Ontario children’s hospitals are limiting surgeries and warning of lengthy emergency-room wait times amid a “triple threat” of respiratory illnesses that have forced pediatric intensive-care units to operate beyond capacity.
Toronto’s Hospital for Sick Children said Friday it would limit surgeries to prioritize urgent procedures, as its ICU operated at above 127-per-cent capacity for several days this week – with more than half of those patients on a ventilator.
Similarly, the ICU at McMaster Children’s Hospital was operating at 140-per-cent capacity on Friday, and ER wait times have at times reached up to 13 hours. On Saturday, MCH started transferring 16- and 17-year-old surgical patients to two regular hospitals in the region to alleviate strain.
At the Children’s Hospital of Eastern Ontario, where a second ICU was recently created, administrators said they’re dealing with double the number of patients than usual, with wait times approaching 11 hours on Saturday morning. CHEO said it is contacting patients whose surgeries are being affected.
Children’s hospitals are being inundated as they simultaneously deal with an early and fast-moving flu season, continuing challenges from COVID-19 infections and an emergence of respiratory syncytial virus, according to medical professionals. RSV is a common pediatric infection that can require hospitalization for vulnerable children, such as those with asthma.
Medical professionals say the surge of respiratory infections is impacting hospitals that were already struggling with high numbers of patients and staffing challenges owing to sick and burnt-out workers.
“We were having trouble in Canadian health care even in the summer months where across the country we had emergency departments closing because of personnel issues,” said Isaac Bogoch, an infectious-disease expert and staff physician at Toronto’s University Health Network.
Anthony Dale, president and CEO of the Ontario Hospital Association, implored people to mask up in crowded areas and to stay home if sick, saying he was “increasingly concerned” about rising pressures on pediatric hospitals in particular.
“Children often wait longer than adults for surgeries and access to specialist clinics and diagnostic procedures,” said Mr. Dale.
“Unfortunately, pediatric hospitals are being forced to cancel many of these services to free up physicians, staff and clinical spaces for children with very serious respiratory conditions.”
He added that a large number of the children currently being hospitalized do not have COVID-19, are not immunocompromised and have no underlying health conditions.
Parents, such as Ottawa resident Mahreen Kazi, say the strain on the health care system has been frustrating.
Ms. Kazi was advised against taking her six-year-old son to the hospital after he was diagnosed with a respiratory illness last week to help ease the strain on children’s hospitals. When she asked a doctor for medication, she said she was told there was a shortage in amoxicillin for children, and her son was prescribed azithromycin instead.
”We have to run around for asking for basics, and it just tears me up from inside,” said Ms. Kazi, who said that she, along with her husband and other son, were sick as well.
“Every time my child coughs, every time he’s unable to sleep at night, it just frustrates me.”
This isn’t the first time she felt let down by Ontario’s health care system, she added. When the same six-year-old son fell ill earlier this year, Ms. Kazi said she tried to take him to CHEO, but ended up leaving without treatment after waiting for more than 16 hours.
Now, she says, she makes sure her kids are masked when they leave the house, adding she’ll try anything if it means easing the strain on hospitals so her son can get the care he needs, including going back to mask mandates.
The province’s Chief Medical Officer of Health, Kieran Moore, is reportedly going to urge Ontarians on Monday to resume masking – though his update will not be accompanied by a renewed mask mandate.
Ronald Cohn, the president and chief executive officer of SickKids Hospital, told CP24 the return of mask mandates would help alleviate the “unprecedented” strain on children’s hospitals. “We are really seeing these pressures all across the province and we would certainly support a universal masking mandate,” Dr. Cohn said in the interview.
Dr. Bogoch said there are other mechanisms that the province can utilize to further proliferate masking besides mandates, including making them more widely available at congregated settings, such as sporting events and places of worship.
“With good communication and strong community outreach and lowering barriers to masking, just like vaccines, you’ll see much better uptake,” he said.
Asked about the situation in the children’s hospitals during a Sunday news conference, Premier Doug Ford said the province is responding with “all hands on deck,” pointing to previously announced plans to add more beds and nurses to the broader health-care system.
Mr. Ford called on more pediatric doctors to resume in-person appointments after many moved to virtual visits at the onset of the pandemic. He also urged the federal government to act on addressing shortages in medications for children.
”I have confidence in the system, yes there will be bumps in the road, but we’re working on solutions every single day,” he said.
The premier encourages residents to “wear a mask every time possible” and said he will follow the recommendations of Dr. Moore when it comes to mandatory masking and other health measures.
Rose Zacharias, president of the Ontario Medical Association, called on all levels of government to streamline the licensing process for foreign-trained medical professionals who are already in Canada. She said personnel issues are keeping the medical system from being able to raise emergency capacity, and others in the field have already been calling for foreign-trained professionals to be utilized for months.
Dr. Zacharias also called on governments decrease the documentation burden on doctors, who currently deal with two hours of administrative work for every hour of patient care. Lastly, she said governments could establish integrated ambulatory centres, which are standalone surgical centres that could focus on less acute surgeries, such as hip, knee, cataract and hernia procedures.
“Physician burnout and health care team shortages can compromise patient care,” she said. “That’s why we are committed with working with all levels of government and inside our publicly funded health care system to implement some solutions to alleviate the strain.”
With a report from The Canadian Press