said. “It’s not just pediatric hospitals that are full, everyone is full, primary care and acute care are just swamped with respiratory infections.”

A recent study by the Canadian Institute for Health Information found the average overtime hours for health care workers across the country were the highest in more than a decade.

A spokeswoman for Health Minister Sylvia Jones said the government is grateful to health care workers in their “all-hands- on-deck” approach to deal with the current surge of respiratory illnesses.

“Recognizing that not all Ontarians can access primary care for their children during the regular work week or within regular working hours, we have asked for organizations to expand their clinical services to meet the needs of patients, especially for sick children,” Hannah Jensen said.

“This will help avoid unnecessary visits to hospitals and keep our emergency departments available for those who require urgent care.”

Primary-care providers will be compensated through OHIP and providers can contact the ministry for any extraordinary costs associated with the expanded hours, Ms. Jensen said.

Last week, children’s ICUs in Ontario had more patients than beds, provincial data showed.

Children and teens are also hitting emergency departments at a rate two-to-three times higher than usual this time of year, statistics from Acute Care Enhanced Surveillance, a real-time Ontario-wide system that monitors hospital registration records, show.

There has been a slight downward trend in children going to the emergency departments for respiratory illnesses over the past week.

Ontario Health, the agency that oversees the province’s health care system, recently directed the province’s general hospitals to accept children 14 and older who need critical care. It also directed them to accept children who no longer need to be in the ICU, but aren’t well enough yet to go home.