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Some facts on COVID in the GTA and our response:
In the GTA hospitals run on average with 95% capacity with many running at over 100% capacity (what we call hallway medicine). This is especially true in winter months. https://www.oha.com/Documents/Ontario%20Hospitals%20-%20Leaders%20in%20Efficiency.pdf
In the GTA hospitals run on average with 95% capacity with many running at over 100% capacity (what we call hallway medicine). This is especially true in winter months. https://www.oha.com/Documents/Ontario%20Hospitals%20-%20Leaders%20in%20Efficiency.pdf
On average 18% of beds are used by patients discharged medically but awaiting a home (LTC, hospice etc). This is 'ALC'. This is about 5000 hospital beds being used as temporary homes for mostly frail, elderly people often with some form of dementia.
https://rnao.ca/sites/rnao-ca/files/Transforming_long-term_care_backgrounder.pdf
https://rnao.ca/sites/rnao-ca/files/Transforming_long-term_care_backgrounder.pdf
In the GTA, due to fear of Covid we had a huge decrease in hospital beds allocation from March-June for multiple reasons.
1) the hospitals offloaded a remarkable number of ALC patients (over 2,000 in Ontario somehow found beds). https://cmajnews.com/2020/05/15/covid-alc-1095873/
1) the hospitals offloaded a remarkable number of ALC patients (over 2,000 in Ontario somehow found beds). https://cmajnews.com/2020/05/15/covid-alc-1095873/
2) Cancelled 'non emergent surgeries' which Dr. Irish and his team document at over 148,000 delayed or cancelled surgeries ( https://www.cmaj.ca/content/192/44/E1347)
3) Fear to present to ED as documented by decreased ED volumes. This included seriously ill patients. https://www.cbc.ca/news/health/er-visits-covid19-canada-1.5698144
3) Fear to present to ED as documented by decreased ED volumes. This included seriously ill patients. https://www.cbc.ca/news/health/er-visits-covid19-canada-1.5698144
What we saw afterwards was anecdotally sicker patients coming in with delayed presentations, cancer migrations and a decent amount of self harm/mental health crisis/addiction related admissions.
Currently, there has been no change in non-elective admissions into hospitals yet hospitals are still becoming full. The admissions are actually down compared to previous years at this time maybe due to less flu or peoples fear of presenting. https://www.kflaphi.ca/ontario-acute-care-surge-monitor/
So we don't have more people coming into hospital. We have less people leaving hospital. In actuality, our admissions for respiratory illness is down this year compared to 2019. https://mapper.kflaphi.ca/respmapper/analysis/ontario-charts
Hospital are full because of our inability to discharge patients. After the spring decline we are now worse than we were in February with a record ALC numbers with over 20% of hospital beds being used by patients who are discharged but have no where to go.
This is related to the change in LTC ward rooms to double rooms, decreased home care, worried patients refusing to leave hospital before their cancer work up complete and delayed presentations leading to longer length of stays. https://healthydebate.ca/opinions/eliminating-3-and-4-bed-wards-ltc
Additionally, I have seen many patients refusing to go back to their LTC/Retirement home because they are locked in their rooms without visitors. They want to stay in hospital because they see nurses, physios and we allow some family to visit.
Some have mentioned how much better the food in hospital is than what is dropped, often cold at their closed door in the LTC/RHs currently. https://www.thestar.com/news/canada/2017/03/10/ontario-nursing-homes-feed-seniors-on-833-a-day.html
IMO lockdown measures have only acted to worsen hospital capacity & will cause further capacity issues moving forward more delayed presentations cancer migrations, delayed elective surgeries leading to emergent treatments and increased obesity and addiction within the community.
Cancer migration fallout will be huge. There has been a major decrease in cancer screenings and visits to the doctor. https://www.thestar.com/news/canada/2020/05/05/covid-19-has-put-routine-cancer-screening-for-many-in-ontario-on-hold.html For example Ontario is still working through March colon cancer FIT tests.
The harm to the economy cannot be overlooked. The increased unemployment is expected to cause suicides to increase with an increase in suicide rates of 1% for each 1% increase in unemployment. This could be over 2000 excess suicides in Canada in 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7236718/
In addition, we are burdening our children with a massive generational debt. Ontario's debt crisis was one of the worst in the world before covid. https://www.cbc.ca/news/canada/toronto/ontario-budget-2020-covid-19-doug-ford-1.5790724
Now with massive spending programs, decreased tax revenue and no way out i fear for the needed social services our community needs. https://www.publichealthontario.ca/-/media/event-presentations/2020/pho-rounds-covid-19-incidental-impacts.pdf?la=en
I hope we can respect COVID while investing in where the problems lay. Invest in LTC and home care capacity. Invest in improving hospital capacity. Do our best to protect our vulnerable but respect their humanity while avoiding the harms of lockdown
