Plan to expand hospital capacity could more than double ICU beds in case of COVID-19 patient surge
Announcement of plan comes after Manitoba doctors signed a letter warning about strain on health system
Manitoba health leaders have a plan to more than double the number of critical care beds in the province should a surge of COVID-19 patients stretch hospital capacity.
The plan involves shuffling around staff and bringing in potentially thousands of students and other specialized health workers.
Health officials have mapped out space within hospitals that could be converted into intensive care units, expanding the number of intensive care unit beds from the current baseline of 72 to potentially 173.
Those beds would be spread throughout hospitals in Winnipeg and at the Brandon Medical Centre.
Officials have also identified space where more than 1,000 medical beds for COVID-19 patients can be added.
The number of patients with COVID-19 has more than tripled in the last two weeks, pushing capacity to the brink. As of Friday, there were 161 people in hospital with the virus, 20 of those in intensive care.
Details of the plan were shared with members of the media in a technical briefing Friday morning.
Doctors raise concerns
The Friday briefing came after two high-profile letters signed by Manitoba doctors called on the province to tighten restrictions and prevent the spread of COVID-19.
Dr. Anand Kumar, a Winnipeg intensive care doctor who wrote one of the letters and signed the other, said he still has concerns about the province's response and plan for hospital staffing.
"The primary bottleneck will be manpower and health-care workers, nurses, respiratory technicians, maybe even physicians. And that, I don't think has been adequately addressed," he said.
Doctors, including Kumar, received a separate virtual briefing from officials about the health-care plan on Thursday evening. Neither Premier Brian Pallister nor Health Minister Cameron Friesen were on the call.
Three-phased plan
The plan would be rolled out in three phases, depending on how high the demand for space is. In the first phase, medical and critical care beds would be created by reducing surgical beds.
In the second phase, additional space would be created by relocating some services and repurposing more space, while staff would be redeployed based on their skills and work history.
In the event of an extreme space crunch, non-COVID patients with lower health needs could be moved into spaces within the hospital not normally used for medical purposes, or to sites outside of the hospital, such as hotels.
There are up to 300 beds on hospital campuses that could be repurposed in such a situation, and 400 off-site beds have been identified, according to the plan.
These beds would be staffed by drawing workers in from other areas, including surgery, medicine and ambulatory care. Around 600 trained critical care nurses working in other fields could be brought in, as well as former and retired staff and approximately 6,000 students.
"Our biggest area of work at this point of time in time is staff planning," said Manitoba Shared Health Nursing Officer Lanette Siragusa at a news conference Friday afternoon.
"While we have the space, equipment and supplies, any planning amidst a pandemic is going to be challenged by maintaining appropriate staffing to provide safe patient care."
Health officials are in the process of putting together teams of specialists, led by critical care nurses, to care for patients.
Since the spring, the province has purchased hundreds of ventilators, beds, monitors and other equipment, as well as increased its stockpile of personal protective equipment.
The province now has a 90-day reserve supply of all essential items, except for a 53-day supply of small N-95 masks.
The plan to expand the number of hospital beds will be implemented gradually, as demand requires.
Siragusa said the province added six critical care beds. As of Friday morning, intensive care units (ICUs) in Winnipeg were at about 80 per cent capacity, while rural and northern ICUs were at about 75 per cent capacity.
More staff needed, doctor says
Much of the plan had been developed earlier this spring, Siragusa said.
Manitoba NDP Health Critic Uzoma Asagwara, who worked as a nurse before entering politics, said the plan unveiled on Friday is good, but it needs to be backed up by adequate government funding.
"If you're going to expand and have hundreds of more beds available, if you're going to expand and bolster ICU capacity, which we need to do, that has to be met with the staffing who can actually provide care," Asagwara said.
After the briefing Thursday, Kumar said he was reassured by the province's plan for equipment, but the largest concern for doctors — staffing — remains an issue.
He's urging the province to consider calling on health-care workers from other provinces or support from the military.
Kumar and other physicians are still pleading with the province to tighten restrictions and introduce further lockdowns. If that doesn't happen and cases continue to increase, Kumar said the consequences could be dire for the health-care system.
"We have a significant problem. We don't feel that it's being adequately addressed, and ... we think that if we don't go more aggressively at this from a public health point of view, that we will overwhelm the system."
With files from Karen Pauls and Marina Von Stackelberg