Hamilton General’s cardiac unit cancelled surgeries amid COVID cases occupying ICUs

A top doc with Hamilton General’s cardiac unit says despite a low volume of COVID-19 patients currently at that hospital, his unit had to cancel all cardiac surgeries last Friday due to an unavailability of intensive care (ICU) resources.

Dr. Craig Ainsworth, director of the cardiac care unit at the Hamilton Health Sciences (HHS) hospital, says the unfortunate part of the circumstance is that the occupancy likely could have been avoided if the patients had got a pair of COVID vaccine shots.

“In the last six weeks in our ICU, we’ve had 100 per cent of our admissions having been unvaccinated people,” Ainsworth told Global News.

On Monday, HHS reported 37 COVID patients were in their hospitals requiring care and that of the 15 ICU patients, all of them were individuals who are not fully vaccinated against the affliction.

Ainsworth says despite COVID hospitalizations dropping to about a third of what it was between March and April amid the third wave, ICU occupancy in the fourth wave has generally only dropped by about half at best.

Compounding the problem is the number of nurses and allied health support staff who have not stuck around during the fourth wave either taking early retirement or stress leave.

“Despite the fact that we have less patients overall with COVID in our hospital, we just don’t have the slack or the resources to manage even the smaller numbers we have right now,” said Ainsworth.

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“So most definitely because of primarily lack of nursing staff and allied health supports, surgeries are getting cancelled right now.”

Ontario reported 289 people in general hospital wards with COVID-19 from Sunday’s data. Of the 189 in ICUs, 103 were not vaccinated against COVID, while eight were partially vaccinated, 15 were fully vaccinated and the status of 63 had not yet been determined.

Hamilton’s medical officer of health says she continues to hear about current “pressures” on the system from colleagues who say the volume of ICU admissions are only part of the problem. It’s the length of a stay which is also trouble.

“We know once they’re there, they’re at a higher risk of staying for longer periods especially if they end up in the ICU,” Dr. Elizabeth Richardson said.

“So we do have some of those pressures here in Hamilton because of the case rates we’ve had.”

Last week, the Canadian Institute for Health Information estimated that an ICU stay for a person with COVID is around 15 days at an average cost of $50,000. It’s significantly more than a person who’s had a heart attack, which is pegged at only $8,400.

Since early August, St. Joe’s says its hospitals in Hamilton have had 53 COVID admissions with 15 having to be put in an ICU. Of the total admissions, 47 were not vaccinated for COVID while 11 of the 15 requiring acute care were also not vaccinated.

The hospital has not yet had to cancel surgeries based on the numbers.

Niagara Health hospitals say of the 12 people they had in beds for COVID on the weekend, all were people not vaccinated.

Niagara’s acting medical officer of health hopes the province’s implementation of a vaccine certificate — set for next week to limit gatherings like banquet hall and indoor gym settings — will lower the overall risk of spread.

“Another part (of that strategy) we’re thinking of locally is trying to figure out what are the pockets of where we have infections spreading so we can address that if we’re looking at a breakdown of where outbreaks are,” said Dr. Mustafa Hirji.

In late July, the Ford government promised to address the current surgical backlog in Ontario — currently estimated to be over 400,000 cases — through $216 million in new funding focusing on surgical volumes across the health regions.

Hirji says keeping hospital admissions low will be critical if the province hopes to meet a target of eliminating the backlog in two years.

“If we are dealing with a surge of COVID cases, all that’s going to do is mean we miss more of that care, we defer more of that care, and we’re going to make the problem even worse,’ said Hirji.

“I think it’s really critical that we find a way to keep it under control, especially now we have a tool of vaccinations.”

The positive news for Hamilton on the COVID front is a drop week over week in the seven-day average of new cases, which moved from 56 to 47 on Monday

Active cases also dropped from 447 to 362.

Over the weekend, the city recorded a total of 93 cases over three days, with just over 39 per cent of the city’s active cases among people aged 20 to 39.

The number of tests completed in Hamilton coming back positive for COVID-19 also dropped week over week form 7.1 per cent to 5.87. That puts Hamilton third among the 34 Ontario’s public health units in percent positivity. The provincial average is 3.43 per cent.

Outbreaks in the city also dropped from 13 to eight. Of seven outbreaks declared over, a pair of wedding outbreaks tied to gatherings at LIUNA Station and Galileo Gardens were ended on Sunday.

Combined there were 16 cases between the two surges.

The two new outbreaks reported on the weekend included three cases involving patrons at Freshfhiit gym on the Mountain and a pair of cases at Heritage Green Child Care in Stoney Creek.

Public health recorded one more COVID death tied to a person over 60 who came down with the affliction. There have been 409 fatalities tied to the coronavirus since the pandemic began. A majority of the deaths, 393, are in people over the age of 60.

Just over 74 per cent of residents aged 12-plus have now been fully vaccinated against the virus. That puts Hamilton 31 out of the 34 public health units among vaccination rates.

Ontario’s average for fully vaccinated people over 12 is 78.1 per cent as of Sunday.