Health officials prepare for massive critical-care battle

Hey there, time traveller!
This article was published 07/05/2021 (1800 days ago), so information in it may no longer be current.

A rapid rise in the number of COVID-19 patients needing critical care has forced health leaders to limit non-urgent surgeries and prepare for more extremely ill Manitobans.

Shared Health chief nursing officer Lanette Siragusa told a news briefing Friday that the third wave of the virus is straining critical care in the province.

“We were given the gift of time, really, as we watched the other provinces escalate; we knew it was coming,” she said.

“We did not waste our opportunity and we spent our time, I think, preparing. It’s not to say it won’t be a challenge. These are very high numbers that we’re seeing.”

Some non-urgent and elective surgeries will once again have to be postponed as resources are redirected to accommodate and care for COVID-19 patients.

The impact will be significant, Siragusa said, adding some people will have to travel outside the city for surgery.

Surgical procedures in Brandon and at Grace Hospital have been decreased to make room, she said. Cancer, cardiac and other life-and-limb surgical procedures will continue.

As of Friday morning, 118 Manitobans were in intensive care; 56 were COVID-19 patients and six of them were under the age of 40.

Overall, there were 201 COVID-19 patients in hospital, 40 of whom were under the age of 40.

Officials at Health Sciences Centre said COVID-19 patients were being admitted to its intensive-care unit at a rate of 1.3 per day two weeks ago. Over the past week, the daily number has been five to seven; last Sunday, 10 people were admitted for critical care within a 24-hour period.

“It’s a pace that I don’t think any health system can manage,” said a provincial health-care official speaking on background.

“We were prepared with our planning for… one to two, even three admissions a day.

“But when we saw a day like we did on Sunday, where there were 10, that was extremely concerning. Which is why we expedited pulling our triggers this week.”

Health-care leaders say more patients are being admitted to hospital during the third wave compared to when cases spiked in late fall. The patients are also younger and in better general health than the second-wave admissions were.

Intensive-care admissions peaked at 129 then.

“We are getting close to that now,” Siragusa said. “If we sustain those high admission numbers over the next days — not even weeks — we could reach that number.”

The province was prepared to open as many as 115 beds, including 13 in Brandon, by using recovery space and other areas for expanded ICUs. The overall number does not include beds prioritized for cardiac patients.

In a worst-case scenario, the number of available critical-care beds can be expanded to 173.

“In this situation, there are variables that we have to watch and see what happens with the variants of concern, with the immunized staff, with the younger population and also with the public response,” Siragusa said.

There is currently room for COVID-19 patients who do not require critical care, and the province has expedited the placement of 205 people waiting in hospitals for personal-care home beds.

A virtual outpatient program has reduced the number of patients in hospital, providing virtual check-ins with people recovering at home who require oxygen support.

The province said 39 nurses completed an orientation program last month to work in ICUs supporting critical-care nurses. Since April 2020, a total of 130 nurses have completed the program, and recruitment is ongoing.

To handle the longer-term impacts of COVID-19, Siragusa said the province will add 60 full-time-equivalent nursing positions for people who want to work in critical care.

Officials issued a voluntary callout to nurses with relevant experience to prepare for a shift into ICUs two weeks ago and staff are already being redeployed. Ambulatory-care clinical staff are being asked to pick up shifts in ERs, where demand is expected to increase.

As of Tuesday, the Children’s Hospital ER will treat people up to the age of 19, Siragusa said.

One hospital leader at the media briefing said test-positivity rates are no longer a reliable indicator of hospital admissions.

“If people are refusing to get tested because they want to make a statement or they don’t believe that this is a real disease, then we will be blind as to what’s going on,” said the official, who spoke on background.

“I’m concerned that with fatigue or varying opinions on this disease, that some people have decided they’re not going to get tested, and that hurts us in our ability to predict.”

danielle.dasilva@freepress.mb.ca