Saskatchewan putting lives at risk by not sending more ICU patients to Ontario, says doctor

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Saskatoon's intensive care units are so overwhelmed with COVID patients that some people are being treated in a laundry room, says Dr. Hassan Masri.

So he was taken aback on Wednesday, when the province appeared to have halted a plan to transfer Saskatchewan ICU patients to Ontario.

Saksatchwan has already moved six ICU patients to Ontario since Monday, and Ontario Health had said it was prepared to take at least six more.

Then on Wednesday, Dr. Michael Warren, medical director of critical care at Michael Garron Hospital in Toronto, tweeted that Saskatchewan had cancelled its plans to send more patients, without giving a reason. 

The province said on Wednesday it could not say whether more patients would be transferred out of province, or when. On Thursday it confirmed three more patients would be transferred by Sunday.

In an email to CBC, Saskatchewan government spokesperson Matthew Glover said patient transfers are "an extremely complicated process which requires a high level of technical consideration, medical oversight and review."

The sudden halt of transfers on Wednesday was shocking news to Masri, an intensive care physician at Saskatoon's Royal University Hospital. He was already in the midst of preparing to transfer patients when he saw Garron's tweet.

He spoke to As It Happens host Carol Off on Thursday, before the province confirmed it would go ahead with three further patient transfers. Here is part of their conversation.

We just heard Chief Medical Officer for Saskatchewa Dr. Saqib Shahab [break] down into tears about the situation in your province. Just how bad is it at your hospital?

The situation is certainly quite terrible here in Saskatchewan in general, and certainly here in Saskatoon in our hospitals. ICUs have been at maximum capacity for the last few days.

Many patients that deserve to be in the ICU are not in the ICU due to the fact that the ICU is full. Many people in the ICU are housed ... in rooms that are not designed to be ICU rooms. There [is] actually a laundry room that's converted to an ICU room in Saskatoon.

This is reckless, dangerous behaviour.- Dr. Hassan Masri, Royal University Hospital

Hospitals in Ontario were ... willing [and] able to help you with those ICU patients. And Saskatchewan sent six ICU patients to Ontario. And then what happened? Why haven't there been more transfers?

Yesterday myself and my colleagues were planning for patients No. 7,8 and 9 to leave Saskatchewan today, when we suddenly heard from doctors in Ontario — not from our own government, but we heard from doctors [in] Ontario — that the transfers have been cancelled. And then later on it was confirmed that it was cancelled.

This is reckless, dangerous behaviour. We need to move these patients. We need to move another 30, 40 patients in order to really make sure that people who are … not in the ICU who deserve ICU care are in the ICU. We need to make sure that all serious cancer, heart, brain surgeries go on and [are] not cancelled.

Unfortunately, this is something that is political and there were really no medical reasons to cancel this. This is something that would really help Saskatchewan quite a bit and relieve the pressure that our ICUs have been handling for the last few weeks.

Dr. Michael Warner, who is quite outspoken in Ontario ... told CBC that Ontario has 2,300 ICU beds [and] 1,700 are occupied. So lots of capacity, tremendous capacity, to help without endangering the health of Ontarians, he said. And I believe it was his tweet that told you that the other patients that you were preparing were not going to go to Ontario, right?

Correct ... and people in leadership and on health care here in Saskatchewan were not made aware that the government had made this unilateral decision.

Currently, the citizens of Saskatchewan are receiving less-than-ideal care because of the stretched resources, because of lack of availability, because of everything else that has been going on for a few weeks now.

Ontario, as a much bigger province, could easily accommodate 50 or 60 patients. And if we were able to transfer that many patients, it would provide a lot of help.

The people in Saskatchewan do not deserve to be cared for in laundry rooms.- Masri

I imagine when you're preparing people to transfer, these are critically ill people who have families, who have support. There's a lot of fear around their health at that point. Everything about that transfer to a long distance to Ontario must be very fraught. So how do people respond? Especially when you find out that last moment, through a tweet, that people who you're anticipating are going to get the care they need suddenly can't?

When I sat down with the families of the patients who are being transferred to Ontario, they were gracious. They were kind. They were understanding.

The transfer of patients to Ontario is done after an extensive amount of selection and workup to make sure that these people are, indeed, safe to transfer to Ontario. But, you know, in addition to that, families understand that we are in trouble. I mean, they walk into the ICU to visit their loved ones. They understand. They see it. And really, everyone in this province, with the exception of the premier and his office, have a good understanding of what's going on.

The Saskatchewan government is saying that they have not confirmed whether more patients will be transferred. When asked about Ontario, these transfers, [Saskatchewan Public Safety Agency president] Marlo Pritchard said that [the provincial Emergency Operations Centre doesn't] know where that number came from that there would be six more transferred. So where is the confusion in this?

There really is no confusion whatsoever. The Ontario ICUs were told upfront that they will be receiving 12 patients, and we know that this was a preliminary number to start with. But everybody in the health organization knows that we were already underway in making efforts to move three patients today, two patients on Friday, three on Saturday and two on Sunday.

If there are no plans to move ... more than six patients, then that tells you a lot about the poor planning on the side of this government. It is very obvious that in order to make even the slightest difference, we need to move 40, 50 patients.

So if the government would like to maintain their talking points about confusion, then that's quite embarrassing for them because of the fact that moving six patients is not really not enough at all. There has been zero difference made to the system by moving only six patients.

Unfortunately, this government is mastering the game of politics over mastering the responsibility of taking care of people. 

This government is now chartering on very, very dangerous territory where it's putting pride and politics ahead of the lives of the people here in Saskatchewan. The people in Saskatchewan do not deserve to be cared for in laundry rooms. And the people in Saskatchewan deserve to get the exact same ICU care that every other ICU in the country is giving them.

Written by Sheena Goodyear with files from CBC Saskatchewan. Interview produced by Sarah Jackson. Q&A has been edited for length and clarity.