Quebec to postpone surgeries in preparation for wave of Omicron hospitalizations
Thousands more surgeries will be postponed to free up space in hospitals, beleaguered by staffing shortages
Quebec is planning to postpone surgeries and is requesting support from the Canadian Armed Forces to prepare for an expected spike in hospitalizations due to the Omicron variant.
The goal is to add staff to vaccination centres in order to boost the third-dose campaign.
Part of the plan is to postpone half of scheduled surgeries to free up space in hospitals, which have been decimated by acute staff shortages, according to Radio-Canada.
Some smaller hospital emergency rooms may also have to close to respond to the rise in COVID hospitalizations. Urgent procedures, such as cardiac and cancer-related surgeries, will continue.
Tuesday, Deputy Premier Geneviève Guilbault asked Ottawa for assistance with Quebec's vaccination efforts.
"We are seeing a worrying increase in hospitalizations," Guilbault wrote in a letter addressed to Bill Blair, the federal minister of emergency preparedness, requesting help from the military and any other organization the federal government could deploy, such as the Red Cross.
"One of the measures favoured by our experts to avoid reaching capacity limits is to speed up the vaccination campaign for the third dose and thus reduce the effects of the new variant's contagiousness."
Though Quebec Health Minister Christian Dubé used strong words to describe the province's epidemiological situation in announcing a host of new measures Monday, many front-line workers and experts are asking the province to do more.
Premier François Legault is holding a news conference at 6 p.m. Wednesday and is expected to announce more measures to curb the variant's spread.
"At this point, the trend suggests we will have a much bigger rise in caseload before we see a plateau and if that's the case, it's certainly going to impact our hospitalization capacity in Quebec," said Dr. Patrick Bellemare, who is head of the intensive care unit at Montreal's Sacré-Coeur Hospital.
The current hospital capacity in the province appears to be at its lowest of the COVID-19 pandemic so far.
While public health data shows that in July and August, Quebec hospitals had the capacity to take in 1,780 COVID patients, that number is now at 671.
On Tuesday, there were 415 people in hospital with COVID (not including those in intensive care), and that number has been rising by nearly 20 a day.
"We are eight million people in Quebec. We are at war. We're at war right now against this virus," Dubé said Monday, adding that the province had to close schools, bars, gyms, movie theatres and concert venues in order to protect the health-care system.
"This is du jamais vu. It's unbelievable. The only way to manage this crisis is to react as quickly as possible with the resources that are available," he said.
150,000 Quebecers waiting for surgery
Part of the reason there is reduced capacity is that hospitals took on a larger load of non-COVID patients in the fall to make up for the lack of care they were able to provide during previous waves, according to some health experts. Those cases have also been sicker because of that lack of care.
More room can be made by cancelling non-urgent procedures, as the province is expected to do, but that means an even heavier burden later, which will also be hard on the system.
"As a society, we can't afford to postpone surgeries that require urgent care and there's a time variable that can make a difference between life and death," Bellemare said.
More than 150,000 Quebecers are waiting for surgery, including 19,000 who have been waiting for over a year. Before the pandemic, there were 2,600 people who had been waiting for that long. Typically, 35,000 operations are performed every month in Quebec.
More than 4,000 workers off due to COVID
The health-care network is also short thousands of workers, many of whom have left during the pandemic, exhausted by its toll. In addition, more than 4,000 health workers are off the job, either because they were infected or because they were in close contact with a case.
"We're digging into every last ounce of energy that we have," said Dr. Joseph Dahine, an intensive care specialist at Laval's Cité-de-la-Santé Hospital.
Dahine said those who remain working in the system are doing so out of compassion for patients and in solidarity with their colleagues, who take on more work as more leave, but it hasn't been easy.
"It's never been an issue about a number of beds, but rather, staffing those beds," he explained.
WATCH | 'We're digging into every last ounce of energy that we have': Quebec ICU doctor:
Dr. Fatima Kakkar, an infectious diseases specialist at Montreal's Sainte-Justine Hospital, said many staff were also seconded to do vaccinations.
"We're coming to the critical point in the holidays where people were planning to be absent," Kakkar added. "The biggest danger is we're actually going to be missing personnel over the next few weeks if these cases continue to rise as they are."
Cracks in health care showing
The pandemic has revealed a number of cracks in government systems over the past two years, but one a Montreal university professor believes has been overlooked is hospital preparedness.
François Béland, a Université de Montréal professor specializing in public health systems, says hospitals in the province did not adjust to prepare for future pandemics, despite facing SARS and H1N1.
"Hospital funding has not changed [in recent decades], the only thing that has increased is doctor revenues," Béland said.
Hospitals in Quebec were already stretched thin before the pandemic, when they should have been operating with more than enough staff, Béland said.
He said Quebec's health-care system is too top-heavy and could have better responded to the pandemic and sooner detected major outbreaks in long-term care homes if there had been more of a focus on local and home-care services.
Dr. Donald Vinh, an infectious disease specialist at the McGill University Health Centre, worries what will happen if hospitals run out of capacity for COVID patients.
"If the models are correct, we may risk doubling the number of hospitalizations in two weeks. That's a rate that is not going to be sustainable," Vinh said, adding that in previous waves, doctors were given instructions on how to prioritize patients in need of acute care.
"As a doctor, I can't even imagine having to triage people. To put us in that kind of situation, there's not one physician who feels comfortable with that for something that is as controllable and preventable as COVID."
With files from Lauren Mccallum