Ontario tells hospitals to activate emergency plans as number of COVID-19 patients spikes

Hospitals across Ontario have been ordered to brace for a spike in COVID-19 patients.

A memo from Ontario Health obtained by CBC News tells hospitals to prepare to activate emergency plans immediately. For hospitals in the province's grey lockdown and red control zones that means clearing up to 15 per cent of their beds for COVID-19 patients.

Matthew Anderson, CEO of Ontario Health, a provincial government agency, said in the memo dated Tuesday that the pandemic has entered a more critical phase with community transmission now widespread.

Anderson said the ability of hospitals to care for patients with and without COVID-19 is being challenged. The memo was sent to every hospital CEO in the province.

The memo tells all hospitals to be ready to activate their "surge capacity plans" within 48 hours.

"As we are all aware, we have entered a more critical phase of the pandemic where we are seeing widespread community transmission," Anderson said in the memo. 

"Our ability to care for patients (COVID and non-COVID alike) is being challenged, so we are asking hospitals to work together, even more, to ensure we can continue to have the bed capacity to care for patients safely and effectively."

At the moment, Toronto, Peel and York regions and Windsor are in lockdown while Durham and Halton regions, Hamilton, Simcoe-Muskoka, Waterloo region, Wellington-Dufferin-Guelph and Middlesex-London are in the red or "control" zone in the province's colour-coded system for controlling the pandemic.

Hospitals in the rest of the province are being told to prepare their facilities in case the public health units in which they are located are moved into a red control zone.

"The actions we collectively take in the next days and weeks will set the stage for our ability to meet escalating and anticipated capacity demands," Anderson said. 

"Above and beyond actions at an individual organization's level, we must all take a holistic view to ensure we have a coordinated and equitable approach to serve our patients safely and compassionately across the regions."

'Wrong direction'

Anthony Dale, president and CEO of Ontario Hospital Association (OHA), says clearing 15 per cent of beds means shutting down some "elective activity" such as cancer and cardiac care and organ transplantation.

The consequences on individual patients and their families can be devastating, but he says the move is prudent and necessary given the state of the pandemic. There is a spike after every holiday in the province, he said.

"I've worked at the OHA in different roles for almost 16 years and I've never seen anything like this and I've never been as concerned as I am now about the capacity of our hospital system to care for the needs of the people of Ontario," Dale said.

"This pandemic is clearly rapidly accelerating. All of the hospitalization indicators, whether it's numbers of patients being admitted with COVID or admitted into ICU, requiring life-saving care, they're all heading in the wrong direction," he added.

"Unfortunately, we're heading into the holiday season. I can tell you that our entire sector is extraordinarily worried about people choosing to ignore public health measures and get together in the face of clear warnings about the risks to themselves, their family members and of course the ability of the health-care system to care for them if they do get quite sick."

Dale said health-care workers are not "someone's private army" and they need the public to do its part.

Hospitalizations top 900

The memo comes as the number of COVID-19 patients in Ontario hospitals surpassed 900 for the first time since May. 

The number of people in Ontario hospitals with confirmed cases of COVID-19 is now 921, up from 857 on Monday — an increase of 64.

Of those, 249 are being treated in intensive care and 156 require the use of a ventilator, up five and seven, respectively, from Monday.

Some hospitals in the GTA are already full and have resorted to transferring patients to other facilities to ease the pressure.

Hospitals in Scarborough, Brampton and Mississauga, for example, have cancelled scheduled surgeries, while hospitals in York Region and Hamilton have warned that a capacity crisis is imminent.

In a statement a week ago, the CEOs of three hospitals in York Region said Mackenzie Health, Markham Stouffville Hospital and Southlake Regional Health Centre had reached a "tipping point" in their ability to manage the volume of COVID-19 patients. 

"After seeing a significant increase over the last week in the number of COVID-19 patients admitted to our hospitals, we are concerned about how this may impact access to care like scheduled surgeries for all patients across our communities," the CEOs said.

"We are counting on our communities to help keep our staff, physicians and volunteers safe so they can continue to care for everyone who relies on us for care, for COVID-related illness as well as non-COVID-related illnesses and emergencies. 

The CEOs said while health care facilities had collaborated well to prepare for a second wave, it was the community's turn to step up.

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"What we need now more than ever is support from our communities to be vigilant in following public health guidance aimed at slowing the spread," the statement said.

The province recognizes that COVID-19 has put increasing pressure on hospitals, according to a spokesperson for Health Minister Christine Elliott.

"The situation we are seeing in our hospitals is a reflection of COVID-19 spread in the community," Alexandra Hilkene said in a statement.

"We continue to closely monitor the evolving situation and are committed to working with our partners to ensure there is capacity in hospitals across the province to provide care for any Ontarian requiring hospitalization."