As medical professionals in Ontario’s health care system have been working tirelessly to keep up with record-high COVID-19 cases, paramedics with Ornge air ambulance and other paramedic services have been working around the clock to transfer patients across the province in order to help manage strained intensive care unit capacity.
“There’s nothing we can compare it to. It is the most busy we have ever been. We have surged up more than 200 per cent in the last two weeks alone,” Justin Smith, chief flight paramedic with Ornge, told Global News.
“It is a manageable pace, but for not much longer. I think our crews are getting tired. They’re stepping forward, stepping up, to do the job that’s being asked of them and we’ll do it as long as we can, but as with anything everything has its limits.”
Smith specializes in transporting critical care patients — “the sickest of the sick in the province right now” — and reflected on how the organization has been tasked with relocating patients outside of the Greater Toronto Area, and how severe their cases can be.
“I haven’t had a patient that has been able to talk to me in months. They’re all intubated, ventilated, COVID patients. Somebody mentioned the other day, ‘I had a patient the other day that was awake,’ and it was sort of a remarkable event around the base here,” he said.
“We make sure that all of our patients are well sedated, their pain is well managed, that is top of priority for us. The vast majority of patients we deal with don’t remember their interaction with us.”
Ornge has a fleet of 12 helicopters, up to five fixed-wing planes and nine land ambulances. But in recent times, the organization has partnered with local services such as Toronto Paramedics and York Region Paramedic Services as part of the massive logistical operation — one that can see around 80 patients moved daily.
Looking at April alone, officials said Brampton Civic Hospital — with one of the busiest emergency rooms in Canada that has long been plagued with overcrowding — has been the site with the most people who have been needed to flown or driven out to hospitals as far away as Ottawa and Windsor. So far there have been 170 patients relocated.
In Toronto, 74 people have had to be transferred out of Humber River Hospital, and in Mississauga, 36 patients have been transported from Credit Valley Hospital.
If you’ve been travelling along Highway 401 in recent weeks, there’s a chance you might have seen an ambulance bus belonging to York Region Paramedic Services. There are only three such buses in the province and each one can typically hold eight stretchers. This bus, however, can only take three critical care patients.
The service has contributed an operator and the use of the vehicle toward the effort, and it has transported patients along the highway to destinations as far as Kingston and Brockville from the GTA.
“We’re fortunate to have our multi-patient unit here … This is really one piece of a giant partnership that has been working across Ontario over the last several months,” Chief Chris Spearen said, reflecting on how his service has been able to join with so many others in chipping in to help.
Dr. Chris Simpson, an executive vice-president with Ontario Health (the organization charged with overseeing health care delivery across the province) and a cardiologist with Kingston Health Sciences Centre, praised the logistical efforts being made as hospital staff move to create space for patients “in unconventional places and with unconventional staffing models” while intensive care units across the province deal with record-high COVID-19 admissions.
“It takes quite a coordinated strategy and in general when we look at the modelling and we project ahead to mid-May, we know that we’re looking at probably about 1,500 patients instead of the current 800 that are in ICUs and we know that they’re going to be coming in at a faster rate,” he said, adding Toronto is expected to be particularly affected in the coming weeks.
“A lot of these accelerated transfers has been to try to get as many people out of the GTA as possible to fill up places like Kingston and those outside so that when things get really, really very hot in two or three weeks, we’ll be able to do a lot of rescue transfers over a very short distance in the GTA.”
Simpson said to meet the ICU needs, approximately 200 beds need to be created every week until mid-May to ensure existing facilities aren’t overwhelmed.
He also said there are discussions underway to look at out-of-province transfers, but he noted with the number of resources that would be needed “it’s not a major part of the strategy” currently.
When asked about what the system is facing, Simpson said “never in a million years” would he have predicted what is currently happening and can’t help but look toward the future.
“It will be what happens afterwards when we start to think about all the care that we’ve had to defer for people with cancer and cardiac disease and other care that we’re already 250,000 surgeries and procedures behind before the third wave started. It’s going to go up much higher than that now,” he said.
“So our challenge, I think going forward once we get through all of this tragedy will be to try to get the health care system back online as quickly as possible for those patients by the hundreds of thousands who have had their care delayed.”
On Friday, the Ontario government reported 4,505 new cases of COVID-19 and 34 more deaths linked to the virus. It also said there were 2,287 patients in hospitals with COVID-19 with 818 people in intensive care.
Hospitals in Ontario have been stretched to capacity recently amid an onslaught of COVID-19.
New Brunswick Premier Blaine Higgs said on Friday that his province would send 27 health-care workers to Ontario to help address the capacity crunch. Ontario Premier Doug Ford said the offer was a “massive, massive help.”
The government previously said health-care workers from Newfoundland and Labrador were also expected to arrive to help within days.
Meanwhile, as crews continue their work, Simpson had particular praise being done by paramedics, especially during the third wave of the pandemic.
“Just heroic, you know, 24-7. They’re all exhausted, just like everybody else working in the health care system now,” he said.
“I think people don’t realize how many resources it takes to move a critically ill patient and to do it safely, and they’ve done well over 2,000 since November now, and they just do a fantastic job. I can’t say enough good about the quality of the work they do.”
— With files from The Canadian Press