Ontario's hospitals are filling up, hampering the resumption of surgeries
New COVID-19 rules require hospitals to have 30-day PPE supply, occupancy below 85%
May 23, 2020
The government announced last week that those surgeries (often called elective to distinguish them from emergency surgeries) could resume. But this can happen only in hospitals that meet certain criteria.
Two criteria that are crucial:
- The hospital's occupancy rate must be no higher than 85 per cent.
- The hospital must have a 30-day supply of personal protective equipment (PPE), such as masks, gowns and gloves.
"A large minority of hospitals" do not qualify, said Anthony Dale, president and CEO of the Ontario Hospital Association.
"I know of hospitals already approaching 100 per cent occupancy," Dale said in an interview Friday.
"Why are we allowing hospital occupancy to rise again to very high levels?" he asked, adding that he is "extremely concerned that we're sleepwalking into a situation that we can prevent If we take action now."
Dozens of hospitals are currently registering occupancy rates above the 85 per cent mark, according to the association.
"Clearly this is a risky situation," Dale said. "We have to be serious about the fact that the second wave [of the pandemic] is coming and we need to be prepared."
He is calling on the province to find more space outside of hospital for patients who don't need acute-care beds and to "redouble its efforts" in helping hospitals obtain PPE.
A couple of things here:
First, who decided on 85%? Most hospitals in Ontario, pre-Covid, were running at 95-105% (hallway medicine).
We can all agree that is and was unacceptable.
I wouldn't suggest we go there again, if at all possible.
But as we re-start full-service medicine, the only way for that figure to come in under 95% involves more hospital beds, more transitional (ALC) beds, and more Long-Term care beds.
So far as I know, we haven't opened any new hospitals in the last 3 months or any drastic expansions of existing ones.
As such, 85% as a criteria is likely to stifle the return of medically necessary procedures (as the report suggests it is)
To me this simply isn't workable.
The criteria, instead should be on private patient rooms, for a start.
Second, on proper PPE/hygiene and testing protocols.
Which brings me to the next matter..............why is any hospital in this province short of PPE? At this point there really shouldn't be any excuse.
Finally, we need to get on with adding additional beds in all of hospitals, transitional care centres and LTCs.
No dilly-dallying.
In Toronto, there is a project underway at the planning level working towards replacement of Scarborough General; and another for St. Joe's.
Both should expedited, and given direction to add additional capacity.
Downtown, T-Gen has the most campus area for more space and should be told to begin planning for added patient capacity forthwith.
A Long Term care centre and/or transitional care centre should be added on the T-Gen Campus or on the lands behind hospital row on the west side of University.
The further expansion of St. Mikes should also be greenlit.
Similar investments are needed elsewhere in the province.
Those capital projects will take 2-5 years to deliver (in the case of full hospital redevelopments, 6-7 years is more likely).
So we don't have time to waste.
But we do need interim solutions much, much sooner.
