Ontario residents urged to get flu shot, as hospitals brace for the worst

Thestar.com
Nov. 13, 2019
Rob Ferguson

Prospects for this year’s flu season have health authorities girding for the worst given many Ontario hospitals are already operating at capacity before the potentially deadly bug becomes widespread.

Their message is simple: get a free flu shot at a pharmacy, doctor’s office or public clinic to boost your odds of staying out of a crowded emergency room by half.

“The system is quite fragile at the moment,” Anthony Dale, president of the Ontario Hospital Association, warned Tuesday. “The best thing in those circumstances is always to get the flu shot.”

Health Minister Christine Elliott said the Ontario government has increased its vaccine order by 10 per cent, including high-dose shots aimed at giving those 65 and over increased protection, among other measures to help the health-care system deal with the inevitable increase in patients.

“We are actively advertising for people to go and get the flu vaccine, if not for themselves to protect others around them.”

A bad experience in Australia, where the flu hit early and hard this year, has fuelled concerns about what could happen here -- even if the southern hemisphere’s experience doesn’t always translate to North America.

“The fire under our feet has been, wow, what if it’s a year like they had in Australia where it started early and there is a high sustained activity through a lot of the influenza season,” said Dr. Suzy Hota, medical director of infection prevention and control at the University Health Network.

“That would be a big stress on our system if we end up having high numbers of patients for a prolonged period of time.”

In just one example of preparations, the agency Critical Care Services Ontario has a stockpile of ventilators available for hospitals that run out of machines to keep critically ill flu patients breathing, as outlined in a 16-page “planning guide for respiratory pathogen season” prepared by the health ministry’s emergency management branch last month.

The good news is the flu is not yet widespread in the province and this year’s vaccine appears to be a good match for the two strains now making the rounds, said Dr. Vinita Dubey of Toronto Public Health.

“The flu vaccine is about 50 per cent effective. It’s still more than anything else that we have, like washing your hands regularly and covering your cough,” she added, noting her department has extended the hours of two public flu shot clinics to date because of long lineups.

Elliott told the Star the government is working with hospitals to find more spaces to put beds for the flu season, along with providing financial help to the hospital association, home care and community support agencies to help those stricken with the flu get care “in their homes instead of in hospital.”

“There are a few hospitals that do have some extra spaces and beds that are available,” she added. “We want to make sure that every possible bed is available for patient care knowing that flu season will bring more people in to our hospitals but also to deal with the hallway health care situation.”

Premier Doug Ford’s government has promised to end the treatment of patients in hospital emergency room hallways and other spaces, such as patient lounges and washrooms, that are not proper hospital rooms.

University Health Network, which includes Toronto General and Toronto Western hospitals, is part of Elliott’s efforts to find new beds but said there are limits as to how much can be done.

“Sadly, the hallways are a place where we will have to have more patients. That is part of the plan. Having physical places outside of that, we are looking at opening up some additional spaces but that may not be enough or we may not have the resources to support all that,” said Hota.

“So, unfortunately, as much as we would like to avoid patients in hallways we’re looking to, if that’s the case, do what can we do to make that as safe as possible and as patient-centred as possible.”

With a flu surge in mind, UHN struck a task force to brainstorm solutions to mitigate the effects, such as more emphasis on its annual push to get staff vaccinated along with in-patients and outpatients whose medical conditions allow for flu shots.

The hospital network is also looking to divert some patients from its emergency room, such as to Women’s College Hospital where there is an acute ambulatory care unit that could handle overflow, and to get people whose conditions don’t require emergency treatment to visit walk-in clinics or urgent care centres.

“There is still a little bit of the ‘walking well’ who use our emergency department,” said Hota. “That’s a challenge because when people show up at our emergency department we care for them.”

The Australian experience “certainly made everybody sit up and take notice,” said Dale of the hospital association.

“With hospitals at such record high occupancy levels almost year-round we have to make sure we’re equipped. You’ve absolutely got to be ready.”

New Democrat MPP France Gelinas, who has been sounding alarm bells about hospitals working overcapacity, said hospitals with closed beds will need money from the government to staff them so they can be reopened, and will have to find more nurses.

“I can’t remember the last time I have seen hospital executives and people in charge of nursing so nervous,” added Gelinas (Nickel Belt), her party’s health critic. “They all know that it’s going to get more busy.

Dubey said it’s estimated that only one-third of Canadians get flu shots, perhaps because of misconceptions about the vaccine, which can in some causes cause a fever as the body begins making antibodies to ward off the bug.

“The vaccine has no live flu virus,” she said, adding some people may come down with other illnesses as a coincidence after getting the shot. “You cannot get the flu from the flu vaccine.”

While it looks like the vaccine will perform well this year, that could change, Dubey added.

“Flu is predictably unpredictable. It’s a virus that mutates itself. It’s constantly evolving.”