Canadian hospitals getting 'creative' to expand COVID-19 care facilities

The world marvelled at China's ability to build a two-storey, 645,000-square-foot hospital in 10 days.

With many experts predicting a surge in COVID-19 cases here in the next couple of weeks, many Canadian hospitals are also looking for constructive solutions as they scramble to prepare.

They'll have to be "creative" to address an influx of patients and the overflow situations that will result, according to the CEO of HealthCareCAN, the largest national organization of hospitals in Canada.

"They need to be ready for the worst scenario, which would be over-capacity, hospitals not able to treat as many patients as they're getting at their door," Paul-Émile Cloutier said.

He says hospital administrators are looking at recreation centres, hotels and other facilities that may be vacant right now. As well, some have ordered "makeshift" hospitals and quarantine centres to be constructed. "They do not want to be in the same position as Italy," he says.

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'Tight timeline'

Construction has begun this week on a 93-bed Pandemic Response Unit at Joseph Brant Hospital in Burlington, Ont. The temporary modular structure, being built in the hospital's parking lot, is expected to be in operation by April 10. It consists of an aluminum frame covered with an "architectural membrane," and will be outfitted with partitions, washrooms, hand-sanitizing stations and a dedicated supply of oxygen for each bed.

"We've set a tight timeline," said Eric Vandewall, the hospital's president and CEO. "The date was chosen to match our anticipated surge of cases, and while it's tight, it's realistic, and we're committed to that date."

The hospital is also considering housing some patients — those who require a lower level of care — in nearby hotels.  "That work is underway," Vandewall said. "We are finalizing arrangements with local hotels this week."

'Desperately afraid'

The Pandemic Response Unit is being built by Toronto-based BLT Construction. Its vice-president, Paul Waddell, says the company is able to construct a wide variety of emergency medical response structures very quickly: covered drive-thru testing areas, triage centres and hospital wards, for example. 

Waddell would like to get the word out about BLT's possible solutions to hospitals across the country. "We have an incredible construction network. We can scale up very quickly," he says. But he worries about having sufficient materials due to the demand for such structures around the world at the moment. "We're desperately afraid that our current Canadian stock will get gobbled up," he says. 

BLT uses products made by Sprung Instant Structures, a 133-year-old company based in Calgary, but Sprung has long-standing relationships with international customers, including the American military.

"We've tried to secure Sprung, but if other countries demand stock, we can't control that," says Waddell. 

Enough for Canada?

The president of Sprung Instant Structures confirms: "We're talking to hundreds of parties all over the world that require emergency facilities." 

Phil Sprung says his company always keeps "huge" inventory on hand, but says some international clients have taken a demanding tone. "You get customers phoning up and threatening 'We want all of your inventory,'" he said. So far however, no one has actually placed — and paid for — an order of that size.  

"If one of the guys from overseas decides to pull the trigger on a huge order, then suddenly we're trying to balance," Sprung said. "But our position is that we'll also try to retain some inventory in order to take care of our fellow Canadians and fellow North Americans."

Existing infrastructure

There are other solutions to coping with a surge of cases.

In the U.S., naval hospital ships have been pressed into service in New York and California.

An off-site solution, however, presents challenges. The chief of staff of the new Pandemic Response Unit in Burlington prefers to keep the COVID-19 patients close.

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"The rationale for keeping patients on-site is that with COVID-19, patients' conditions can change very quickly," says Dr. Ian Preyra. "We want them to be close to the hospital so that we can transfer them directly to intensive care if their conditions worsen."

That's what they've done In New York City, the epicentre of the hardest-hit state in the country, where the Javits Convention Center has been taken over by the Federal Emergency Management Agency to house some 2,000 hospital beds for non-COVID-19 patients to relieve the burden on local hospitals. 

There's so far no word of the federal government pressing naval ships into COVID-19 service, but there is existing infrastructure in Canada as well that could be transformed into medical facilities to assist with the expected surge of cases.

• In Burnaby B.C., the Edmonds Urgent Care Centre has set up a "satellite" site for assessment, testing and treatment of COVID-19 in the parking lot of a local park.

• In Ottawa, the Brewer Arena is being used as an assessment centre.

• In Montreal, the grounds that host the annual Jazz Festival have been converted into a walk-in test facility, and a drive-thru testing facility has been set up in the parking lot of a local mall in Côte Saint-Luc.

Phil Sprung remains convinced his quick-build structures are an important option. He's even considering creating a "hospital in a box" type of kit, that hospitals could have on hand for future health crises.

"When there's more time for construction and delivery, we can put these box kits together. And certain hospitals could have 500-1000 bed expansion[s] at the ready, at a very reasonable cost when you compare it to conventional construction."