Surge of COVID-19 patients pushing Ottawa hospitals to the limit

As COVID-19 patients continue to stretch Ottawa's hospitals to their limits, administrators are warning other patients may need to be transferred elsewhere for care.

"Hospitals are functioning differently, so there is a chance that you may not ... be admitted to the hospital where you present to," said Dr. Virginia Roth, chief of staff at The Ottawa Hospital (TOH).

"We are working as a region to make sure that everyone gets access to the care that they need, and it may mean that you're admitted to another hospital within Ottawa, or possibly even outside of Ottawa."

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While its Civic campus is currently at 99 per cent capacity and the General campus at 95 per cent, TOH is still faring better than many Toronto-area hospitals, which are beginning to transfer patients to this region for care.

"It's unfortunate when patients can't get care close to home, but we want to make sure that that care is available to the fullest extent," said Roth. 

Nearing capacity

As of Monday morning, TOH was caring for 58 COVID-19 patients, 20 of them in intensive care. Roth said the hospital has had to get inventive to handle the surge.

"What we've been starting to do, [and] other hospitals in the city have done the same, is converting other spaces into bed spaces. So for example, [in] a gym where physiotherapy would normally be conducted, we've got patients in that sort of space," she said. "Patients will get excellent care no matter where they're placed." 

Roth said the pressure on hospitals is greater than at any other time during the pandemic.

Physicians may be asked to make some difficult choices.- Dr. Virginia Roth, The Ottawa Hospital

"I would say this is the biggest challenge that the health system has faced through the pandemic, and so staff are feeling a bit stretched, and there's a fine balance between making sure patients have access to care like elective surgery, like clinic visits, and balancing that around the ... human resources that we need to care for acutely ill patients."

Roth said she believes TOH has an adequate supply of personal protective equipment and ventilators, but said staffing is becoming an issue. She said the province has developed a protocol for triaging critical care patients, should it be needed.

"Where there is a shortage of staff to care for patients who need ventilators, physicians may be asked to make some difficult choices," said Roth. 

Elective surgeries postponed

As reported last week, non-emergency surgeries have been postponed to free up staff to deal with the influx of COVID-19 patients. 

Unlike the early stages of the pandemic, many of the patients now presenting with coronavirus variants are younger, between the ages of 30 and 60, Roth said.

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"By the time you end of up in ICU, it is a long haul from there. It's usually weeks being on a ventilator, immobilized and the recovery is significant," said Roth. 

She said while vaccines will eventually help, for the next six weeks "we're in a real fight that we haven't seen so far in the pandemic."

Staff stretched thin

The Montfort Hospital has also seen a record number of COVID-19 patients — 20 as of Sunday, six in the ICU. Four of those patients were on ventilators. 

Montfort president and CEO Dr. Bernard Leduc said the hospital is also receiving patients from other regions, and elective surgeries have been postponed there, too. Leduc said the Montfort is at about 90 per cent capacity, and all but one of the ICU's 14 beds are currently occupied.

"The next few weeks will be very difficult," said Leduc. "The big problem right now is to get enough human resources to staff all of those beds, even if we had capacity. It's not like we we have an injection of qualified critical care nurses that just happened to arrive in the region."

Dr. Chris Simpson, executive vice-president of Ontario Health, the government agency coordinating health care in the province, confirmed there's already been a record number of patient transfers.

Simpson, a cardiologist in Kingston, said surgeries such as hernia operations and hip replacements will have to be delayed. 

"Doctors ... are used to having to make these kinds of calls. We're just now having to do it on a much larger scale, he said.