Canada’s emergency rooms bear the brunt of a ‘perfect storm’

By Anna Mehler Paperny

TORONTO (Reuters) – Public health officials across Canada have reduced the opening hours of hospital emergency rooms and urgent care clinics in recent weeks, a measure that may extend into the summer in some cases due to a surge in patient numbers and staff shortages.

The situation, clinicians say, is linked to a resurgence of viral infections like COVID-19 in adults and children and a drive by others to seek treatment, delayed by the pandemic and exacerbated by high numbers of sick or burned healthcare workers out.

The stress has led to scenes of congested hospital corridors and crowded clinic waiting rooms, hours of waiting for inpatient care, and occupancy rates in excess of 100% in children’s hospitals. It has also reignited debate about systemic issues in the government-funded healthcare system.

On Thursday, Perth and Smiths Falls District Hospital in eastern Ontario announced that its Perth emergency department would be closed Saturday through Thursday due to a COVID-19 outbreak affecting its staffing.

“It’s like the four horsemen of the apocalypse are all coming at us at the same time in healthcare,” said Alan Drummond, a general practitioner and emergency physician in the city, which is home to about 6,000 people.

Drummond, who spoke to Reuters before announcing the closure, sees patients waiting 20 hours to be admitted, a situation that could lead to their worsening condition or even medical errors. He blames the situation on years of underfunding for hospital beds and community supplies.

While small-town hospitals in Canada are sometimes reducing their hours, regional health centers are less likely to do so.

Ontario’s Department of Health declined to say how many hospitals in Canada’s most populous province are being affected by partial or temporary closures, but said it has taken steps to address the issue, including retaining nurses and other healthcare workers.

“Sometimes hospitals have to make the difficult decision to temporarily close their emergency rooms so operations can continue throughout the hospital,” a ministry spokesman said.

Hospitals in Quebec, the country’s second-largest province, New Brunswick and Manitoba have partially closed departments or temporarily reduced hours for a few weeks to several months, according to the hospitals.

In Kingston, Ontario, Hotel Dieu Hospital’s Urgent Care Clinic reduced its hours over the Canada Day long weekend. A spokesman for Kingston Health Science Center described the move, which began on Friday, as a planned one-off reduction, but added that “staff shortages and the current surge in patient numbers are expected to continue throughout the summer.”

Children have been hit hard by the health care crisis as youngsters who had not previously been exposed to a range of viruses succumbed to illness in the spring as many people shed their face masks used to prevent the spread of COVID-19.

The Children’s Hospital of Eastern Ontario in Ottawa, the nation’s capital, had 110% to 120% occupancy for weeks in May and early June. Occupancy was a record high for the month of May, a spokesman said.

Low staffing requirements and increasing patient numbers are “something like the perfect storm,” said Katharine Smart, a pediatrician and president of the Canadian Medical Association.

FUNDING DEBATE

Canada has the fourth lowest number of funded acute care beds per capita among Organization for Economic Co-operation and Development -acute-care, and the Commonwealth countries, according to the OECD https://www.oecd.org/coronavirus/en/data-insights/hospital-beds Fund https://www.commonwealthfund.org/publications/fund-reports/2021/aug/mirror-mirror-2021-reflecting-poorly#rank Canada’s healthcare system second to bottom out of 11 wealthy countries.

Some have blamed underfunding of the healthcare system since the 1990s, when Canada’s federal government cut spending to deal with the country’s deficit.

Others, like the right-wing Fraser Institute https://www.fraserinstitute.org/studies/understanding-universal-health-care-reform-options-cost-sharing-for-patients, say the federally funded system itself is the root cause of problems, suggesting a shift towards a privately paid model.

Canada may have little time to lose.

Rami Rahal, vice president of the Canadian Partnership Against Cancer, said there is a risk that cancer incidence and deaths could get worse in the country due to long periods of skipping or delaying screenings and postponing treatments.

“We cannot work our way out of this crisis through rents,” he said. “We have to find innovative ways of care.”

(Reporting by Anna Mehler Paperny; Editing by Paul Simao)