Toronto hospitals report surge in sick kids as some pediatricians still won't see them in person

When her 11-month-old son's fever neared the 40 C mark, Sonu Maan followed their pediatrician's advice and took him to Toronto's SickKids emergency department.

Maan said although Kiesh's cough, runny nose and fever were getting worse, it likely didn't warrant hospital attention. She'd much rather walk the half block to his doctor's clinic to put her mind at ease that he wasn't suffering from something serious.

But even after Kiesh tested negative for COVID-19 — and continued going to daycare — Maan said his pediatrician refused to examine him in person and, over the phone, recommended she take him to SickKids.

"It was really shocking to me his doctor wouldn't see him," Mann said.

"At least for the younger kids who can't really talk or communicate what they're going through, it's really important to get a doctor's examination."

She and Kiesh waited five hours in the busy emergency department one evening in July, and then were told they'd need to wait at least five hours more before a doctor would be available, Maan said. At 1 a.m. she called it quits and headed home. 

"I probably would not take him back to emergency," she said. "I felt like it made him more uncomfortable."

But months later, she and her son still face the same barriers, Maan said.

Kiesh has improved slowly but still has lingering symptoms and hasn't yet been examined by a doctor, his mother said. She's been told by his pediatrician that until her son's completely symptom-free, he can't come to the clinic even for a routine wellness check and vaccinations.

Her experience is one shared by parents across the Toronto area.

Last month, CBC News reported that Michelle Sadowski couldn't get her son Avery examined by his pediatrician. She took him to St. Joseph's Just for Kids Clinic where he was diagnosed with a severe ear infection.

Roxana Bakhshian took her 18-month-old daughter Elodie to SickKids last month. She'd been told by Elodie's pediatrician the emergency department was the best option if her child had any symptoms that could indicate she has COVID-19. After a seven-hour wait in the lobby, Elodie was diagnosed with an ear infection and given antibiotics.

"I shouldn't have to take my daughter to the hospital to get a simple check. Something has to give somewhere," Bakhshian said.

SickKids records busiest August in years

The Ministry of Health said since July, it has encouraged all doctors to resume seeing both kids and adults in person.

While August is usually SickKids emergency department's quietest month, so far this year it's the busiest with close to 6,000 patients — 40 per cent more than the same month last year, and 15 per cent more than in 2019, said division head Dr. Jason Fischer.

The hospital has also noticed an increase in patients with less serious or "low acuity" illnesses.

Fischer said it's because patients have less access to community medical care, or think they have limited options. 

When asked what he'd say to doctors hesitant to see patients in their offices, Fischer said: "We know there are lots of family physicians and pediatricians that have made the adjustment to see these patients in person. I think there's a lot we can learn from those individuals."

St. Joseph's Health Centre is also reporting its kids clinic is as busy or busier than before the pandemic, reaching capacity daily, and will soon be expanding its hours to meet the demand, said spokesperson Jennifer Stranges. 

"If a child has a dedicated primary-care provider, we encourage parents to call the provider first to discuss the health issue and navigate next steps," she said. 

The clinic is supposed to be a back-up for when family doctors aren't available or a child's symptoms are urgent but not an emergency, Stranges said. 

Nikki Bergen took her sick toddler Gabrielle to St. Joseph's a few weeks ago as instructed by her pediatrician, who wouldn't examine her in person even after a negative COVID-19 test. Bergen said the hospital was busy with other worried parents who had "nowhere else to go" and tired staff who appeared to be working non-stop.

"I am really grateful for our health-care system," Bergen said. "But having a baby in 2018 and then again in the pandemic, the care is different straight up. It has to be different, I understand that, but I think we need to work on improving it so there are fewer people falling through the cracks."

The Ontario Medical Association's pediatrician section said it encourages pediatricians to see patients in person and has provided suggestions on how it can be done safely. Ultimately, its up to individual clinics to determine if it's feasible.

"As vaccine rates increase among children, doctors will gradually shift back to in-person care while continuing to provide virtual care when appropriate," the pediatricians said.

Pediatricians protecting vulnerable kids 

Oakville pediatrician Sadhana Balakrishnan, who also works at Scarborough General Hospital, said she and her colleagues are balancing the safety of vulnerable patients with the needs of those experiencing what could be COVID-19 symptoms.

Pediatricians are experiencing increased demand as the cold and flu season seems to have begun earlier than usual and parents are on high alert for respiratory illnesses, she said. 

However, Balakrishnan said she manages to see kids with fevers, coughs or gastrointestinal symptoms who have tested negative for COVID-19, by scheduling their appointments at the end of the day, so they don't spend time in the waiting room.

She said if a child isn't seriously unwell but needs a doctor, parents should first consider going to an urgent-care centre or walk-in clinic first. But even with these alternatives, Balakrishnan said she's still concerned about the impacts of patients not routinely seeing their family physician. 

"We're going to potentially see the fallout from delayed access to care over the pandemic in the coming years for both adults and children," Balakrishnan said. 

"I think we're going to have to take stock of what's being missed."