Ontario Premier Doug Ford announced plans on Monday to open 500 new hospital beds – including those inside an entire soon-to-open facility north of Toronto – as the government scrambles to head off a surge of COVID-19 that threatens to overwhelm the province’s intensive-care units.
With the province already moving critical patients by ambulance helicopters from hard-hit hospitals in the Greater Toronto Area to as far away as Kingston to the east, hospitals and medical experts welcomed the added capacity. Hospital officials have warned that rising numbers could soon force them to make difficult life-and-death decisions if ICUs are overrun.
But some health care advocates warn that finding enough of the specially trained nurses and doctors needed to operate enough extra critical-care beds could be difficult and would mean redeploying staff and cancelling even more non-COVID-19-related operations and procedures.
The Premier, speaking from inside Cortellucci Vaughan Hospital – the first added hospital in Ontario for 30 years – said when the new facility opens Feb. 7, it will be used exclusively to ease the crunch caused by COVID-19 in other hospitals across the GTA.
“When we are in the fight of our lives, this incredible new state-of-the-art hospital, it’s like reinforcements coming over the hill,” said Mr. Ford, whose government last week declared a state of emergency and issued a stay-at-home order.
The new hospital itself will offer 185 new beds in total, including 35 critical care beds, to Ontario’s stressed health care system. The Premier said also Monday that the province was spending $125-million to add 500 new “surge” beds in all, including at other hospitals. But that total includes both crucial critical-care beds, which allow for patients to be on ventilators, and lower-level “high intensity” beds.
The government could not say how many of the new beds would be fully equipped for critical care – or when they would be up and running.
Ontario Health Minister Christine Elliott said efforts were under way to find space in hospitals in virus hot spots and to find the staff needed to oversee the new beds. The new beds come on top of the 3,100 health care beds the government says it has already added as part of its COVID-19 response.
On Monday, across the province, there were 416 COVID-19 patients occupying critical care beds, out of a total of about 1,800 patients in ICUs. That’s well past the threshold of 200 COVID-19 ICU patients that has triggered cancellations of other kinds of surgery. The latest projections warned Ontario could see as many as 1,000 patients in ICUs by next month.
The new hospital will be operated by Mackenzie Health, which also operates an existing hospital in nearby Richmond Hill, and will accept both critical and non-critical patients transferred from other hospitals to ease pressures during the pandemic. It will not exclusively treat those with COVID-19, but will also admit those without the virus whose transfer frees up resources in a facility hard-hit by the pandemic. The new hospital will open as usual once the pandemic pressures stabilize, Ms. Elliott said.
The province has issued special orders to allow hospitals to temporarily redeploy staff to other hospitals that need help dealing with COVID-19.
Anthony Dale, CEO of the Ontario Hospital Association, praised the use of the Vaughan hospital to ease the pressures on the GTA health care system, and the pledge of 500 more beds.
“It will help, assuming we can get much of that capacity up and running and online,” Mr. Dale said, warning that once there are more than 700 COVID-19 patients in ICUs, doctors could be forced to make difficult triage decisions.
Michael Warner, head of critical care at Toronto’s Michael Garron Hospital, said it is hard to say what the impact of the beds will be without knowing how many fully equipped ICU beds are being created, or whether enough qualified doctors and nurses can be redeployed to staff them. But he praised the use of the Vaughan hospital to relieve hospitals across the GTA.
“It’s important to have a relief valve for patients close in the GTA because right now we are sending patients to Kingston and St. Catharines,” Dr. Warner said. “So having this facility in the GTA, where most of the patients are with COVID-19, is helpful.”
Doris Grinspun, CEO of the Registered Nurses’ Association of Ontario, said nursing staff would be pulled from other hospital departments and into COVID-19 critical care as elective operations are cancelled. But if ICU admissions keep shooting upwards, she warned, Ontario could run out of qualified staff.
“That’s what happened in Italy in the first wave,” she said. “At the end of the day, it was not the beds. It was that they did not have enough RNs [registered nurses] or physicians that specialize in ICU.”
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