With the Ontario government re-instating a pause all non-emergent and non-urgent surgeries and procedures, a number of Hamilton-area hospitals have begun a shift in care strategies to offset rising Omincron variant COVID-19 cases.
As of Jan. 4, three area hospital networks say the pressure is on in local wards and emergency departments (ED) with patient admissions up and more than 100 staffers off work and in isolation with COVID symptoms.
In a town hall just before the Christmas break, executive vice president and chief operating officer Sharon Pierson characterized the staffing situation at Hamilton Health Sciences (HHS) as “precarious” due to a significant number of staff cases.
“You are all well aware we have precarious staffing situations across all our sites with the impact of the outbreaks and our staff and exposure to family members as well,” Pierson told employees in a briefing on Dec. 23.
During a Hamilton Public health update on Tuesday, HHS President Rob MacIsaac confirmed the challenges continue with COVID and other illnesses bumping overall hospital visits across the city.
“The result is we see very high volumes in our ED’s, including an extraordinary number of patients arriving by ambulance,” said MacIsaac.
Of HHS’ estimated 13,000 employees close to 500 are not at work and are isolating with COVID symptoms as of Wednesday. The network is also struggling with eight outbreaks tied to about 90 total cases with around 30 staffers affected.
St. Joseph’s Healthcare has 223 of it’s estimated 5,800 workers in isolation, representing about three per cent of it’s available workforce.
President Melissa Farrell says the agency is managing, but the absences are “tough on the team.”
St. Joe’s numbers have been rapidly increasing by the day, according to Farrell, and have moved from zero in mid-December to 143 on Dec. 31 to over 200 as of Jan. 4.
“Really the rapid rise in the staff cases is a clear indicator just how quickly the Omicron variant is spreading,” Farrell said.
“It’s prevalent in our community and it’s prevalent amongst our healthcare workers.”
Joseph Brant in Burlington reported close to 240 affected staffers as of Jan. 4.
The president and CEO of Joseph Brant Hospital in Burlington revealed in a release on Monday that an additional 72 workers were awaiting test results.
Eric Vandewall said, on average, the network is seeing between 50 and 70 workers entering isolation daily due to COVID and “seasonal illnesses” contributing to an increase in staff sick calls.
“Prior to Omicron, the hospital was already operating with a 9.4 per cent staff shortage,” Vandewall said.
The hospital chief says an increase in emergency department visits is also creating “unprecedented pressure” on the network.
“There is a 30 per cent increase in the number of people coming to our emergency department for care as compared to December 2020,” said Vandewall.
On Monday, premier Doug Ford and health minister Christine Elliott announced a ramp-down of procedural and scheduled surgical care across the province, effective immediately.
CEO of Ontario Health Matt Anderson said an average of about 8,000 to 10,000 surgeries per week will be impacted by the pause.
The province estimates close to 50,000 new daily COVID cases would equate to around 500 hospital admissions per day – greater than the peak daily hospitalizations of 265 per day from last spring, when hospitals suffered amid the third wave of the pandemic.
“The evidence tells us that about one per cent of people who get Omicron will end up in the hospital,” Ford said. “Our public health experts tell us we could see hundreds of thousands of cases every single day. One per cent of hundreds of thousands is too many new patients for our hospitals to handle.”
The scientific director for Ontario’s COVID-19 science table told 900 CHML’s Bill Kelly Show the current challenge tracking the infectious Omicron variant surrounds the province’s current limitations in testing.
As of January, Ontario only has the ability to diagnose about 100,000 cases per day which roughly equates to finding maybe one in five actual COVID cases, according to Dr. Peter Juni.
“It could even be less than that we detect, and that shows you the challenges we have,” said Juni.
With the Province’s order to ramp down procedures, MacIsaac said existing staffers are now being redeployed to areas of the system suffering shortages as of this week.
That vacuum may require further strategies down the line including bringing in staff that should be isolating from a COVID exposure or the recruitment of retired health care workers in the community.
“We’re not doing that today, but I think that would be an ‘arrow in our quiver’ if we have to get to that,” said MacIsaac.
Vandewall said the ramp-down also allows for a similar redeployment at Joseph Brant to units that need additional staffing to continue urgent and emergent surgeries, including cancer procedures.
The CEO also urged those who think they have COVID to avoid hospital emergency departments, if possible.
