Canada ‘Tipping point’: A look inside Canada’s hospitals as COVID-19 variants surge

15:20  08 april  2021
15:20  08 april  2021 Source:   globalnews.ca

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Seuyan was hospitalized at the Humber River Hospital in Toronto for nearly two weeks after testing positive for the B.1.1.7 coronavirus variant last month.

The 55-year-old registered massage therapist said she felt feverish at the start and knew right away that it was COVID-19.

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“It was really scary. I had a really high fever for one week probably,” the patient told Global News.

As more contagious coronavirus variants continue to spread across Canada, hospitals are grappling with an increase in intensive care unit (ICU) admissions and wait times in emergency rooms.

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As of Wednesday, more than 16,000 cases of variants of concern (VOC) had been reported in all 10 provinces. Evidence suggests that VOC can cause more severe illness and an increased risk of death.

With ICU beds occupied at full capacity, a higher number of young patients and staff feeling burnt out, it is a dire situation, front-line health workers say.

“We're definitely knee-deep or maybe hip-deep into the third wave right now,” said Dr. Jamie Spiegelman, internal medicine and critical care specialist at Humber River Hospital.

Read more: Gripped by third COVID-19 wave, will new restrictions rescue Ontario?

The health-care system is at a “tipping point”, he added, with a large portion of the ICU admissions concerning new variant cases.

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Doina Budeanu, a nurse at Humber River Hospital, said the “acuity of the patients”, especially more young people, was a major concern.

“They're very, very sick…and they can turn on a dime,” she told Global News.

Across Ontario, hospitalizations are up by 41 per cent over the past two weeks and new variants of concern now account for 65 per cent of all cases in the province.

According to the modelling released by the Ontario COVID-19 Science Advisory Table last week, the risk of ICU admission is two times higher while the risk of death is 1.5 times higher in regards to the VOC, which originated in the U.K. (B.1.1.7).

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While the symptoms for variant cases are not any different, they are more intense, said Dr. Amir Ginzburg, a specialist in internal medicine at Trillium Health Partners.

We're seeing a lot of breathing compromise, for example, resulting in people going to our intensive care units,” he told Global News.

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“We are worried about what the next few weeks are going to bring us as cases continue to accelerate.”

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Meanwhile, the rapid spread in British Columbia of the P.1 variant, which was originally found in Brazil, is a worrying trend, experts say. In just a matter of days, cases of the P.1 variant there have surged from double to triple digits.

On Monday, B.C. Health Minister Adrian Dix warned that the variants could soon drive the transmission of COVID-19.

Dr. Joseph Finkler, an emergency physician at the St. John’s Hospital in Vancouver, said he and his colleagues are seeing an uptick in COVID-19 patients and there were increased delays in getting them treatment.

We have lots of people sitting in the beds waiting to find out their COVID-19 status so they can be admitted to a ward,” he told Global News.

You're waiting eight hours or six hours for a decision. It is backed up.

Video: B.C. health officials on ‘aggressive case management’ of COVID-19 variant

It's a similar situation in Alberta.

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Dr. Shazma Mithani, an emergency physician at the Royal Alexandra Hospital in Edmonton, said there is increasing pressure on the hospital capacity because COVID-19 patients have to be kept separate from each other until their variant status is determined.

Read more: COVID-19 variants reducing hospital capacity, increasing ER wait times: Alberta doctor

“We're seeing a dramatic increase in wait times in the emergency department right now, and one of the main reasons for that is actually our inability to move patients up as readily because of the COVID-19 variants,” she told Global News.

In waves one and two of the pandemic, Mithani said COVID-19 units could cohort between two and four positive patients in the same room.

But that is not the case anymore as the hospital isn’t allowed to cohort patients together until their variant tests results come back.

“So that effectively reduces our hospital capacity in the COVID wards upstairs and that trickles down to the emergency department, where we cannot move patients up as quickly, and that spills into the wait room with increased wait times.”

While infections have declined in Canadians aged 80 and older since January, case counts are now highest among young adults aged 20 to 39, according to the latest national public health modelling released March 26.

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The rise of new, more transmissible variants, vaccination programs focusing on the elderly and coronavirus fatigue are driving the spread among the younger group, experts say.

Read more: ‘Hit the hardest’: Why COVID-19 cases are rising among young Canadians

It is a worrying trend with many young people ending up in ICU wards.

“It's incredible how many younger people we're seeing. And I'm talking younger in their 20s and 30s, people with no comorbidities, people who are healthy, who are coming in with low oxygen, who are coming in and feeling unwell or getting admitted into the ICU,” Dr. Marko Erak, an emergency physician at Humber River Hospital.

Dr. Tasleem Nimjee, the physician lead for the COVID-19 emergency response at Humber River Hospital, said, “It’s hard to stomach when you see young people that are otherwise well that you wouldn't expect to see this sick.”

Shortage of staff and beds is also a concern, forcing hospitals to transfer COVID-19 patients to others in the city.

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“This is the most challenging time for all of the healthcare workers with the amount of stress that they all have,” said Leo Zhu, manager in the emergency department at Humber River Hospital.

Thirteen months into the pandemic, front-line workers are continuing to feel fatigued.

“We're tired and there's moments where we're also frustrated, but we're resilient and we are prepared and we are doing absolutely everything that we can be doing to manage the increased volumes that come,” said Ginzburg.

With files from Global News’ Jeff Semple and Heather Yourex-West

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