Let's talk about hospital capacity in the context of how patients "flow" through the hospital. This should help give you a sense of why the focus on hospital capacity is important, and why hospitalizations and ICU admissions are one of the benchmarks for COVID-19 restrictions. /1

Say you slip and break your ankle. You come in the ER and get assessed by the triage nurse. The nurse takes your vital signs and asks you why you're there. You are then assigned a "triage score," which helps decide what order patients are brought in to be seen by a doctor. /2

I think we can all agree that a person that comes in with a heart attack is going to be placed as a higher priority patient compared to someone who broke their ankle and is otherwise ok. Then what? You wait in the waiting room until your turn comes. /3

You get brought into a bed and get assessed by your nurse and your doctor. You get x-rays and it's deemed that your ankle fracture is bad enough to require urgent surgery. The orthopaedic surgery team on call comes to see you in the ER and writes admission orders. /4

You wait until a bed is available upstairs. Once available, you move upstairs and wait for surgery. Seems simple. But let's take a step back and look at all the points along the way where hospital capacity can affect how you flow through the system. /5

We will start at the top, to show the trickle down effect on how quickly we can see people in the ER. There are > 600 "extra" pts in hospital wards, and >100 "extra" pts in our ICU beds with COVID-19 in ABV. How does this affect you, with a straightforward broken ankle? /6

Remember how your were waiting for a bed upstairs once the orthopaedic surgeon admitted you? What if there isn't a bed available upstairs because there are just so many patients admitted with COVID-19? Then you wait in the ER for hours and hours until there is one. /7

But wait, let's go back even further. Let's say that you're still in the waiting room, and there are people who are sicker who come in after you (with heart attacks, appendicitis, difficulty breathing, or cardiac arrests). They will, appropriately, get brought in ASAP. /8

They are now occupying the ER beds and you can't be brought in from the waiting room. When there are more and more very sick patients, even those who are sick with less serious conditions end up waiting in the waiting room for longer. /9

Now, once all of these sicker patients get admitted to hospital, they then wait to move up to the hospital ward as well, once a bed becomes available. As the wards get more full (with COVID-19 patients and others), people wait in ER beds for longer. /10

It's easy to see how this leads to a build up of pts in the ER, and those needing ER care waiting longer. Remember, the ongoing functioning of our healthcare system is important for EVERYONE. Whether someone with complications of COVID-19, with a stroke or with a broken bone. /11

This is why it's important to get COVID-19 numbers under control with the restrictions that are in place. Thankfully, so far they're working to help decrease case numbers and ease the stress on our healthcare system. /12