In Edmonton, hospitals are regularly exceeding 120 per cent of their funded capacity, prompting the government to postpone about 600 non-emergency surgeries a week. Alberta recorded about 800 new infections on Thursday, by far a daily record, as the province’s health officer warned that the system was reaching a tipping point.
In Winnipeg, the provincial government has suspended non-urgent and elective surgeries as a spike in COVID-19 cases has pushed the city’s critical-care capacity to its limit.
And in Quebec City, about 5,000 outpatient appointments and 200 surgeries are being delayed every week – but that is fewer than the city’s hospital system feared when it announced a plan to dial down services in mid-October, because of a decrease in COVID-19 patients.
Although Canada’s hospitals are faring much better than their counterparts in virus-battered regions of Europe and the United States, the fall wave of the pandemic is exerting enough pressure that hospitals in some of this country’s hot spots have been forced to scale back care for non-COVID-19 patients, many of whom have already waited longer than usual because of the pandemic.
The situation is particularly dire in Winnipeg, where extra intensive-care beds had to be added over the weekend to help the system cope. The province reported 153 COVID-19 patients in hospitals on Thursday, 16 of them in intensive care.
“If the curve isn’t flattened immediately, I think the hospitals will become overwhelmed,” said Dan Roberts, a critical-care doctor at Winnipeg Health Sciences and a former head of the department of medicine at the University of Manitoba. “There are going to be a lot of people without COVID who are going to suffer from having surgery delays and delayed investigations for cancer.”
The Manitoba government has enacted new restrictions in a bid to bring the virus to heel, including closing indoor dining, suspending sports and recreation programming and limiting retail shops to 25 per cent of capacity in Winnipeg, the epicentre of the second wave on the Prairies.
In Alberta, there were 164 COVID-19 patients in hospital as of Wednesday, including 30 in intensive care. The bulk of those cases were in Edmonton, where alarming infection rates two weeks ago prompted the province to reduce non-essential surgeries and other hospital non-urgent services by 30 per cent.
On Thursday, the province reported about 800 new infections, by far the highest daily total since the pandemic began, although a technical issue prevented the release of more precise data. Alberta has among the highest rates of new infections, active cases and hospitalizations in the country, and all of those indicators are accelerating.
Deena Hinshaw, the province’s Chief Medical Health Officer, warned that hospitalizations will likely continue increasing in the next week, as she pleaded with Albertans to heed her guidance to limit social gatherings and stay home when sick.
“I am very concerned about the level of hospitalizations for COVID in Edmonton and Calgary,” said Dr. Hinshaw, who added that she is considering recommending additional restrictions to curb the spread.
“We must protect our health system by reducing community transmission. The fact that we are now reporting 800 new cases is extremely concerning.”
Outside of Winnipeg and Edmonton, hospitals aren’t struggling to the same degree. Although the number of Canadians in hospital with COVID-19 has quadrupled since mid-September – to just more than 1,200 as of Monday night – that number is still not half as high as it was at the peak in May, when cases in hospital topped 3,000.
“We have seen an increase in patients compared to the summer, certainly,” said Anish Mitra, a critical-care doctor at Surrey Memorial Hospital in British Columbia. “But within the ICU, it hasn’t been as bad as it was in the first wave in the spring.”
The case fatality ratio among patients admitted to Canadian hospitals has continued to drop since the start of the pandemic, according to figures crunched by the Public Health Agency of Canada at the request of The Globe and Mail.
Between March and June, when 8,946 COVID-19 deaths were recorded, the fatality ratio among people admitted to hospital (either to an inpatient ward or an intensive-care unit) was 26.1 per cent. From July to October, when 1,106 deaths were logged, the fatality ratio of hospitalized cases was 11.8 per cent, the agency concluded, while cautioning that October data are preliminary.
The improvement seems to owe to better care for the sickest COVID-19 patients, coupled with a shift from the first wave in the demographics of who is catching the virus. So far, 52 per cent of second-wave deaths have been in residents of seniors' facilities, compared with 81 per cent in the spring, according to the public-health agency.
The challenge hospitals are facing this fall and winter is keeping their regular operations going in the face of rising COVID-19 cases. Health care facilities are also coping with infection-control measures that require extra time and resources, as well as workers who are sick themselves or who must self-isolate because they have been in contact with someone who has contracted the virus.
“This is going to be going on for a long, long time,” Paul Warshawsky, chief of adult critical care at the Jewish General Hospital in Montreal, said of the second wave. “My people are already burnt out.”
In Alberta, the province also announced a significant scaling back of the province’s contact tracing system, which can no longer keep up with the pace of new infections.
Contact tracers will now focus on outbreaks in high-risk settings such as long-term care homes, health-care facilities and schools. In other circumstances, people who test positive will be asked to inform their own close contacts, and organizers of events such as weddings or parties will be told to reach out to their guests.
The Globe and Mail
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