Quebec ER overcrowding will ‘continue to be difficult,’ says health minister

Quebec Health Minister Christian Dubé had mostly bad news Wednesday as he provided an update on the province’s overtaxed emergency room network.

With emergency departments across the province averaging 137 per cent capacity, Dubé told reporters in Montreal the situation would persist for much of the winter.
“I said it has been difficult and it will continue to be difficult,” Dubé said.

Dubé said on any given day an average of 10,000 people visit emergency rooms in the province. In the past two weeks, there have been 1,000 extra visits daily. He said about 1,900 people a day are visiting emergency rooms for respiratory viruses, a rate roughly double what was seen at the same time last year.

As well, Dubé said more people over the age of 65 are going to ERs, which results in more complex cases in addition to increased volume.

Emergency rooms in the greater Montreal region, including the suburbs to the north and south, are most affected.

Three circulating viruses — COVID-19, influenza and Respiratory syncytial virus, or RSV — have complicated issues.

A later flu season compared to last year hit hard during Christmas when staff was minimal, and the number of cases is rising.

Meanwhile, COVID-19 seems to be reaching a peak, with an estimated three million Quebecers having been infected since the fall. And the number of RSV cases has stabilized.

3:06 Can at home care ease the burden on Quebec ERs?

Dubé noted vaccination is still available and could help ease the situation, particularly for flu infections. And Dubé said workers who took time off for the holidays are returning to the health system this week and easing pressure on overworked staff.

The minister said almost half of the daily ER visits are for ailments that aren’t urgent and could be treated at family medicine clinics or with family doctors, but he acknowledged such appointments are hard to come by.

“The system needs to do a better service for those (minor cases),” said Dr. Gilbert Boucher, president of the Association des spécialistes en médecine d’urgence du Québec and an emergency physician at the Montreal Heart Institute.

“We often hear, ‘It has been three weeks that I’ve been trying to see somebody to get some advice’ and they are failing, and then they end up in the emergency,” he said.
Dubé drew criticism before Christmas when he called on Quebecers to avoid the ER, with the Canadian Association of Emergency Physicians expressing concern about the messaging. He said Wednesday he was referring to non-urgent cases, such as a minor allergic reaction or an infection that could be treated at a clinic.

“First of all, every time we ask people not to come to the emergency, we also mention that if you feel sick, if you’re not well, we are there for you,” Boucher said. “We’re sorry if that wasn’t clear, but people have to understand we are there for the sickest patients all the time, 24/7.”

Boucher added that much of the criticism was coming from outside the province, where doctors are not grappling with ER occupancy rates that can hit 200 to 250 per cent and half of patients leave without seeing a doctor, as is the case in some Quebec hospitals.

“In (the) face of the congestion we’re facing right now, we decided to ask everybody to help us a little bit,” Boucher said.