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Surrey Memorial Hospital in Surrey, B.C., on April 10, 2018.Rafal Gerszak/For The Globe and Mail

Surrey has been Ground Zero for the pandemic in B.C. almost since the start. And Surrey Memorial Hospital is at the centre of it.

Last week, the hospital began to cancel a small number of surgeries as a record number of patients were taken into critical care. This is British Columbia’s second-largest hospital, with the busiest emergency department in the province, and while the beds are not all full, the capacity to treat patients is at the limits. It is a forewarning for B.C.’s health care system.

“Medical staff that have been working incredibly hard throughout the whole pandemic, so people are tired,” said Victoria Lee, president and chief executive officer of the Fraser Health Authority. “We’re leveraging every opportunity to ensure that we’re providing all of the care we currently have.”

While staff are giving their all, the challenges they face are growing. Surrey’s COVID-19 case counts this month eclipse all other communities in B.C. by a long shot, and provincial modelling shows the caseload could easily double in the coming weeks if current trends continue.

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So health officials are preparing for a much larger disruption.

“If we go with our current trajectory, the number of cases as well as hospitalizations and acute system impacts, are quite significant and we’re preparing for that,” Dr. Lee said.

Dr. Lee said the contingency plans include “pulling away from current services, whether it’s ambulatory or surgical.” That means more non-emergency surgeries or outpatient services may be cancelled, or patients could be sent to other communities for treatment.

Fraser Health looks after more people than any of British Columbia’s other health regions – 1.8 million people who are served by 12 acute-care hospitals across 20 communities, including Surrey and Burnaby. Surrey Memorial Hospital, on average, takes half of all the region’s COVID-19 cases, and since the start of April it has witnessed a change. Younger and sicker patients are arriving as the virus’s variants of concern have spread.

“What we’re seeing is quite an increase in terms of number of hospitalizations, as well as cases, and the majority of the variants in our region are in the Surrey area, so that’s another concerning pattern,” Dr. Lee said.

While the pressures are acute at Surrey Memorial, the health care system across the province is under strain with record numbers of patients in critical care. Details will be released on Monday about how B.C. will adapt. B.C. Health Minister Adrian Dix, speaking to reporters on Friday, said the system is still “fine” and he suggested changes can be made without the widespread surgery cancellations that he ordered last spring.

“This is something we are assessing multiple times a day to make sure we are in good shape, and today we are holding on,” he said. “But there is no doubt this is extremely stressful for our staff.”

So far, the province has offered no new measures that would change the current trajectory of fast-rising caseloads. Last week, British Columbians were reminded again to avoid social gatherings and non-essential travel, to get outside but to stay away from others. They were advised to stay home if anyone in their household is sick, and keep everyone home until they can all be tested for COVID-19.

But Dr. Lee pointed out those instructions are not options for many Surrey residents – and that’s why this community has had such persistently high rates of COVID-19.

While the data released on Thursday showed that workplace exposures in Vancouver Coastal have been primarily in bars and restaurants, the Fraser Health region is quite different. Workplace exposures are widespread, in industrial settings, on farms, in retail and office buildings.

“There’s a more dense population, there’s more people who are essential workers that are in that geographical area, but also there are populations that are socio-economically disadvantaged, who have to work,” she said. “And they don’t have the means to not go to work, and they don’t have the means to be able to get tested when they like.”

This challenge was acknowledged when COVID-19 was first detected in B.C. Premier John Horgan called on British Columbians not to go to work while sick. He was quickly reminded that not everyone gets sick pay, and those workers who are most vulnerable can least afford to take time off. Many of them are essential workers, at risk of COVID-19, and while they can now apply for some relief from Ottawa, the benefits offered do not replace the sick pay that many white-collar workers enjoy.

Mr. Horgan said he is willing to “fill the gaps” in the federal benefits plan, but according to the BC Federation of Labour, it will take more than a patch. More than half of workers in B.C. have no paid sick leave at all; if they miss a day’s work, they lose a day’s pay.

The province could step in and mandate sick pay – and Surrey’s front-line hospital workers would thank them for it.

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