Ontario hospitals grapple with virus-related absences

By Holly McKenzie-Sutter and Noushin Ziafati

TORONTO – As Ontario hospitals grapple with staffing pressures from the latest wave of COVID-19 cases, the provincial Opposition voiced concerns Wednesday that surgeries could again be cancelled, though health-care officials stressed that the current situation is manageable.

The New Democrats asked what further steps the province would take to avoid again postponing long-delayed procedures.

NDP Deputy Leader Sara Singh pointed Wednesday to recent comments by Dr. Kieran Moore, the province’s chief medical officer, indicating that ICU admissions could reach 600 over the next several weeks of the sixth wave.

“When the ICUs fill up, hospitals have no choice but to redeploy critical staff resources away from surgeries,” she said in the legislature. “Why is this government continuing to claim that everything is fine when the risk of surgeries being cancelled is so high?”

Health Minister Christine Elliott said, however, that the risk of that happening is not high because the province has added hospital beds and now has antiviral drugs to treat COVID-19.

“Whatever happens with respect to the pandemic, we can continue to care for the people with COVID, but also to continue with those surgeries that many people have been waiting for a long period of time,” she said. “We don’t want them to have to wait any longer.”

Days after the province’s top doctor shared that prediction on intensive care admissions, hospitals said they were already feeling pressure as a result of staff absences due to the virus.

London Health Sciences Centre said the sixth wave was having a significant impact, particularly from “rising numbers” of staff who are off work because of COVID-19 infections or exposures.

Kingston Health Sciences Centre said more employees were calling in sick with COVID-19 than at any other time during the pandemic. Dr. David Pichora, the hospital’s president and CEO, said about 200 employees were off on Wednesday because they had COVID-19 and a “bunch more” were off because their immediate contacts had COVID-19.

“It’s important to emphasize that this is an acute problem on top of a chronic, systemic issue,” Pichora said, noting the hospital also has job vacancies due to staff retirements, difficulties finding skilled workers and having more jobs to fill as it expanded during the pandemic.

Pichora added that the Kingston Health Sciences Centre has had some recent surgery cancellations due to staff and patients catching COVID-19, but the hospital is doing its best to get as close as to 100 per cent capacity as possible.

“We’re … trying to run all of our operating rooms. Some days, that doesn’t work, other days, it does. It really is a day by day thing in terms of the impact,” he said.

Mary Cardinal, vice president of people and chief quality executive at Huron Perth Healthcare Alliance, said her organization reported 85 COVID-19 related staff absences across the four hospitals it oversees in Clinton, St. Marys, Seaforth and Stratford on Tuesday.

In the last three weeks, Cardinal said some surgeries have been cancelled at the HPHA’s hospitals due to COVID-19 related staff absences. But she stressed that they’re doing their best to mitigate the disruption to services, with part-time staff working full-time hours and full-time staff working overtime.

“We have resumed up to 90 per cent of our pre-COVID volumes in surgery, but on a given day, it may be that cases will need to be cancelled,” she said.

Meanwhile, Hamilton Health Sciences said it had returned to 80 per cent of pre-pandemic services but wasn’t in a position to continue ramping up with staffing levels “precarious” due to workers isolating and other factors.

Ontario most recently paused surgeries and other procedures in January when hospitals were under pressure from the first wave of Omicron cases.

Since then, the province has lifted most public health measures aimed at controlling the virus and officials have indicated they won’t be brought back as cases and hospitalizations rise again.

Ontario reported 1,332 people in hospital with COVID-19 on Wednesday and 182 in intensive care, compared with 1,366 hospitalizations on Tuesday, and 190 people in ICUs.

Another 3,833 new infections were reported on Wednesday, but access to PCR testing is restricted. The scientific director of Ontario’s panel of COVID-19 advisers has said wastewater surveillance suggests the province is seeing between 100,000 and 120,000 new cases each day.

Anthony Dale, CEO of the Ontario Hospital Association, said Wednesday that hospitalizations were “accelerating” during the sixth wave, and health worker infections are having an impact.

“Widespread illness among health care workers due to community spread of COVID-19 is directly impeding the ability of hospitals to operate normally at this time,” he said in an emailed statement.

Dale noted that most hospitalizations from the virus so far are in general medicine, not intensive care, but the sheer number of admitted patients could become more problematic.

“It is not yet clear if hospitalizations will reach the January high-water mark of more than 4,000 admitted patients,” he said in an emailed statement. “That would be highly disruptive as at present, hospital activities have not yet recovered from the December/January wave.”

Dr. Michael Warner, an intensivist at Michael Garron Hospital in Toronto, said so far, the current wave isn’t straining the health system as severely as the first Omicron wave did in January.

Warner also said it’s unclear whether 600 people will actually be admitted to ICU in the coming weeks, as Dr. Moore suggested was possible.

However, he said the projection indicates Moore is prepared to again pause procedures deemed non-urgent if the situation calls for it, “which is really concerning.”