Health officials in northwestern Ontario warn the region’s fragile healthcare system could buckle under the pressures of an ongoing spike in three respiratory illnesses sending children to the emergency room.
Ontario is in the midst of a triple threat of COVID-19, the earlier than normal rise in respiratory syncytial virus (RSV), and influenza. It’s straining emergency rooms and pediatric care resources that in many cases were already stretched to the brink.
“I am very worried,” said Dr. Kit Young Hoon, the chief medical health officer for the Northwestern Health Unit during a news conference where several regional health leaders outlined their concerns.
“We have seen a rapid increase in hospitalizations and emergency department visits for respiratory illness, particularly for children,” she said. “We are facing a potentially difficult winter season, and now is the time to take action.
“This is a surge that is overwhelming hospitals in an area of Ontario where they have more capacity than we do. And we are in a region where capacity is historically lower within the healthcare system,” Young Hoon said.
Sue LeBeau, the CEO for the hospital in Red Lake, Ont., echoed those concerns, saying she’s worried as she sees hospitals open up extra pediatric care wards, and sending teens to adult wards.
“Those are signs all is not the usual in pediatrics for sure and may signal a wave in the adult population later,” LeBeau said. “This is something that I have not seen.”
Small hospitals in Ontario’s northern communities have been operating on razor thin margins staffing-wise this year and some have been forced to periodically close emergency rooms due to staffing shortages since the spring.
“We are often one or two sick calls away either physician or staff-wise from having to close,” LeBeau said. “It’s very important to protect our patients and our community and our health care providers.”
Young Hoon recommended that everyone return to mask-wearing indoors and other mitigation strategies introduced during the COVID-19 pandemic to help slow the spread of these viruses.
Not only are the number of people in the emergency room going up, the rate of children coming to the emergency room is growing, explained Ray Racette, the CEO at the Lake of the Woods District Hospital in Kenora.
In the first two weeks of November, 25 per cent of patients admitted to the emergency room were 16 or younger. One month earlier in October, that number was 14 per cent. Most of those children are coming because of respiratory illnesses, Racette said.
“That’s really what we’re going to face and we’re just getting into the beginning of whatever surge is coming our way,” he said.
Province recommends return to masking
Dr. Kieran Moore, Ontario’s chief public health officer said the province is facing “extraordinary pressures” and called for collective efforts to alleviate the strain — but stopped short of re-introducing mask mandates.
“What we are facing is a triple threat that requires our collective action and action to protect the most vulnerable in our communities — the very young, the very old and those with underlying medical issues — to ensure that our health-care system remains able to care for Ontarians when they need it,” Moore said.
Dr. Janet DeMille, the chief medical officer of health in Thunder Bay said she agreed with Moore’s recommendation and is also asking people to mask up in public.
“We are seeing that increase in emergency department visits, we’re seeing our flu cases go up, we’ve seen our flu cases go up, we had an early start to the flu season and certainly, seeing the pressures on the healthcare system right now,” DeMille said.
On the issue of whether to issue mask mandate, instead of a strong recommendation, DeMille did not go further than Dr. Moore in calling for a mask mandate, but said bringing one in would likely have a major effect on reducing cases.
“I think that’s a fairly minimal imposition wearing masks indoors,” she said.
Superior Morning7:38Dr. Janet DeMille: Masking
Meanwhile, the Thunder Bay Regional Health Sciences Centre continued its call for people to avoid the emergency room unless it was absolutely necessary.
Hospital occupancy at the regional health sciences centre is over capacity at 101.2 per cent and the ICU is at 86.4 per cent.
“We are asking for everyone’s patience as our teams prioritize the needs of each patient. Please be mindful of extended wait times and be courteous to staff if you are using the emergency department,” a hospital spokesperson said in a statement.
Unprecedented surge of sick children
The recommendation to mask up comes as pediatric hospitals across Ontario have been dealing with an unprecedented surge of sick children in recent weeks.
Moore said children aged two to five should only wear a mask with supervision if they can safely tolerate masking, and can put it on and take it off.
Moore has previously said this fall and winter would see a resurgence of respiratory illnesses and that he would recommend masking in certain indoor settings if hospitals begin cancelling surgeries to deal with a surge of patients.
“The difficult and complex fall that was predicted has materialized,” Moore said Monday.
“COVID-19, influenza and RSV — all three are actively circulating across Ontario in all of our communities … contributing to the pressures on our pediatric health-care system.”
Medical officials have also been increasingly calling for the public to mask up after children’s hospitals across the province became overwhelmed with young patients in emergency departments, pediatric wards and intensive care units.