Physicians press for emergency order to triage rising virus caseload

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This article was published 24/05/2021 (1601 days ago), so information in it may no longer be current.

Manitoba’s pandemic stressed health care system is nearing the point where one in five of its COVID-19 patients in intensive care units have been shuttled out of the province to beds in Ontario.

A spokesperson for Shared Health said Monday four additional Manitoba COVID-19 patients were sent to ICUs in Ontario on Sunday, for a total 14 patients in beds in Ottawa, Thunder Bay, Sault Ste. Marie, North Bay, Windsor and London.

As of Monday, there are a total of 74 COVID-19 patients currently in Manitoba intensive care units, 11 of whom are under the age of 40, the spokesperson said, for a record 88 Manitobans requiring critical care as a result of the virus. Approximately 16 per cent of those patients are now in out-of-province hospitals for care. Shared Health said further patients were expected to be transferred later Monday.

The province also recorded 353 new cases as of 9:30 a.m. Monday. Over the holiday weekend, 1,237 cases were added to the provincial count, for a total of 5,061 active cases.

Test positivity rates remain high in Manitoba, hovering at 14.3 per cent.

As cases continue to rise and health-care workers struggle to manage existing caseloads of severely ill patients, the Canadian Medical Protective Association (a legal group representing physicians) submitted a letter to Premier Brian Pallister and Health Minister Heather Stefanson Friday (before the latter stepped down for a medical leave) asking for triage protocol to navigate critical care surges.

A triage protocol, enacted by emergency order, would provide a framework allowing health-care providers to prioritize access to ICU beds, the letter said, stating not enough resources exist to treat everyone in need. The triage protocol would create a system to help decide which patients get beds, which patients are transferred out of province and which could recover in makeshift ICU beds.

“Without a triage protocol, health-care providers will not be able to take the necessary steps to minimize the number of people who will die as a result of ICU overcapacity,” wrote Dr. Lisa Calder, CEO of the group.

“Manitoba is imminently facing the prospect of having insufficient ICU nurses and beds to manage the surge of patients with COVID-19, given the alarming rise of COVID-19 cases driven by new variants of concern.”

“Without a triage protocol, health-care providers will not be able to take the necessary steps to minimize the number of people who will die as a result of ICU overcapacity.” – Dr. Lisa Calder

Alberta and Quebec have already enacted similar protocols, the letter said.

Calder acknowledged the province has asked the federal government for critical care nurses and respiratory therapists, and has begun shuffling patients to Ontario hospitals, but noted the worsening situation has potential to further overwhelm the health-care system.

The Free Press obtained a copy of the letter, which Doctors Manitoba also forwarded to its members, reiterating the call for a triage protocol to “guide decision making” for critical care and ER physicians.

“In the absence of such a protocol, decisions are being made on an ad hoc basis, and that creates confusion and results in delays of care. Delays for intensive care, even just a few minutes, can have life-and-death consequences for critically ill patients,” wrote Doctors Manitoba CEO Theresa Oswald.

In a statement over the weekend, Doctors Manitoba said the organization “is trying to work directly with provincial health officials to resolve physicians’ concerns, including over this long weekend.”

“In the absence of such a protocol, decisions are being made on an ad hoc basis, and that creates confusion and results in delays of care. Delays for intensive care, even just a few minutes, can have life-and-death consequences for critically ill patients.” – Doctors Manitoba CEO Theresa Oswald

The federal department for public safety and emergency preparedness released a statement Monday confirming Ottawa will send Red Cross medical staff, Canadian Armed Forces and federal health human resources to assist.

The government is also “prepared to deploy epidemiologists, public health capacity, laboratory technicians and increased testing capacity” as needed.

Provincial leaders are also considering new strategies to tackle vaccine hesitancy by floating a vaccination incentive program.

On Monday, the province unveiled a survey asking residents for their take on vaccine rollout, the vaccine experience, and what a possible incentive program could look like.

Among the offerings for those hesitant to get the shot: meal or grocery vouchers, free admission to local attractions, free items at bars and restaurants, retail discounts, draws for prizes, and financial incentives up to $100.

So far, the province has administered 748,270 vaccine doses, including 12,977 scheduled for Monday. More than 50 per cent of Manitobans over the age of 18 have received at least one dose of a COVID-19 vaccine.

julia-simone.rutgers@freepress.mb.ca

Twitter: @jsrutgers