How Saskatoon hospitals are preparing for a surge in COVID-19 cases

A field hospital in an arena. "Negative pressure" rooms that keep the novel coronavirus from entering other parts of hospitals. Family physicians signing up to work for the Saskatchewan Health Authority as needed. 

These are some of the ways the SHA pandemic response team in Saskatoon is preparing for a potential surge in COVID-19 cases. 

Doctors answered questions about the logistics of the provincial plan at a news briefing on Thursday. 

Dr. Jasmine Hasselback, medical health officer for the SHA Integrated Health Incident Command Centre in Saskatoon, said medical staff know that a surge will come. 

"The question is when and to what scale," said Hasselback, adding that she has faith in the team in Saskatchewan. 

"I guess that uncertainty is present, but the reality is that we are working daily already to respond in the ways that are needed.

"There is the concept of, 'it's coming,' but also we're right in the middle of it in a different way, and so I am regularly feeling very thankful for that which is in place."

On Wednesday, the SHA revealed its plans and projections for handling the pandemic in different scenarios based on the extent of the outbreak.

The planning document, entitled Health System Readiness for COVID-19, confirmed the Merlis Belsher Place arena would be transformed into a field hospital with 250 beds. The hospital would be split between the arena and the nearby Saskatoon Field House indoor track and field facility. Both are on University of Saskatchewan grounds.   

Suzanne Mahaffey is the incident commander for the SHA response in Saskatoon. 

She said the $43-million facility would be ready for patients within four weeks, regardless of whether it is needed at that time. 

"If we need to expedite that based on the epidemiology and the number of cases, then we'll do so," said Mahaffey.

"We have very detailed footprints down to where the cots and the stretchers will be."

Stopping the spread in hospitals

The SHA projections released on Wednesday included modelling for a range of outcomes, including estimates of between 3,000 and 8,000 deaths and approximately 20 to 200 daily intensive care admissions from COVID-19 at its peak.

The document explained that there would be a staged response to increased demand using mixed hospitals with both COVID-19 and non-COVID-19 patients. 

Patients being treated for the virus would be separated by floors and units, a process that medical staff call "cohorting."

Dr. Jon Witt, the physician pandemic lead in Saskatoon, said the geographical location of Saskatchewan has afforded the local team with time and expertise.

"We get the benefit of learning from what has been done in other areas and where they've had some missteps," said Witt, adding that infection control within hospitals has been a major part of SHA planning. 

He said cohorting staff is also an important aspect of preventing the spread of the virus in hospitals. 

"We've really worked to have staff not move through the hospital or between the units because we've learned from our colleagues elsewhere," said Witt. 

"It might seem somewhat minor that somebody is going to see one patient on one unit and then on another, [but] this is how this virus will spread." 

More "negative pressure rooms" have also been created within the hospitals. 

Family doctors asked if they will join response

"When you're in that room, if you took a piece of tissue paper or something, it would kind of suck out against the vent, so it's sucking the air out of that room and venting it often through like a HEPA or a viral filter and then externally," said Witt. 

"So it isn't recirculated around the room and it isn't being spread throughout the hospital."

In the case of an "acute surge," additional beds would be opened up at all Saskatoon hospitals. 

In all, 1,266 COVID-19 beds and 301 non-COVID-19 beds would be spread between Saskatoon City Hospital, St. Paul's Hospital, Royal University Hospital and the field hospital at Merlis Belsher Place.

Beds are also being earmarked at the geriatric unit at the Parkridge Centre long-term care home. 

SHA staff are being taught additional skills and medical workers, such as family physicians, who do not work for the SHA have been asked to indicate their willingness in joining the pandemic response if needed. 

Witt said the SHA is prioritizing the most urgent care for people with non-COVID-19 conditions.   

Mahaffey said the health authority has paid particular attention to maintaining services for patients with mental health issues, addictions or anxiety. 

"Recognizing that they may need more support in the community so that they do not need health care in a hospital," said Mahaffey.  

"Our community mental health and addiction services, we were very hesitant to scale back any of those services because we know that the public really needs them and it is preventive medicine."

She said outreach services in core neighbourhoods are spending more time checking in on patients.

In late March it was revealed that the Calder Centre for addictions treatment had stopped taking new admissions for adult and youth patients — except for those going into the youth stabilization unit. 

Witt said the province still needs the public's help, especially as it heads into a long weekend.

"Please, please, please help us, and I know you are and I thank you for it, but stay safe, keep your space and continue all the good work that people are doing out there."