‘Standard of care can no longer be met’: Infection surge creates ‘desperate’ scenario for hospitals

“Right now hospitals across this province are feverishly working to create a patchwork of desperate solutions. All of Ontario’s patients will feel the consequence of that. Reaching ‘capacity’ is when the standard of care can no longer be met; we have passed that point. Stay safe.”

Harrowing words.

They were published on Twitter Monday morning by Dr. Shady Ashamalla, head of general surgery at Toronto’s Sunnybrook Hospital.

The dire warning came on the heels of the worst five days in Ontario since the start of the pandemic. Twice, within a week, more infections were reported than ever before, and in Peel, the numbers were even worse.

The region recorded 860 new cases Sunday and in each of the previous four days the numbers were also disturbing: 669, 532, 649, 596.

These numbers are about three times higher than those seen in the first week of March, shortly before some of the restrictive measures put in place by the Province were lifted.

Peel's daily new infection case counts since the start of the pandemic

Peel, along with the rest of Ontario, was put back in a stay-at-home-order on Thursday, the day after the government declared the third state of emergency since the start of the pandemic.

"The COVID-19 situation is at a critical stage and we must act quickly and decisively to stay ahead of these deadly new variants," Premier Doug Ford stated, explaining why the Province had to take its latest drastic steps. "By imposing these strict new measures we will keep people safe while allowing our vaccination program to reach more people, starting with our high risk population and identified hot spots. Although this is difficult, I urge everyone to follow these public health measures and together we will defeat this deadly virus."

His stops and starts, instead of keeping strict measures in place, and the government’s failure to focus on hotspots in Peel have resulted in a nightmare scenario now facing hospitals.

Acute care capacity in the region was at 96 percent as of April 5, according to Peel’s latest weekly epidemiological report. This means Brampton Civic Hospital, Credit Valley Hospital and Mississauga Hospital are effectively operating beyond their ability to provide a basic standard of care.

When capacity reaches 90 percent, a hospital system struggles to maintain its standard of care for patients. As Dr. Ashamalla stated, we are beyond this point now.

Elective surgeries across Ontario are being cancelled, under a provincial directive and hospitals began transferring patients without their consent under new orders issued by the government Friday.  Home-care employees allowed to work in hospitals are also being redeployed in response to the surge in infections, under the latest provincial directive as the healthcare system scrambles to deal with overflowing units.

The number of hospitalized patients with COVID-19 has skyrocketed.

As of Saturday there were 1,524 patients in Ontario hospitalized with COVID, compared to 601 on March 14. In less than a month the number more than doubled, putting what doctors are calling “unprecedented” strain on the province’s already stretched front-line healthcare system.

Elective surgeries and other procedures are now being cancelled at most Ontario hospitals, putting hundreds of thousands of patients in an extended period of uncertainty as many suffer with pain while waiting for operations.

Dr. Michael Warner, medical director of critical care at Toronto’s Michael Garron Hospital, issued a desperate plea over the weekend. He called on the provincial and federal governments to scramble hospital staff from other provinces into Ontario to confront the current crisis.

Health Minister Christine Elliott sounded more confident.

"We have a very resilient health-care system that we can expand and we have the tools to do that with the emergency orders that have just been declared," she said Friday, when announcing the directive to transfer patients without consent and redeploy staff from home-care settings.

The patient transfers without consent will only happen in "a major surge event", Elliott said.

Email: [email protected]

Twitter: @JoeljWittnebel 

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