‘Occupancy pressures’ holding back Hamilton hospital from resuming non-urgent procedures

Executives with Hamilton’s biggest hospital network say they’re not ready to go back to “business as usual’ despite Ontario giving a green light to a resumption of non-urgent and non-emergent surgeries and procedures.

The province’s top doc, Kieran Moore, said Thursday that recent declines in COVID-19-related hospitalizations and intensive care admissions across Ontario are behind the decision to lift Directive 2 – an initiative issued last month ordering hospitals to pause non-urgent and non-emergent surgeries and procedures.

But Hamilton Health Sciences’ president says “occupancy pressures” will hold back the city’s largest network with acute occupancy rates over 100 per cent at two of its major hospitals.

“As we continue to face occupancy pressures well over 100 per cent and as high as 120 per cent of some of our sites, like the Juravinski, particularly, Hamilton Health Sciences is not yet in a position to resume business as usual or services on any significant scale,” HHS’s Rob MacIsaac told staff in a town hall.

MacIsaac revealed ramp-up plans are proceeding “cautiously and gradually” but said a resumption of the services is not in the cards yet until executives are certain access to urgent and emergent care will not be affected.

As of Thursday, combined Hamilton’s hospitals are treating 164 COVID patients – about 60 less than the same day last week.

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There are 19 patients in intensive care units (ICU), representing 15 less than last Thursday.

HHS total adult ICU occupancy rate is at 89 per cent as of Feb. 10, while St. Joseph’s is reporting 104 per cent.

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EVP and chief operating officer Sharon Pierson revealed patient volumes at HHS sites are now flat and returning to pre-pandemic numbers.

However, occupancy rates are still over 100 per cent affected by longer stays from COVID patients slowing discharges of patients from their hospitals.

As of Thursday, the network had more than 200 alternate level of care (ALC) patients – those occupying a bed in a hospital but do not require intense resources for care.

“Half of those patients are within the satellite health facility (downtown Hamilton) to offset the pressures,” Pierson said.

“We are relying heavily on our unfunded bed capacity and that’s sitting at 86 beds.”

Positive signs are the continual decline of staff isolating for COVID which is less than 200 of HHS’ 13,500 staffers as of Jan. 10.  St. Joe’s has just 97 workers isolating for COVID-19.

Also, overall emergency department volumes, ICU admission and cases involving respiratory illness are decreasing, according to Pierson.

Local epidemiologist Dr. Dominik Mertz told staff about six Hamiltonians are being admitted for COVID per day into the city’s hospitals as of Thursday – a drop of about one and a half week over week.

“ICU continues to drop as well … no cases yesterday, one case per day in the days before,” Mertz said.

Week over week, COVID-19 outbreaks tied to the city’s hospitals have dropped by half.

On Thursday, public health reported just five among the two networks with only 29 related cases – 25 among patients.

Last week, there were 10 involving 43 cases.

Homes containing seniors still represent the largest group carrying outbreak cases in Hamilton as of Feb. 10 — 670  total cases from 14 surges.

Public health data revealed about 600 of those are tied to 10 long-term care homes (LTCH) with outbreaks.

The city’s retirement homes account for just over 50 cases from three surges. More than half of all cases (382) at homes with seniors are residents.

Just over 1,000 cases are connected to the city’s 34 confirmed institutional outbreaks.

There were at least 260 reported COVID-19 cases in seven Hamilton shelter outbreaks as of Thursday.

As of Feb. 10, the city has put about 1.2 million COVID vaccine doses into arms with about 462,000 second doses and 276,000 third shots.

Close to 82.5 per cent of eligible Hamiltonians aged five and up have had a pair of doses, while 86.9 per cent have gotten at least one shot.

About 87.5 per cent of residents aged 12-plus have had at least two shots, while about 90 per cent have had a first dose.

The city is still behind the provincial average, which has 89.6 per cent of those 12-plus with two doses and 92.2 per cent with a single dose.

Excluding kids aged five to 11, Hamiltonians in the 12-to-17 age group represent the lowest vaccination rates of those eligible in all communities.

Just over 81 per cent have had two shots and only about two per cent have had third doses.

Hamilton is also slightly behind the provincial average in first doses for those aged five to 11 — 50 per cent compared to Ontario’s 54.7 per cent.

The city’s rate of second doses in the age group is at 22 per cent compared to the province’s 25.4 per cent.