Some children’s hospitals in the country are running at occupancy rates of over 100 per cent amid a rise in viral illnesses that are typically seen in the fall and winter.
The emergence of respiratory viruses other than COVID-19 and lack of access to primary care is driving the spike in emergency room visits, health-care workers say.
“What’s happening right now in emergency rooms across the country is really kind of the coming together of a perfect storm,” said Dr. Ann Collins, past president of the Canadian Medical Association (CMA) and a semi-retired family physician in Fredericton, New Brunswick.
“We are seeing an increased demand of emergency room services by many different people across the country,” she added.
In the country’s capital, Ottawa, CHEO, one of the country’s biggest pediatric hospitals and research centre, occupancy in May and June were the highest on record for those months at the hospital.
“Typically, every day, particularly on our inpatient medicine wards, our mental health wards were at or above 100 per cent occupancy,” said Tammy DeGiovanni, senior vice-president of clinical services and the chief nursing executive at CHEO.
She said “really high volumes” as well as staff shortages have resulted in long wait times in the emergency department.
At the Hospital for Sick Children (SickKids) in Toronto, families looking for in-person care are also facing long delays in the emergency rooms.
“Our emergency department is quite overcrowded. It’s probably 20 per cent over what we had pre-pandemic, which is quite a jump from the volumes we were seeing during the pandemic,” said Dr. Jason Fischer, division head of emergency medicine at SickKids.
He said the volumes were unusual for this time of the year, with children coming in with classic symptoms of viral illnesses — that are non-COVID — such as fever, cough, cold, diarrhea and vomiting.
“What we’re struggling with is the amount of patients seeking care for primary care, not emergency care, who are coming to our emergency department, who aren’t able to access their physician like they have in the past,” he said.
DeGiovanni at CHEO agreed, saying COVID-19 has really exposed the holes in access to primary care with health workers stretched to capacity and amid infection control restrictions.
“Kids are waiting longer than anybody than adults than anywhere in the health system,” she said.
And the longer they wait for surgeries and specialty appointments, the greater the impact on their developmental milestones, DeGiovanni added.
Last week, the Perth and Smiths Falls District Hospital in eastern Ontario announced that its emergency department in Perth would be closed from Saturday to Thursday due to a COVID-19 outbreak affecting its staffing.
In Kingston, Ont., the Hotel Dieu Hospital’s Urgent Care Clinic reduced its hours over the Canada Day long weekend.
It’s a similar situation in other parts of the country that has forced hospitals in different provinces to resort to “planned closures” of ERs, said Collins.
Hospitals in Quebec, the country’s second-largest province, New Brunswick and Manitoba have also partially shut departments or temporarily cut hours for anywhere from a couple of weeks to a number of months, according to statements from the hospitals.
The idea is to prevent an unsafe environment where patients may be seeking attention from a department that is not adequately staffed, Collins told Global News.
“Sadly, it’s trying to take control of a very unfortunate situation,” Collins added.
Meanwhile, hospitals continue to struggle with staff shortages and COVID-19 burnout, with many health-care workers leaving the medical field.
There is also growing frustration among families that end up waiting for hours in the overcrowded ERs.
“There’s a lot of incivility that we’re seeing and this has taken a particular toll on our nursing staff at triage and with our physicians and with all our other staff,” said Fischer at SickKids.
What is the solution?
In March, the federal government announced a $2-billion lump sum to help provinces work through the thousands of surgeries and procedures that were postponed during the pandemic.
Provinces, while grateful for the one-time cash, have clamoured for a sustained increase to the federal health transfer so they can make more systemic improvements to their systems.
To tackle the children’s health-care challenges, in Ontario, pediatric hospitals and other agencies have come together with a proposal called Make Kids Count.
Besides a $1 billion investment over the next four years, the campaign is calling for government collaboration with specialized children’s health-care organizations and community members as well as developing the province’s first-ever children’s health strategy.
With an expected spike in cases of COVID-19, flu, RSV and other common respiratory viruses in the fall and winter, experts are concerned about the additional burden on the health-care system.
Collins stressed the need continue masking, taking other safety precautions and staying up to date with vaccinations to minimize the chances of having to seek acute care.
“Longer term, we need to see some very serious intention by our policymakers, our politicians or elected officials to confront this health, human resource problem across the country,” she said.
Fischer said the current crisis is not sustainable in the long run.
“Clearly, there needs to be investment made or changes made across the system to release some of this burden,” he said.
— with files from Reuters and The Canadian Press