March 30, 2020

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Opinion

Hospitals mostly prepared, but Manitobans will determine how bad things get

Manitoba has more hospital beds per capita than the national average, the Canadian Institute for Health Information says. But will it be enough to handle the expected surge of COVID-19 infected patients who will require hospitalization?

Hospital capacity will be of the utmost importance over the next few weeks as health officials prepare for what could be one of the largest waves of hospitalization in Manitoba's recent history.

As of Wednesday, Manitoba had only one COVID-19 case in hospital; a patient recently diagnosed with the disease, listed in critical condition. But that number is expected to grow rapidly as more cases make their way into the province and as community transmission takes a foothold.

Manitoba has more hospital beds per capita compared with most provinces. CIHI’s most recent data says Manitoba has 2.7 beds per 1,000 people, well above the national average of two. By contrast, Ontario has 1.7 and British Columbia 1.8.

The other important metric to consider is bed occupancy — the percentage of beds currently in use. As of Wednesday, hospital bed occupancy in Manitoba was at 78 per cent. That’s a historically low rate. Winnipeg hospitals have regularly had occupancy rates above 90 per cent. From 2015-16 to 2018-19, the average occupancy rate in Winnipeg hospitals ranged between 90 per cent and 92 per cent.

At 78 per cent, Manitoba hospitals appear to be in a better position than usual to absorb an influx of patients. That number tends to fluctuate daily. But it does point to some flexibility in the system.

The number of patients admitted to hospital in Winnipeg awaiting a bed is also at historically low levels. According to Manitoba Health, there was an average of 22 admitted patients waiting for a bed in Winnipeg hospitals for the week of March 9 to March 15 (online data is updated weekly). That’s the lowest it’s been for that week since 2013 when it was 18. The highest in recent years was 74 in 2002.

One of the reasons for the decrease in bed occupancy rates has been a reduction in the number of seniors in hospital awaiting placement in a personal-care home. Last week there was an average of 12 patients in hospital awaiting placement. That’s down from 56 for the same week in 2017 and 64 in 2016.

Hospitals have several options to increase capacity, which they regularly employ during outbreaks of influenza (and are doing so now to get ready for the expected surge). That includes postponing elective surgeries to free up operating room space for beds, as well as opening temporary beds. For the COVID-19 pandemic, Health Sciences Centre has a created a dedicated intensive-care unit. Also, unions have agreed to relax collective agreement rules to allow health-care workers to be more easily deployed between units.

One of the biggest challenges now for hospitals is ensuring they have enough equipment to handle a surge of COVID-19 patients — both personal protective equipment for health-care staff, such as masks, gowns and gloves and medical equipment, such as ventilators.

There is no existing shortage of those supplies now, officials say. But the need to stock up on them is vital, because of the influx of patients expected to be treated in hospital in the coming weeks.

Will all these efforts be enough? No one knows. Government data modelling provides officials with projections on possible deaths and hospitalizations (which they don’t share publicly because the information can be misinterpreted, as we saw when projections were leaked in Saskatchewan this week).

All government can do is plan for something close to a worst-case scenario. The scale of the COVID-19 pandemic is far too great to even speculate what that might be.

In the end, the collective behaviour of the public will be the determining factor. The more vigilant Manitobans are in maintaining physical distancing, obeying self-isolation rules, washing their hands frequently and staying home when they’re sick, the less impact there will be on hospitals. It’s really that simple.

Governments can only do so much. It’s now mostly in the hands of the public.

tom.brodbeck@freepress.mb.ca

Tom Brodbeck

Tom Brodbeck
Columnist

Tom has been covering Manitoba politics since the early 1990s and joined the Winnipeg Free Press news team in 2019.

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History

Updated on Wednesday, March 25, 2020 at 6:39 PM CDT: Updates main chart

6:43 PM: Swaps lead chart

8:36 PM: Removes 100K rate chart

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