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Manitoba doctors plea for decisive action to reverse ‘catastrophe’ unfolding in health care

Click to play video: 'More ICU patients being moved out of province' More ICU patients being moved out of province
Manitoba has gone from a grim outlook to a dire one as a total of 23 critically ill COVID-19 patients have now been moved to hospitals in Ontario. Brittany Greenslade reports. – May 25, 2021

A group of doctors is painting a distressing picture of the state of Manitoba’s health-care system, as they urge action from officials and ask everyone to stay home.

Under the strain of COVID-19, non-pandemic-related patient care is deteriorating the doctors say. Manitobans are being left with life-altering conditions and some are dying, they warned at a Tuesday press conference.

“It is clear that cancers are progressing and are not being operated on; people who have aneurisms, the aneurisms are bursting at home and people are dying,” said Dr. Eric Jacobsohn, an intensive care physician at Winnipeg’s Health Sciences Centre (HSC).

“There are people now who are waiting to have their spines operated on that are losing control of their bowels and bladder and becoming paralyzed, and in fact the province has now started transferring these patients to U.S. institutions for surgeries.”

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Read more: Doctors Manitoba calls on province to develop and implement triage protocols amid ICU strain

Dr. Jacobsohn says while it may have been the case that only elective surgeries were being postponed at the onset of the pandemic, things “have progressed far beyond that.”

He said out of 188 people on a waiting list for heart surgery, six have already died.

A screengrab of Dr. Eric Jacobsohn speaking about the unfolding crisis in the health care system Tuesday. File / Global News

At a technical briefing Tuesday morning, Dr. Perry Gray, a chief medical officer with Shared Health, said the province was looking at sending some patients requiring surgery, including cardiac and certain spinal surgeries, out of province for the procedures.

Numbers provided by the province show between 900 and 1,000 Manitobans are currently not getting their required surgeries every week.

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The provincial numbers show 190 cardiac cases are currently on a wait list — up from 60 pre-COVID-19 — including 75 considered urgent.

Endoscopy procedures, non-surgical diagnostic procedures used to evaluate throat, stomach and colon issues, are also being cancelled, the province said.

Read more: COVID-19: Doctor expects Manitoba to ‘blow by’ previous ICU high as numbers climb

The group of doctors — which includes an infectious disease specialist, associate professor of internal medicine, as well as other physicians — is calling for action to address the “catastrophe.”

“We need decisive action. There are thousands of people at risk,” said Dr. Daniel Roberts, a critical care physician at HSC.

Waiting for herd immunity could take months, Dr. Roberts explained, and with more dangerous variants of COVID-19 now circulating widely, the stress on the health-care system shows no signs of abating.

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The group is calling on public health to implement a stay-at-home order and for all non-essential businesses to be closed immediately to “prevent the agony of extended lockdowns, further loss of life and disability.”

They’d also like the provincial government to follow in the footsteps of Ontario and B.C. and introduce a mandatory paid sick leave program, rather than a voluntary one.

Read more: Manitoba expects to break record for ICU demand as COVID-19 numbers rise

“We’re asking the public to do everything they can to keep themselves safe, and their loved ones,” Dr. Roberts continued.

“We’re asking people to stay home even if the government is not requiring it.”

Dr. Pam Orr, who is an infectious disease specialist and has seen increasingly younger COVID-19 patients requiring critical care, says some perceptions about the virus may be skewed.

“I’m not sure Manitobans understand that there are patients who are following all the rules and yet becoming sick in the workplace,” Dr. Orr said.

Click to play video: 'Manitoba man warns others of harrowing COVID-19 experience' Manitoba man warns others of harrowing COVID-19 experience
Manitoba man warns others of harrowing COVID-19 experience – May 21, 2021

“There is a tremendous burden of illness … but also, if you’re lucky enough to make it out of the ICU, many of these individuals are left with severe disability and many will never be the same again.

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“In Manitoba, we actually don’t have the rehabilitation resources to look after these people properly and in the way they deserve.”

Read more: Vaccine incentives must maintain balance between encouragement and ethics: professor

In contrast, Gray encouraged people to continue following the public health guidelines.

“The better the public health compliance, the more people we can return back to non-COVID care and provide more care to people who don’t have COVID,” Gray said.

When pressed on if the current health restrictions were enough, Gray said it wasn’t his area of expertise, but no matter the orders, it starts with compliance.

“Even if one were to ask for more strict public health measures, if there’s not compliance, then you’re not going to have the result you need.”

“I’m definitely pleading for greater compliance; I leave the exact nature of the restrictions to Brent Roussin.”

Click to play video: 'Manitoba doubling fines for COVID-19 measures offenders' Manitoba doubling fines for COVID-19 measures offenders
Manitoba doubling fines for COVID-19 measures offenders – May 7, 2021

While vaccination efforts are promising, the doctors say only about six per cent of Manitobans are fully vaccinated, and roughly half have received a first dose.

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On Monday, health officials reaffirmed their “principal strategy” to deal with the COVID-19 patient load is to increase ICU capacity, which they say has been doubled from 72 beds to 140.

Six additional ICU beds were to be added Tuesday with nursing staff redeployments stemming from a further shutdown of surgeries, the province said.

Read more: Manitoba extends May long weekend COVID-19 public health order by 3 days

The difficulty, they say, is beds require staff to attend to them, and those people need to come from somewhere — right now many are coming from surgery.

As of Monday morning, 126 patients were in ICU, which doesn’t include the 18 others sent to various facilities in Ontario to receive care.

Dr. Jacobsohn, however, stressed that the intensive care staff have “far exceeded our ability to provide quality, nuanced care.”

“Attempting to expand to 150, 160, 170 beds is impractical, and not the right thing to do for these patients,” Dr. Jacobsohn said.

In addition to handling the momentous surge of COVID-19 patients and the growing backlog of people whose conditions are deteriorating while they await surgery, Dr. Charles Bernstein says the system needs to begin setting its sights on recovery efforts.

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“I would encourage us all to be asking of the government to ensure that they have a contingency plan for how we’re going to catch up,” said Bernstein, a gastroenterologist and professor of internal medicine.

“We are going to [need] an enormous injection of resources into our health-care economy to catch up, just to bring us back to where we were in 2019.”

–With files from Shane Gibson

Click to play video: 'Manitoba ICUs on brink of collapse' Manitoba ICUs on brink of collapse
Manitoba ICUs on brink of collapse – May 21, 2021

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