In the wake of Omicron’s rapid spread in Canada, medical staff have been sounding the alarm bell: our system is being stretched to its limits.
On Sunday, both Quebec and Ontario reported record-high hospitalizations with COVID-19, with more than 3,300 and 3,957 admissions respectively. Last week, Ontario also reported a record-number of ICU admissions in a single day (80), though there are fewer patients there overall than during the spring 2021 wave.
In Quebec, each health unit is tasked with assessing the level of COVID-19 circulation in the community. They then dedicate a certain percentage of hospital beds to patients with COVID-19 based on that level of circulation. Most health regions are currently in level four. As of January 11, the number of patients hospitalized with COVID-19 in 15 of the province’s 24 health units had exceeded the designated beds for that level. The province is considering creating a level five, in order to cancel more surgeries and make room for an increased number of COVID-19 patients. As of January 11, the Montéregie-Est health unit — where capacity is most strained — had exceeded its bed capacity for COVID-19 patients by 191 per cent, and already cancelled 70 per cent of surgeries.
On January 10, Peel Memorial Centre in Brampton, Ont., announced its emergency ward will remain closed until at least February 1, leaving the city of more than 600,000 people with just one remaining emergency room. The announcement advised people to go to a family doctor for non-emergencies, or to visit another hospital. At 26 deaths, Peel Region currently has the second highest number of death claims paid out in Ontario to workers who died from COVID-19 that they caught on the job.
From the start of the pandemic, Canadians have been told that their personal actions have the power to stop the spread of COVID-19. This message has stuck, transforming this hospital crisis from one decades in the making due to neoliberal public policies into something caused by selfish anti-vaxxers. This narrative also splashes onto those of us who are vaccinated, as we’re told to stay away from the hospital and follow public health orders to avoid Omicron, lest we become tomorrow’s hospital bed statistic.
By personalizing the pandemic, politicians and journalists can avoid talking about systemic problems. When a doctor who just worked an ICU shift in an over-crowded hospital is interviewed, he doesn’t start by reminding Canadians about the billions of dollars Jean Chrétien’s government pulled out of Canada’s social safety net with the 1995 budget. Naturally, he pleads to whoever is listening to do whatever they can to make this better. And, as a majority of the audience are individuals with little power to change things, similar advice is repeated: get vaccinated, follow public health orders.
But there are many things governments across Canada could have done and should be doing to help ease the strain on the hospital system.
In March 2020, Joanne Liu, the former president of Doctors Without Borders, argued in a Globe and Mail article that Canada needed to consider creating dedicated COVID-19 hospitals to ease pressure and help prevent the virus from infecting other patients. This never happened in Quebec (though the idea is now being raised again within the media.) Instead, health units have rented hotel spaces for COVID-19 patients who are in recovery. In Quebec City, two floors at the Hotel Le Concorde are once again being transformed into recovery spaces for people who have COVID-19 and are stable, but who can’t yet return to their residence.
Increasing capacity also means increasing medical staff. In 2020, Quebec aimed to fast-track training for 10,000 orderlies, and is now about to launch a similar program for auxiliary nurses, which already has more than 8,300 applicants. If these nurses work for two years, they will be given a $20,000 bursary. Ontario is planning to allow nurses educated abroad to work in hospitals and long-term care homes that are facing staffing shortages.
But doing this throughout Canada, for all kinds of healthcare workers, would require hundreds of different organizations, regulatory agencies and governments to work together, which doesn’t seem possible, even in a pandemic. Aside from these measures, very little is being done in Canada to address the staff shortage crisis.
There are also steps that can be taken to reduce emergency room visits in the first place. Pregnancy is the most common reason for hospitalization in Canada, and yet there’s been no attempt in the pandemic to make more space for people to give birth in non-hospital settings. In April 2021, Yukon’s only working midwife was forced to leave the territory after new regulations were brought in insisting midwives must practice in another Canadian province or territory for a year. This has forced people there to either give birth at home unassisted, or go to a hospital.
After childbirth, the most common reasons for hospitalization are chronic obstructive pulmonary disease and bronchitis, heart attack, heart failure, and osteoarthritis of the knee. Could special clinics be set up to specifically manage some of these illnesses?
And what about infant visits to the ER? New parents need easy access to quick diagnoses. Issues that can be treated with antibiotics shouldn’t take up emergency room resources, but they so often do, as getting an appointment with a doctor within 24 hours can be impossible, especially if you don’t have a family doctor to begin with.
And then there are trauma and poisoning visits, which comprise nearly a quarter of all emergency room visits in Ontario. Why have there been no policies imposed anywhere to limit the likelihood of traumatic events? Limiting people’s time on the roads could reduce car accidents. Forcing dangerous work environments to slow or even stop operating during a surge would also reduce the number of people heading to the ER with a workplace-acquired trauma.
Emergency room visits don’t arise from thin air: they are connected to broader social forces related to poverty and addiction, income, and access to other kinds of health services. They are also related to sudden and surprising health issues, injuries, and chronic conditions. If our emergency rooms and hospitals are buckling under the pressure of the pandemic, we need to immediately create relief.
Enough with the nonstop stories about how bad things are right now. These stories are already well-known, and take up space in discussion that should go to devising solutions for our hospitals that go beyond the current manta: don’t get COVID-19, and make sure you’re vaccinated.