A senior emergency doctor in Nova Scotia says the pressures in ERs across the province are unprecedented in his career, as the Omicron variant of the novel coronavirus overloads the capacity of an already fragile health system.
“Since just before Christmas, every day is worse than the day before,” Dr. Kirk Magee, chief of the central zone network of emergency departments, said in an interview Monday.
“I’ve been an emergency physician for 22 years and I can say unequivocally I’ve never seen it this bad before.”
Meanwhile, the province’s Health Department on Monday reported a surge in COVID-19 admissions: 29 patients entered hospital and 19 were discharged since the last update on Jan. 7. The department also reported that three men – one in his 60s, one in his 70s and one in his 80s – had died of COVID-19.
The rising number of infections has sickened health staff and created bottlenecks in emergency rooms, Magee said.
On Monday, all 36 beds in the Halifax Infirmary emergency room, where Magee works, were occupied, he said, along with some beds in a holding area. Patients at greatest risk were still being treated promptly, but patients who are at middle levels of risk may be waiting many hours to be examined, he added.
Patients with serious conditions that require emergency intervention – people at Level 3 of the Canadian triage and acuity scale – were waiting in excess of eight hours to be seen on Monday, he said. That five-level system is used by emergency room doctors in Canada to evaluate the seriousness of patients’ conditions. The Canadian standard for a Level 3 patient to be seen is “within 30 minutes, 90 per cent of the time,” he said.
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Emergency departments across the province have seen rising delays over the past two weeks, Magee said.
“We’re not seeing patients in beds,” he added. “Often, we’re seeing them in hallways, meeting rooms and in chairs. We’re also not able to access beds for patients who are acutely ill. They’re being seen on ambulance stretchers in hallways because there’s simply no bed for them.”
The veteran emergency doctor said the latest wave of COVID-19 has met “a health-care system that was already fragile and with Omicron, the wheels have really fallen off it.”
About 600 out of 22,000 health staff in the province are off the job because they have contracted COVID-19 or have been exposed to it, according to Nova Scotia Health spokesman Brendan Elliott. There were 170 patients in hospital with COVID-19, either because they were admitted with the illness or because they contracted the disease while in hospital, he said Monday in an email. There were 348 other patients in hospital beds awaiting transfer to long-term care facilities, he added.
About 120 scheduled surgeries have been postponed across the province, Elliott said. “We’re at the point where the demand on the acute care system exceeds our capacity to provide high-quality care.”
In a briefing on Friday, Dr. Nicole Boutilier, vice-president of medicine with Nova Scotia Health, told reporters the health system was already experiencing staff shortages before the pandemic. Before the Omicron wave, between 14 and 39 per cent of positions were vacant, she said.
Kevin MacMullin, the business manager of the International Union of Operating Engineers, which represents paramedics, said members of his union say they are waiting hours outside hospitals to admit patients. While ambulances carrying patients wait outside hospitals, paramedics are out of circulation, he added.
The union said in an email Monday that since Dec. 20, 2021, there have been 154 occasions of “code critical” situations – where there have been two or fewer ambulances in a single county available to respond to calls.
This report by The Canadian Press was first published Jan. 10, 2022.