Hamilton hospitals may let COVID-positive staff work if Omicron continues to surge

Hamilton hospitals may allow COVID-positive staff to work, put patients in "unconventional spaces" like hallways and sun rooms and close regional programs if Omicron overwhelms them.

Those last-resort measures are not happening now, but hospital leaders at St. Joseph's Healthcare Hamilton and Hamliton Health Sciences (HHS) said Tuesday those plans are in place if needed.

It's unclear how bad things would need to get for COVID-positive staff to be required to work or what the process would look like, but that also been discussed in Ottawa and British Columbia.

However, unlike jurisdictions like Niagara, which has changed its vaccination policy, the local hospital networks told CBC Hamilton they will still terminate unvaccinated employees.

"Vaccines are an important measure in our collective fight against the pandemic," said HHS spokesperson Wendy Stewart.

The possibility of COVID-positive staff working was mentioned on Tuesday afternoon during a joint press conference between HHS and St. Joe's.

The six experts and hospital leaders at the conference all emphasized that the situation is dire, with hospital beds filling up rapidly and the number of staff dwindling.

Hamilton is among the hardest hit cities of the Omicron wave, based on its high rate of hospitalizations, and local modelling projects there could be up to 1,046 new hospital patients with the virus by the end of February.

Hamilton hospitals near or at capacity

Dr. Greg Rutledge, St. Joe's chief of emergency medicine and the deputy chief of staff, said the hospital has 87 COVID-19 patients and 15 in the intensive care unit (ICU), which is close to full.

He said while people are more commonly coming in with less severe illnesses — like fatigue, cognitive decline and weakness — there are far more patients, putting a different kind of strain on hospitals compared to the last wave.

He also said about half of cases coming in are people with one vaccine dose or none, while Dr. Bram Rochwerg, the site lead of an HHS intensive care unit, said the majority of ICU patients are unvaccinated.

Sharon Pierson, HHS executive vice president of clinical operations and chief operating officer, said the hospital network has 171 COVID-19 patients and 23 in the intensive care unit (ICU) and fewer than five people using ECMO machines, an artificial heart-lung bypass for the sickest patients.

For comparison, on Jan. 5, at HHS and St Joe's combined, there were 230 COVID-19 patients in hospitals and 36 in the ICU.

"Three months ago if we looked at our COVID numbers, they only accounted for six per cent of our adult occupancy, today that number is 17 per cent," Pierson said.

"We're all going to have to be extremely innovative ... in terms of 'where else can we physically find space for patients.' "

Bruce Squires, president of McMaster Children's Hospital, said the hospital has paused scheduled, less-urgent procedures to free up staff due to "intense pressures" in areas like the neonatal intensive care and pediatric critical care units. The last four months, he said, have also led to record-high occupancy levels at the facility.

Rutledge said St. Joe's hospitals are around 95 per cent capacity. Pierson said HHS hospitals are well above 100 per cent capacity.

To try and accommodate patients, with and without COVID-19, HHS opened up 70 more beds.

'Uncertainty hangs over us all'

The hospital networks are also managing more outbreaks than ever, which has also contributed to the ramping down of some services and staffing shortages.

Rochwerg said there are also staff on leave due to stress or exhaustion and most in isolation got COVID-19 in the community.

Data from both hospitals shows there are 709 staff in self-isolation.

"This uncertainty hangs over us all, right? And is tomorrow going to be worse than today? And I'm already being asked to be stretched today, how much more can I stretch tomorrow or a week from now?" Rochwerg said.

"It's palpable. You walk around the halls of the hospital and I think we all want to feel like we're doing our best and caring for patients, but there's this uncertainty and you don't know where things are going and you see the trajectory and you feel the stress from folks."