GTA hospitals closing pediatric units as COVID-19 case counts and admissions climb

Theglobeandmail.com
April 12, 2021
Kelly Grant

Record numbers of COVID-19 cases in Ontario are prompting most hospitals in the Greater Toronto Area to shut down their pediatric units, clearing space and staff for coronavirus patients as Canada’s Chief Public Health Officer warns of a worsening situation across the country.

Theresa Tam said Sunday intensive care admissions have jumped by 23 per cent over the past seven days compared with the week before. In Ontario, which reported a record 4,456 cases Sunday, the chief of emergency services at William Osler Health System said worse is yet to come.

“This is the largest strain I’ve even seen on the health care system in my career and it is only expected to get worse,” said Andrew Healey. William Osler includes hospitals in the hard-hit communities of Etobicoke and Brampton.

“Our future for the next two weeks is already set in stone.”

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Dr. Tam said COVID-19 infections and hospitalizations are increasingly affecting younger people, adding figures show a jump in the number of hospitalizations among those 40 to 59 years old. The percentage of patients in intensive care who were between the ages of 18 and 39 also doubled from January to March, from 7.4 per cent to 15 per cent of the total.

“Strong public health measures and individual precautions must be sustained where COVID-19 is circulating,” Dr. Tam said in a statement.

As of Sunday evening, Quebec moved up its curfew in the Montreal and Laval areas to 8 p.m. from 9:30 in an effort to clamp down on rising numbers in that province. In British Columbia, health officials prioritized all adult residents of Whistler for vaccination, regardless of age, in an effort to stamp out an outbreak in the resort community fuelled in part by highly contagious variants, including one that originated in Brazil.

The situation in Ontario hospitals is more dire now than at any time in the pandemic, particularly in the Greater Toronto Area.

Of Ontario’s new infections reported Sunday, 1,353 of them were in Toronto and 860 were in Peel, the region that covers Brampton. There were 593 COVID-19 patients in Ontario ICUs, according to Critical Care Services Ontario -- also a record.

“We’re not feeling the effect of 4,500 cases [yet]. That’s in two weeks,” said Dr. Healey, who is also a critical-care physician. “That effectively doubles or triples our current threat and we’re barely keeping our heads above water.”

The order requiring hospitals in the GTA to close their pediatric units, handed down by the GTA Hospital Incident Management System Command Centre and obtained by The Globe and Mail, takes effect Monday. The hospitals will clear space and staff for COVID-19 patients by sending teens and children in need of in-patient care to Toronto’s Hospital for Sick Children.

There are 14 hospitals on the list, including those run by Trillium Health Partners in Mississauga, William Osler Health System in Brampton and Etobicoke, Lakeridge Health in Oshawa and Ajax, and the Scarborough Health Network, among others.

Ronald Cohn, the president and chief executive officer of SickKids, said Sunday the children’s hospital will be able to care for the extra patients using the same surge protocols the hospital activates during bad winter virus seasons. He said scheduled pediatric operations wouldn’t be affected, and that parents could still take children to their local hospital in an emergency.

SickKids opened an eight-bed adult ICU late last week to care for otherwise healthy people in their 20s and 30s with COVID-19. As of Sunday morning, Dr. Cohn said there were five patients in the newly opened unit and two more were set to be transferred later in the day from other hospitals.

“We are clearly at a very concerning point in the pandemic right now,” Dr. Cohn said. “If you look at SickKids taking adult patients, we actually looked into our archives and it’s an unprecedented situation. It’s never happened before.”

Ontario Health, the superagency that oversees the day-to-day operations of the health care system, has already ordered all hospitals outside Northern Ontario to begin ramping down scheduled and non-urgent surgery.

During his weekend shift in the emergency department at Brampton General Hospital, Dr. Healey said the hospital came close to running out of machines that provide high-flow nasal oxygen, a step below ventilation.

The hospital had to tap a national stockpile of the machines, he said, and now has enough for the moment.

Dr. Healey said, at Osler, about 80 physicians who wouldn’t normally care for COVID-19 patients -- including rheumatologists, gastroenterologists and cardiologists -- have stepped up to perform nursing duties in COVID-19 units.

Quebec reported 1,535 new infections on Sunday, as well as a 25-person jump in hospitalizations -- numbers the province’s Health Minister described as “worrisome.”

New case data were not available for B.C. for Sunday, but over the past week, the province’s per-capita case counts have followed only slightly behind those of Ontario.

Whistler has been a hotspot and although the ski runs have been shut down, Vancouver Coastal Health advised residents with proof of permanent residency or employment in the community that they would be eligible for the vaccine starting Monday.

From the start of the new year to April 5, there have been 1,505 COVID-19 cases in Whistler, with the majority occurring in people 20 to 39. The health authority said the Howe Sound health area has the highest rate of COVID-19 of any local health area in the province, with the majority of these cases residing in the Whistler community.

Whistler Mayor Jack Crompton said the vaccination drive will protect more than the residents of his town.

“This protects Whistlerites, but I believe it will protect the province as well,” Mr. Crompton said in an interview. “The community vaccination means that when people come from Vancouver into this community and go home, they’ll be more protected than they would’ve been otherwise.’'

B.C. has recorded 974 cases of the variant that originated in Brazil, the highest in Canada. Of those cases, there are at least 197 of the variant cases in Whistler.