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Non-urgent procedures still on hold as Ontario eases public health measures

Posted: January 22, 2022

(JAN 20,2022)

While Ontarians will soon be able to dine indoors and go to the gym, those seeking elective surgeries or non-urgent health procedures in Ontario hospitals will still have to wait.

Ontario Premier Doug Ford announced on Thursday that beginning Jan. 31, public health restrictions will be eased, increasing social gathering limits to 10 people indoors and 25 people outdoors, and increasing capacity limits to 50 per cent in indoor public settings including restaurants, cinemas and retailers.

Despite the increasing of capacity limits, Health Minister Christine Elliot was clear that the province would not be directing hospitals to resume non-urgent care, explaining that hospitalizations are lagging indicators of COVID-19.

“We know that many people are upset and frustrated at having their surgeries pushed off yet again. We want to get back on track with them as soon as we can. But both hospitalizations and admissions to ICU are lagging indicators. We don’t expect the peak of the admissions to ICU to happen until mid-February. So as soon as we see the numbers are going down, both in terms of admissions to hospital and in terms of intensive care admissions, then we’ll be able to get back on track with those surgeries and procedures,” she said in the news conference.

While public health officials are currently observing positive trends in community transmission of COVID-19, in the hospital system the situation is remains bad. There are currently 4,061 patients in Ontario hospitals with COVID-19 — down from a peak of 4,183 on Tuesday — and hospitals continue to grapple with severe staffing shortages.

In response to the measures announced Thursday, the Ontario Health Coalition issued a release calling for more support for the health-care system from the province.

“We are in a far worse place in health care than we were last year at this time,” Natalie Mehra, executive director of the Ontario Health Coalition, said in a news release. “Right now we are in a health system catastrophe, and this government has done virtually nothing to help get care to patients in need. We need accountability. We need answers. We need leadership in the public interest.”

As the COVID-19 situation in hospitals has worsened in other regions across the province, Kingston, Frontenac and Lennox and Addington hospitalizations have stabilized.

According to local medical officer of health Dr. Piotr Oglaza, while the burden of COVID-19 on the health-care system has lessened locally, until the situation improves across the province, hospitals will not be prioritizing non-urgent procedures.

“Even though our situation here in the KFL&A region looks much more promising this week, it may not be the case in other parts of the province, and the provincial system for acute care is highly interconnected,” Oglaza said in a media call on Wednesday. “There might be time where we might be seeing patients coming again back into KFL&A from other parts of the province, again to help with that capacity for the provincial health-care system. So at this point, any of these decisions that are made locally have to take into account what’s happening in other parts of Ontario.”

According to Dr. David Pichora, president and CEO of Kingston Health Sciences Centre, those transfers are already beginning.

“So far we’ve been directed to take two ICU patients from outside of our region. I believe that one of them is coming in today, and I haven’t heard about the second one. These are not big numbers, and hopefully it stays that way, but that’s entirely dependent on what’s happening elsewhere and on our ability to accept patients relative to other hospitals,” Pichora said in an interview with the Whig-Standard.

While KHSC is seeing far lower numbers of COVID-19 patients than earlier on in the pandemic, Pichora said there are multiple factors putting pressure on health-care capacity.

“It’s much more multifactorial right now. It’s not just one pressure point, it’s multiple pressure points that are really stressing the system now in contrast to back in the spring. We’re seeing a lot of emergency activity that’s not COVID-related, you know, regular types of patients coming to the ER, and they’re generally very sick, too. These are not inconsequential visits,” he said.

Staffing levels are another significant challenge that must be addressed in order to increase capacity. In addition to already low staffing levels, many staff are required to self-isolate due to COVID-19 or stay home with children who are sick. According to KHSC, on Wednesday alone, 73 staff were off sick with COVID-19.

“What’s different now is the staffing pressures: how many rooms can we actually operate irrespective of directive? That has to be taken into consideration. We’re concerned, we’re continuing to hire very actively and train very actively, but we’re just doing a lot more things than we did before. We need more people and we’re trying to address it as actively as we can,” Pichora said.

Across the province, nurses and health-care workers have been calling for the repeal of Bill 124, which caps health-care wage increases in a year when health-care workers have been on the front lines of the pandemic.

Pichora is aware of the toll the pandemic has had on hospital workers throughout the past two years.

“Our staff have been at this for a long time now, and they need a break just as much, or more, than anybody else. Our front-line staff have been doing a terrific job. And we want to make sure that there’s light at the end of the tunnel and we’re getting closer and closer to the end of that tunnel,” he said.

While Pichora is looking to avoid any added stress on hospital workers at KHSC, he is hopeful that the hospital system in the province is equipped to handle the easing of restrictions over the next few weeks.

“It’s a balancing act because no one really has a crystal ball. But the evidence is that the restrictions have made a big difference,” he said. “So hopefully it’s not premature and hopefully people will be responsible about how they do that.”