At least one major hospital network is cancelling all surgeries except for the most urgent and emergency cases, while others manage an increase in staff testing positive for COVID-19 and clamp down on outside visitors, all in an attempt to get ahead of potential surges caused by the Omicron variant.
In Toronto, Unity Health Toronto and the University Health Network — two major hospital networks in the city — announced they are no longer allowing visitors for patients with hospital stays that are shorter than seven days. Sunnybrook Health Sciences Centre and Michael Garron Hospital are also introducing visitor restrictions.
Omicron’s exponential growth in cases hasn’t yet translated into huge new numbers of people admitted to hospital, and ICU numbers are stable, although hospitalizations are trending up in the province. But in the face of unknowns regarding Omicron’s severity and possible staffing shortages due to its contagiousness, hospitals are already taking steps to prepare.
Dr. Michael Warner, head of the ICU unit at Michael Garron Hospital in Toronto, said many of the intensive care units in the GTA haven’t seen the impact of the Omicron variant yet, but they are being proactive to protect staff and patients.
“It’s really difficult to gauge what will happen,” he said, adding he is anticipating the variant’s maximum impact may not be felt until mid-to-late January.
Unity Health Toronto, which includes St. Joseph’s and St. Michael’s hospitals and Providence Healthcare, has cancelled outpatient appointments (such as diabetes and fracture clinics), except for the most essential, and surgeries that aren’t urgent or emergencies, effective Monday. Outpatient procedures have been moved to virtual where possible.
“It has become very clear that we are facing another significant surge of COVID-19 in Toronto and across Ontario,” wrote president and CEO Tim Rutledge in a statement posted online.
“Omicron is presenting all of us with a number of challenges and uncertainties. We are still learning about this new variant, however, one thing that we have all seen is the extremely rapid pace of transmission between people,” he added. “This variant is moving fast.”
The University Health Network in Toronto, which oversees Toronto General and Toronto Western hospitals, is going into the holiday period with its usual staff reduction, as some will be taking time off over the winter break.
But Gillian Howard, spokesperson for UHN, said the hospital network is seeing more COVID-19 cases among staff, forcing it to adjust staffing models and rely more on virtual care options as well, wherever possible.
Hospital leaders are also preparing for the possibility of staff being called back to work during the holidays, and redeploying staff to other units if needed as a last resort. As of Tuesday, however, COVID-19 cases in the ICU remain low with four throughout the network.
“The concern is that if there are increasing numbers of people who have acquired this variant, that we will see an increasing number of patients admitted to the hospital or the ICUs,” Howard said. “Only time will tell whether this variant and the level of disease within the population will put pressure on all ICUs.”
Michael Garron spokesperson Shelley Darling said in an email that the hospital is not considering suspending non-emergency surgeries.
Dr. Carmine Simone, vice-president, medical, said in an emailed statement that staff there are “triaging high-priority and time-sensitive cases given workforce shortages that have been amplified because of the COVID-19 pandemic,” and assessing the situation daily.
“At this time, we have not completely cancelled all outpatient scheduled care,” she added.
Over the last two months the hospital’s operating rooms have been running at about 15 per cent less than normal “due to staffing pressures and unprecedented volumes of admissions from our Emergency Department requiring surgical care.”
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Trillium Health Partners, a hospital network that includes Credit Valley Hospital, Mississauga Hospital and Queensway Health Centre, has one COVID-19 patient in the ICU as of Tuesday. But due to a surge in Omicron cases, the network has also introduced new visiting restrictions, limiting the number of essential visitors for patients to two, with only one allowed to visit at a time for a maximum of two hours.
Thomas Tenkate, a professor at the school of Occupational and Public Health at the university formerly known as Ryerson, said that due to Omicron’s rapid spread, hospital are trying to be “pre-emptive.”
Experts need more data to determine if Omicron is less severe than Delta, he said, but even if it does turn out to be milder, the “sheer number of cases” will strain the system, because it’s so much more contagious.
As of Tuesday, Ontario reported 3,453 new cases of COVID-19, with 412 people hospitalized and 165 in the ICU province-wide. The positivity rate is 9.9 per cent, up from six per cent, which suggests that there are more cases in the community that aren’t being picked up.
Cases have increased by 125.2 per cent since last week’s seven-day average, fuelling concerns that more people will be hospitalized in the coming days and weeks.
In a press conference Tuesday, Dr. Kieran Moore, Ontario’s chief medical officer of health, said officials are “hoping for the best but preparing for the worst” when it comes to Omicron, which is estimated to be four to eight times more contagious than Delta and now the dominant variant in the province.
Hospitalizations have increased nine per cent over the past week, according to Moore. But out of the 4,600 Ontarians who have Omicron, only 15 were admitted to hospital and none are in the ICU, he said — though this is a fairly young population in their 20s and 30s.
Moore said officials are reviewing all the emerging evidence on Omicron, including watching data from Denmark and the U.K. closely. But he hasn’t made “any firm conclusion” on severity yet.
Tenkate said that with more cases in general, more health-care workers will become infected and will need to isolate, even if they don’t get that sick.
“That combination on top of potential surging cases is going to really be challenging for the health-care system,” he said.
Moore told reporters Tuesday that officials are hoping to prioritize rapid tests for health-care workers to deal with this, as they otherwise anticipate a 20-30 per cent absentee rate with Omicron.
That is something weighing on Warner and others who are stressed about the possibility of staff getting sick and having to isolate, especially when they are already operating at “razor-thin margins,” he said.
There are only four doctors working at Michael Garron’s ICU unit, Warner added, and “even if you lose one, it’s a huge problem” as patients will lack sufficient care.
“When we leave the hospital, we don’t go anywhere, we go home and we don’t see anybody because we’re so scared of getting Omicron,” he said. “We’re so scared of not being able to work.”
May Warren is a Toronto-based breaking news reporter for the Star. Follow her on Twitter: @maywarren11
Nadine Yousif is a Toronto-based reporter for the Star covering mental health. Follow her on Twitter: @nadineyousif_
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