Short-staffed and COVID burdened, hospital officials explain tough decisions behind new policies

Hospitals in southwestern Ontario made changes to visitor and care policies this week, as officials leading those teams see the effects the burden of COVID-19 is having on the communities around them. 

While the province reported a new pandemic-high of 10,436 cases of COVID-19 on Wednesday, local hospitals in Windsor-Essex implemented "no visitor" policies — with some exceptions — to prepare for what some officials are expecting will be an onslaught of COVID-19 patients in hospital. 

Of the officials who spoke with CBC News, all described this as something hospitals wanted to avoid as much as possible. 

"Not an easy decision, and I know it's a frustrating one for many in the public and I would feel the same most likely, but it's an action we had to take to provide essential health care services for both COVID and non COVID patients," said Kristin Kennedy, president and CEO of Erie Shores HealthCare.

Many individuals are now seeking care at a hospital and are more greatly sick than they were pre-pandemic because they were not at a hospital or haven't seen a primary care physician,- Kristin Kennedy, CEO Erie Shores HealthCare

Erie Shores was the first hospital in the region to implement its policy on Tuesday. There are some exceptions, including one visit by one visitor to a dying patient and one support person for a woman in labour, or to a minor. Windsor Regional Hospital and Hôtel-Dieu Grace Healthcare followed suit with similar policies. 

But the reasons behind the decision aren't just due to the increase of COVID-19 cases being seen.

"Our concern is not related necessary just to COVID in the hospital, it's the convergence of COVID-19, flu and many of the other illnesses we see this time of year and occupancy challenges," said Kennedy. 

"Many individuals are now seeking care at a hospital and are more greatly sick than they were pre-pandemic because they were not at a hospital or haven't seen a primary care physician." 

Kennedy said the convergence of those issues puts a strain on the capacity for the hospital to take in more patients. 

That, combined with the spike in local cases, could make it difficult to care for people. 

"We do anticipate that post-Christmas holidays we'll see an uptick in cases at the hospital," said Kennedy, adding that COVID-19 positivity rates have climbed at the hospital's assessment centre. 

"We know there is a community burden of COVID and we anticipate that will translate into admissions in the coming days and weeks."

Staffing issues 

Meanwhile at Bluewater Health in Sarnia, chief of staff Dr. Mike Haddad said staffing issues have led to a policy change at that hospital to once again delay non-urgent surgeries and procedures. For now, the hospital is still allowing visitors for patients.

"We've been experiencing an extra patient load in addition to staffing shortages, said Haddad. "For the time being, we're reassessing this everyday and hopefully it's not long term."

Haddad said the decision was difficult, and one that had to be done in May of this year. Over the summer, the hospital was able to get through their backlog of surgeries, unlike elsewhere in the province. But postponing procedures was still something to be avoided. 

It was only recently officials realized what may be coming. 

"Last week it became clear we were having some staffing difficulty, we had an increased patient load," said Haddad. 

"Everyday we have people who are sick for whatever reason, we've basically doubled those numbers in the last week or so which made it more difficult to backfill."

About 55 staff members were off on Wednesday, which is double than usual said Haddad. With the ICU being full at least once this week and the hospital's medical beds full, that kind of shortage isn't sustainable. Haddad said the hospital is at capacity, and unable to take on other patients from elsewhere in the southwest. 

As of Wednesday, there were 17 COVID-19 patients in the hospital's ICU. 

"If you talked to me a year ago, 17 would have been less of an issue because we had full staffing," said Haddad.

"20 months later, with people exhausted, retirements, not too many people want to do this, people getting sick in the community because this particular variant is more contagious — it's affecting more people even our own staff — so 17 now is equivalent to having 34 those days."

Windsor Regional Hospital is seeing a similar issue. The organization has about 4,800 staff members, some clinical and some non-clinical. As of Wednesday, 71 staff members were self-isolating due to COVID-19 and another 43 were off work after testing positive. 

Haddad agrees that as the virus spreads, there will be more hospitalizations. 

"The sheer size or number of COVID illness out there is seeping into hospital," he said. 

The Windsor-Essex County Health Unit in southwestern Ontario on Wednesday reported 993 new COVID-19 cases that go back to Dec. 24. 

Due to testing backlogs, it's not clear to officials how much the Omicron variant may be spreading in the communities.

"I think that the general view is that by the end of the month, Omicron will be the dominating strain," acting medical officer of health Dr. Shanker Nesathurai said in a media briefing Wednesday. 

Nesathurai warned that while these numbers are high, there will be other metrics to watch to see how the spread of this virus will affect the community. 

"One thing to think about is as testing capacity becomes diminished — where we currently are at in the pandemic — case counts are not the best metric to measure burden of disease in the community."

Windsor-Essex's top doctor explained that deaths, hospitalizations and intensive care patients with COVID-19 may be a better indicator for how the disease is tracking in the community as case counts become unmanageable to predict. 

"We'll wait for provincial guidance on this item but with diminished testing there's limited or no ability to call outbreaks." 

Ontario's chief medical officer of health is set to make an announcement Thursday after the province said recently it would make changes to COVID-19 case and contact management protocols and testing guidance.

New visitor policies at Windsor Regional Hospital, Erie Shores HealthCare and Hotel Dieu Grace Healthcare begin Thursday.