There are some signs the sixth COVID-19 wave may be peaking in Ontario, Canada’s most populous province. But hospitals are facing a double whammy of new COVID infections and, to a much greater degree, health workers off sick or isolating due to COVID just as some had begun to tackle pandemic backlogs.
COVID hospitalizations in Ontario are below their January peak but, as a lagging indicator, keep rising after estimated infections may be peaking.
Health worker absences are hitting operations when burnout is high and as hospitals struggle to cope with years of deferred care, administrators say.
There are between 225,000 and 250,000 people in Ontario awaiting surgeries, the province’s health agency told Reuters, up from about 200,000 before the pandemic.
This week the Monfort Hospital in the national capital of Ottawa had to postpone “non-urgent interventions” — about 5% of the surgeries and procedures scheduled for Tuesday, a spokesperson said.
“We don’t know exactly how long we will have to postpone procedures; the situation is changing rapidly and we are reassessing the need to reduce activity every day, which depends very much on our staff returning to work in the next few weeks,” the spokesperson added.
The western Quebec health region of Abitibi-Temiscamingue put a “partial and temporary” cap on obstetric services in one of its hospitals from April 15 to 18, a spokesperson said.
In Ontario, the Kingston Health Sciences Centre had not yet returned to 100% surgical capacity. Over the last few weeks, the hospital has seen “a small number of ad-hoc operating room cancellations” for non-emergency procedures due to staff shortages, according to a statement.
In the first waves of the pandemic, the center cut as much as 60% to 70% of surgeries. But they found patients whose procedures were cancelled would worsen and end up in the emergency department, Chief Operating Officer Renate Ilse told Reuters.
And there is less room to cut now, Dr. Ilse said. After two years of pandemic “there’s a lot of accumulated deferred care.”
Hospitals are strapped for staff. The vacancy rate in the health and social assistance sector was 5.5% in the fourth quarter of 2021, the highest quarter since at least 2015, according to Statistics Canada.
“We hear a lot of conversations that say we should start planning to just live like this and manage like this. I don’t think we could do that, from a staffing perspective,” Ilse said.
Another Ontario facility, Hamilton Health Sciences Centre, which is operating at 80% of its pre-pandemic capacity, has not scaled back procedures in this wave, said its physician in chief, Dr. Khalid Azzam.
Azzam, however, sees the impact of years of deferred care come through his hospital doors.
“There’s no doubt we do see, anecdotally, increased burden of illness and presentation of patients with advanced heart disease, advanced cancer. … This is most likely due to delays in care in the past two years.”