Ontario hospitals affected by COVID-19 transfer record number of patients to province
Ontario hospitals are transferring unprecedented numbers of patients within the province as the COVID-19 pandemic puts intense pressure on the health care system.
Doctors say the record number of patient transfers comes as hospitals face an increase in hospitalizations and admissions to their intensive care units during the third wave. And they say they are worried about what could happen if hospital resources were strained more.
Hospitals in the Greater Toronto Area are now so full that they are transferring dozens of patients every day. Ornge, the organization in charge of patient transport, says patients are moved mainly by its intensive care ground ambulances, but also by its helicopters and planes, and with the help of local paramedics.
Patients are transferred from hospitals in the Greater Toronto Area to facilities in Kingston, London, St. Catharines, Barrie, Peterborough, Ottawa and Sudbury.
According to Ontario Health, a total of 2,059 patients have been transferred since mid-November, when the Ontario government activated the Greater Toronto Hospital Incident Management System. The system monitors bed capacity in Ontario.
Dr Andrew Healey, chief of emergency services and emergency and intensive care physician at William Osler Health System, said on Tuesday the transfers were having a huge impact on patients, families and hospitals.
“We are moving the most we have ever seen into the system, not only from Osler but also province-wide,” Healey said.
Eleven days ago, the province issued emergency orders allowing Ontario hospitals at risk of being overwhelmed by COVID-19 to transfer patients without their consent. This is the first time that such an order has been issued during the pandemic.
“People want to be treated at the hospital closest to their home. And this is the beginning of the stress associated with this type of transfer system. Healey said.
“It also affects the layer of complexity that occurs within the hospital itself, getting consent where we can for transfer, directing patients to other facilities, ensuring that patients and families are well informed of this transfer, by organizing the real transfer mechanism, doctors, ensuring their transfer in complete safety, ”he declared.
“The task is extremely complex. And the sicker the patient, the more complex the task. We have certainly seen times when different family members were in three different hospitals, one deteriorating in a hospital and another. deteriorating into another and trying to have conversations. “
Hospital system is reaching its limits, doctor says
Healey expressed concern about what would happen if the William Osler Health System, a network of hospitals in Peel Region and western Toronto, were overwhelmed.
WATCH | Dr Andrew Healey says most COVID-19 patients in Peel are essential workers employed indoors:
“I am very concerned about the potential for us not to be able to meet the demands of the pace at which patients will present themselves through the front doors of our hospital,” he said.
“We are dangerously close to not being able to provide typical care in typical spaces to patients with COVID-19 infection and others in our hospital system.”
With transportation and hospital systems running at full speed, there are concerns about what would happen following a further rise in the number of COVID-19 patients requiring intensive care. Healey said individual hospitals could suddenly become overwhelmed if they received a number of COVID-19 patients who needed oxygen hour after hour.
“Hospitals are already stressed and they are doing their best. And then we get a huge influx internally of a major influx of people who need care. And this is the situation that worries me the most and I think it’s almost inevitable. “
William Osler transferred 565 patients
Healey said the William Osler healthcare system has benefited the most from the patient referral system. It has transferred 565 patients since mid-November. He said this reflects the size of his healthcare system as well as the number of people infected with the novel coronavirus.
Healey said hospitals “are trying to find the right patients to send who are safe for transport.” Many of those who are transferred have COVID-19, but not all. They include patients in acute care and intensive care units.
“We are transferring at a rate that is getting closer but that does not quite meet the demands of patients who come through the front door. We are supporting over 200 critically ill COVID patients in our system at this time.
Ornge recreates the ICU in the back of the ambulance
Ornge’s chief medical officer Dr Bruce Sawadsky said transfers are not a simple matter. Ornge, a not-for-profit organization, provides air ambulance and critical care transport services in Ontario by air and land.
“Basically he takes that intensive care unit that they come from and recreates it in the back of a land ambulance for that sometimes two to three hour trip,” he said.
“A lot of these patients need high levels of oxygen. They can be very difficult to ventilate. And putting them in a transport environment makes it even more difficult. It’s doing what we usually do, but doing it. much more, and over a longer distance, especially in PPE. So it’s quite taxing for the staff. “
Transfers have taken place regularly in March, but the pace has picked up considerably this month. He said Ornge had transferred 194 patients in April so far.
“We’re pretty much at maximum right now. Our staff has really intensified over the past two weeks. We have planned and are committed to providing this level of support for the next two to four weeks or as long as but at this point I don’t think we can provide any more resources given our current situation, ”Sawadsky said.
Province using entire health care system as 1 resource
Health Minister Christine Elliott said on Tuesday that patient transfers maximize the use of the hospital system, using the entire health care system as a single resource. “We are still building, we are still creating capacity,” she said.
The provincial government is trying “to make sure that if anyone needs to be admitted to intensive care, whether it’s due to COVID or some other reason, we will have the space for them.”
The number of COVID patients in Ontario hospitals has more than tripled in the past month and is now at an all time high. The number of intensive care units has doubled in the past three weeks and is the highest since the start of the pandemic.
The result is that some hospitals receiving transfers of patients from the GTA are also filling up and having to send their own patients out of town.
On Tuesday, Ontario reported that there were 2,360 people hospitalized with COVID-19, including 773 in intensive care units due to COVID-19-related illness. A total of 537 breathe in intensive care units using ventilators.