Quebec pediatric hospitals overrun, doctors label situation as 'historic crisis'

Dr. Beth Foster says she has never seen pediatric hospitals in such critical condition in her life.

The Intensive Care Unit (ICU) at the Montreal Children's Hospital has been full for weeks. Single patient rooms have been converted to two-patient rooms for children with the same viral illness. Physical space is running out and staffing shortages are serious.

Foster, the chair of the department of pediatrics at McGill University and pediatrician-in-chief at the Children's, said she thinks "it's going to get worse before it gets better," due to the nature of viral illnesses that are affecting children disproportionately.

Children's hospitals across Quebec and parts of Canada are in the same boat, as respiratory viruses, including respiratory syncytial virus (RSV), "overload" the system, said Dr. Marc-André Dugas, chief of the pediatric unit at Quebec City's Centre hospitalier de l'Université Laval (CHUL).

In Montreal, the ICUs at the Children's and Sainte-Justine Hospital have reached their capacity, prompting officials to transfer some patients to regional hospitals, including Sherbrooke's Fleurimont hospital (CHUS) and the CHUL in Quebec City.

'Historic Crisis'

Foster is one of several pediatric care specialists who signed an open letter in La Presse over the weekend, describing the situation as a "historic crisis."

The letter said that, faced with unprecedented demand, hospital staff are required to make "impossible decisions" about which child receives care.

Dr. Fatima Kakkar, a pediatric infectious diseases specialist at the Sainte-Justine's mother and child hospital in Montreal, says the lower influenza vaccination rates and the rollback of COVID-19 safety precautions, including the wearing of masks in public spaces and large gatherings, have contributed to the situation.

"I've been at Sainte-Justine's for over 10 years and this is the busiest I've seen our hospital," said Kakkar.

"I don't think we're at the peak quite yet so we're a bit concerned about the next three to four weeks."

Children transferred to ICUs hours away

In the past month, Sainte-Justine Hospital confirmed eight patients from the South Shore were redirected to Sherbrooke and five patients from Mauricie and Central Quebec were redirected to Quebec City.

As a general rule, a child admitted to intensive care in a pediatric hospital remains in the same hospital for the entirety of his or her stay in that ward, said the Health Ministry in an emailed statement.

In case of overcrowding, a provincial system determines the location of available intensive care beds and the hospital most prepared to accept the next patient, said Foster.

"It's very good to have this kind of co-ordination. The problem is that transferring critically ill children is obviously challenging. There are some risks involved," said Foster.

Hal Newman, a former paramedic and a writer behind the Facebook page, the Last Ambulance, shared stories from paramedics who transferred kids between regions by plane or ambulance. He says the situation is heart-wrenching for parents.

"If your kid is seriously ill and you're a parent living in the Laurentians and they transfer [them] from Saint-Jérôme, let's say all the way to the CHUS [in Sherbrooke]... Then where do you stay? Do you have family there? How does that all get arranged?" said Newman.

"[It's] very stressful for the parents. My heart goes out to them."

Suggestions for parents

Added to the stress of overcrowded hospitals, doctors say the shortage of children's acetaminophen, a medication often used to treat fever, is worrisome and can contribute to the high hospitalization rates, as parents struggle to keep fevers down.

Kakkar suggests that parents should focus on treating their child's fever if they become uncomfortable, cranky and unwilling to eat or drink.

"If they're child is in that state with the fever, my first suggestion is to check with the pharmacist," said Kakkar.

She added that as a way to prevent further infections, Quebecers should consider getting vaccinated for influenza and return to wearing masks indoors or in busy spaces.

At a news conference today, Health Minister Christian Dubé and public health officials recommended Quebecers wear masks in crowded public spaces.

To help relieve the pressure on the hospital system, Dubé says priority will be on reducing the pressure on the emergency rooms. People are encouraged to call 811, which can connect phone users with a nurse for non-urgent health problems, says Dubé.