Ontario hospitals to ramp down elective surgeries as COVID-19 cases surge

Ontario hospitals have been instructed to start ramping down elective surgeries and non-urgent procedures next week to ensure they have the capacity to treat a growing number of COVID-19 patients.

The president and CEO of Ontario Health – which oversees the province’s health system – told hospitals to make the move as the number of COVID-19 patients in the province’s intensive care units hit a new high.

“Given increasing case counts and widespread community transmission across many parts of the province, we are facing mounting and extreme pressure on our critical care capacity,” Matthew Anderson said in a memo issued Thursday night.

Hospitals in northern Ontario are exempt but Anderson said they should prepare to ramp down quickly in the near future.

The memo also asks hospitals to identify staff who may be redeployed to other sites if necessary.

Ontario Health will continue to monitor the situation with a view to bring back surgical capacity for deferred services as soon as possible, Anderson said.

“These are very difficult and challenging times for all Ontarians, and we understand that deferring scheduled care will have an impact on patients and their families and caregivers,” he said.

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That guidance comes as the regulatory body for Ontario physicians shared a message of support for doctors who may have to decide which patients will receive life-saving treatment if intensive care units are overwhelmed.

The province’s critical care triage tool has not been enacted, with Ontario’s health minister saying this week that the protocols were not yet finalized.

The College of Physicians and Surgeons of Ontario told doctors they will be supported if the measure takes effect.

“We firmly believe physicians need to be supported if they are required to make extraordinary decisions about which of their patients will be offered critical care resources that are in short supply,” Nancy Whitmore, registrar of the college, said in a message to the profession Thursday night.

She said the college will be there to provide clarity if the protocol is enacted, acknowledging the “unprecedented situation” in Ontario intensive care units and noting that “physicians may soon be faced with making incredibly difficult decisions that they never imagined having to make.”

“We are supportive of physicians acting in accordance with this protocol even when doing so requires departing from our policy expectations. These are extraordinary times that require extraordinary decision-making and patients’ best interests will be served by following the protocols developed by our command tables,” Whitmore’s message said.

There are 1,492 people hospitalized in Ontario because of COVID-19, with 552 in intensive care and 344 on a ventilator.

According to the province’s most recent COVID-19 modelling, the surgical backlog is nearing 250,000 since the province paused elective surgeries at the beginning of the pandemic.

The modelling also predicted patients in the ICU will reach 800 by April 30.

Dr. Adalsteinn Brown, who presented the data, said at that point, with 800 people in the ICUs, “We are not able to provide all the care as well as we would want to people.”

The latest news came as Ontario Premier Doug Ford received a COVID-19 vaccine at Toronto pharmacy on Friday and said “things are looking really, really positive out there.”

Ford said ramping up the province’s vaccine rollout will help address the capacity crunch in Ontario’s hospitals.

“The quicker we can get these vaccines into people’s arms, the quicker they’re going to be able to resume the surgeries,” he said. “Folks, we will get to those surgeries as soon as possible.”

Ford said that by the end of the Friday, Ontario will have given 3 million people their first dose.

A total of 2,940,166 vaccine doses have been given in Ontario so far as of Thursday night.

Earlier this week he said the province will give 40 per cent of adults in Ontario – or five million people – their first shot over the next four weeks.

NDP Leader Andrea Horwath said the Ford government started to reopen the province too soon after the second wave, which has led to the “devastating” situation in hospitals.

“Doug Ford marched us right into this crisis with his eyes wide open,” she said. “And so now people need to know how the Ford government is going to get us out of it.”

Green party Leader Mike Schreiner said the situation in hospitals was preventable.

“(Premier) Ford’s delay to enact stricter measures and his refusal to implement key policies like paid sick days has put hospitals in the difficult position of having to stop elective surgeries,” he said in a statement. “Ford ignored the advice of his own experts who predicted this months ago.”

Meanwhile, vaccine appointment bookings opened to residents aged 50 and older in Toronto and Peel Region on Friday.

Toronto said people who live in hot spot neighbourhoods can book an appointment to get their shot, while Peel has opened the bookings for anyone in the age group.

The Ontario government said earlier this week that people aged 60 and over were permitted to book their vaccine appointments in every region.