Hospitals Struggle to Cope With Increase in COVID Patients

Hospitals Struggle to Cope With Increase in COVID Patients
Paramedics transport a man to the emergency department of the Mississauga Hospital in Mississauga, Ont., on Nov. 19, 2020. (The Canadian Press/Nathan Denette)
Shane Miller

As COVID-19 cases rise and hospitals in many parts of the country face rapid increases in patients, there are concerns about the ability of the health-care system to cope with the influx and still deliver a certain quality of care.

In the third week of November, the situation in Ontario’s hospitals reached a critical point, with 150 patients in the province’s intensive care units. That number crossed a threshold that the government had indicated could lead to cancelled surgeries.

This development coincided with the government’s announcement that new lockdown measures would begin on Nov. 23 in Toronto and the Peel and York regions. The urgent need to protect hospital capacity was among the reasons.

But many health professionals expressed concern that this situation may hinder the ability of those who need other non-COVID-related care to receive it if surgeries and other treatments are cancelled to enhance capacity.

A similar situation has developed in Alberta. An Alberta Health Services (AHS) memo obtained by Global News said hospitals in Edmonton and Calgary are operating “frequently exceeding 100 percent” capacity, with some units operating at as high as 125 percent. The memo was sent by email to all AHS staff and volunteers in the second week of November.

In Manitoba, which has recently experienced record-breaking numbers of COVID-19 cases and an accompanying increase in hospitalizations, public health officials worry that hospitals will become overwhelmed since they are already near capacity.

Bacchus Barua, associate director of health policy studies at the Fraser Institute think tank, says health-care officials deserve praise for the work they are doing during the pandemic, but the situations they find themselves in are also due to conditions that have existed long before the crisis struck.

“While COVID has clearly impacted the health-care system in meaningful ways, historical data suggests that many of Ontario’s current challenges started well before the pandemic,” Barua said in an interview.

A CBC News investigation found that many Ontario hospitals regularly operate beyond capacity—even apart from COVID-19 or the flu season—making “hallway medicine” a prevalent phenomenon, with overcrowding causing patients to be placed in places such as hallways, auditoriums, and conference rooms.

With reference to these issues, a new report by the Fraser Institute, authored by Barua and his colleague Mackenzie Moir, explores the performance of Canada’s health-care system compared with other affluent countries with universal health care. It concludes that Canada’s spending remains among the highest while its model continues to yield disappointing outcomes.

“Canada ranks 26th for physicians, 14th for nurses, 25th for curative (acute) care beds (out of 26), 24th for psychiatric care beds per thousand population, ranked 7th (out of 25) for long-term care beds per thousand population (65 and over),” the report says.

“Except for above-average availability of long-term care, and middling nursing density, Canada clearly has many fewer human and capital medical resources per capita when compared to other high-income OECD countries with universal health care.”

Looking ahead, Barua says the present crisis should be seen as an opportunity to study the universal health systems elsewhere that are performing better and explore reforms that could improve Canada’s model.

“In the present context, I suppose the best we can do is support our health-care workers as best as we can, and perhaps look into forming partnerships with third-party private clinics to contract public services and reduce the burden on the public system,” he says.

“However, in the longer run, we should use this opportunity to study other universal health-care models—not just with regard to how they respond to COVID, but how their models function in a broader sense.

“While just about every country around the world has been affected by COVID, it’s important to recognize that when we get through this pandemic, they will return to a very different normal’ in comparison to Canada. Let’s try and find a way to return to a better normal’ in Canada—one where overcrowded hospitals and long wait times are no longer the norm.”