“If you have mild COVID-19 symptoms, you do not need to come to the ED,” Vandewall said.
“Coming to the ED risks exposing vulnerable people to the virus. Please call your primary care provider or TeleHealth Ontario for advice on managing mild COVID-19 symptoms at home.”
The three Hamilton-area hospitals have a combined 236 COVID patients as of Jan. 4, up more than 50 day over day. There are over 30 people in intensive care units (ICUs) with two requiring ECMO treatment — or extracorporeal membrane oxygenation — which is a form of life support.
The combined current average of hospital admissions is about four a day between St. Joe’s and HHS.
Public Health Ontario reported another day-over-day increase in hospital admissions by 58, equating to a total of 1,290 in hospital wards as of Tuesday, with more than 260 in ICUs.
Both MacIsaac and Farrell echoed the Vandewall’s message suggesting those with lesser COVID symptoms avoid a visit to emergency ,if possible.
“For those who have mild symptoms, if you are sick, consider if that is something you can manage at home,” Farrell said.
“Is it something that can be managed at home or by your family physician.”
Juni says something to look out for in a severe COVID illness is being “breathless” during normal activities. He says it’s a “good red flag” in deciding whether to visit a health care provider or make a potential trip to the a hospital.
“If you basically walk … and start to be breathless, you can’t walk the stairs as normal, that’s the moment when you need to seek help,” Juni said.
Hamilton reporting over 6,600 active COVID cases, 13 outbreaks in hospitals
Hamilton’s chief medical officer says with limited COVID testing now available in Ontario, due to the rapid spread of Omicron, current daily case numbers in the city “are very underestimated.”
Dr. Elizabeth Richardson said the city is now reporting just the “tip of the iceberg” with a number of cases now going unreported.
“So as we go forward, we’re going to start predominantly be focusing on key heath indicators … which of course are our hospitalizations and our ICU admissions,” Richardson said.
With that, the city added another 417 reported COVID cases to the 35,000-plus tracked since the pandemic began.
More than 6,649 active cases are on the city’s status report as of Tuesday, up 189 day over day.
The seven day average number of cases dropped slightly in a 24-hour period to 708 from 717 as of Jan. 4.
Close to 75 per cent of Hamilton’s reported active cases are in people under age 50, while 44 per cent of infected individuals are between the ages of 20 to 39.
One more COVID-related death was recorded in the city over the last two days, a person over 80. At least 64 per cent of the city’s deaths tied to COVID have been among people over 80.
Of the 51 outbreaks being revealed by public health, most involve health care-related facilities.
About 130 of the over 320 total cases reported are tied to 14 surges at city hospitals.
HHS has about 90 of the cases, St. Joe’s has 31 COVID patients out of its 40 cases as of Tuesday.
St. Joe’s is dealing with six outbreaks, the highest it’s had during the entire pandemic.
More than 100 cases have been associated with 20 ongoing outbreaks at homes containing seniors since Dec. 24, 60 tied to residents.
Five new outbreaks at three long-term care homes and a pair of retirement homes were added to the list on Monday.
The city has no reported outbreaks among city schools having declared the last of the five outbreaks in the fall semester over on Saturday.
In the last 14 days, there have been 76 new COVID cases reported between the two public boards. All of the infections are with the Hamilton Wentworth District School Board (HWDSB), 57 among students and staff in elementary schools.
There are no active cases with the Catholic board (HWCDSB).
Close to 79% of eligible Hamiltonians fully vaccinated
Hamilton’s health partners administered over 7,550 vaccine doses on Monday, a slight increase in shots compared with the same day a week ago when just under 7,500 were given.
Close to 45,000 doses have been administered over the past seven days, which is up from the estimated 44,000 given out the seven days before.
As of Monday, 79.6 per cent of eligible Hamiltonians aged five and up have been fully vaccinated while 84.7 per cent have had at least a single dose.
About 86 per cent of residents aged 12-plus have had at a pair of shots, while about 88.6 per cent have had at least one.
The city is still behind the provincial average, which has 88.2 per cent of those 12-plus fully vaccinated and 90.9 per cent with at least a single dose.
More than 90 per cent of those aged 60-plus in the city are fully vaccinated.
Excluding kids aged five to 11, Hamiltonians in the 18-to-24 age group represent the lowest vaccination rates of those eligible in the community at just over 78 per cent fully vaccinated.