Level of alert raised: hospitals on the verge of a breakdown in services

Saint-Eustache hospital in intensive care

About 13,000 healthcare workers are absent in Quebec due to COVID-19. The record from the first wave of the pandemic was broken on Wednesday as 925 infected people were added, according to CBC.

It is in this context that hospitals have triggered the maximum alert level and have moved to level 4 of load shedding, which means postponing even more surgeries to free up staff. The CISSS des Laurentides Integrated Health and Social Services Center exceeded the level 3 target and asked Quebec to move up to 4th, but this has not yet been accepted.

If the Omicron variant occupies little intensive care, it overflows the floors of hospitalizations, and not necessarily because of its severity. The absences of health workers in isolation have tripled since December 19, thus considerably reducing the reception capacity of establishments.

At the same time, more and more Quebecers who go to hospital for fractures, childbirth or appendicitis attacks are more and more likely to discover on the spot that they are infected. At least 30 to 40% of hospitalizations are secondary diagnoses, the national director of public health, Horacio Arruda, revealed on Wednesday. These patients are still placed in COVID units and require additional resources to avoid outbreaks.

The Laurentians in “critical” condition

A quarter of workers are absent from the emergency rooms of Saint-Jérôme and Saint-Eustache hospitals, always according to CBC sources. In Saint-Eustache, 6 of the 12 intensive care beds are closed due to lack of personnel. The situation is critical in several departments, Rosemonde Landry, President and CEO of CISSS des Laurentides, wrote in an internal memo. Load shedding is essential.

This level of load shedding provides a target of 48 COVID beds for the Integrated Health and Social Services Center CISSS des Laurentides . However, there were 111 patients infected in hospitals in the region on Wednesday last week, more than double.

The Integrated Health and Social Services Center CISSS des Laurentides did not want to confirm its request to go to level 4 for load shedding. “In collaboration with the ministry, we are monitoring the situation closely, as it can change very quickly”, said spokesperson Véronique Bernier. “Our wish is obviously to maintain regular activities as much as possible to meet the needs of the population.”

What does stage 4 of load shedding mean?

Level 4 implies that elective surgeries will be postponed progressively beyond the 50% mark, until reaching, ultimately, 100% postponement of these non-essential activities, for example knee or cataract surgeries. Level 4 also involves closing small emergencies to redirect resources to larger ones. For example, the CISSS des Laurentides has on its list the closure of emergencies in Lachute and Rivière-Rouge, but the situation has not yet imposed.

The plan of the Integrated Health and Social Services Center CISSS, provides for postponing even more surgeries, even if 10,000 people are already awaiting an operation in the region. It is also planned, when necessary, to close the emergency room and the operating room in Argenteuil in order to repatriate resources to Saint-Jérôme to avoid a possible disruption of services.

Generalized outbreaks

At the Saint-Eustache hospital, 9 units are in outbreak out of a total of 15 and there were, on Wednesday the 5th of January, 7 outbreaks at the Saint-Jérôme hospital center. The emergencies of the two establishments are in bloom, as well as the cancer center of Saint-Eustache.

Doctors and nurses stationed in Saint-Eustache explained how outbreaks slow down all operations. The staff redouble their precautions and a room must be left empty for 20 minutes after the passage of an operated patient, in order to eliminate the aerosols. Some operations are extended by 40 minutes because of the precautions that must be taken, explained orthopedic surgeon Pierre-André Clermont.