'The system is beyond capacity,' Health expert weighs in on status of ICUs

CTV's Craig Momney speaks with infectious disease specialist Dr. Isaac Bogoch about the status of intensive care units across the province.

Craig Momney: COVID patients are being transferred daily out of the GTA to other hospitals, including Barrie and Orillia. How much more can the system take?

Dr. Isaac Bogoch: Well, clearly, the system is beyond capacity when we're certainly sending patients, not just to Barrie and Orillia, but I mean, even much farther, right. Basically, it's an all-hands-on-deck approach in the province.

They've cancelled surgeries, for example, you know, non-essential surgeries across the province to care for an influx of patients with COVID-19. So yeah, I mean, I think to expect to see more of this over the coming weeks because we're are really, unfortunately, filling up the bathtub.

Craig Momney: You mention the cancelling of surgeries. Have you ever seen this before?

Dr. Isaac Bogoch: Well, it did happen during the first wave, and during the second wave, not to the same extent I'd say, but we certainly did have cancellation of, I'm going to call them, I was going to say non-essential surgeries, but that's probably not the right way to frame it. Another way to frame it is scheduled surgeries. They're still important, they're still very, very important surgeries that need to be done, but we have to triage healthcare resources in the province because we have such a tremendous number of people coming into hospital and the ICUs with COVID-19.

We truly need all hands on deck, we need all available resources in the hospital, and we also need all personnel to help out. We saw it before but not to this extent.

Craig Momney: Who does this impact, and how long will this go on?

Dr. Isaac Bogoch: Well, it impacts anyone and everyone who needs to utilize the health care system right because when the healthcare system is stretched beyond capacity, it's not just for those with COVID-19.

It also has ripple effects for anyone who needs to use the healthcare system in Canada. Everyone's so focused, and all the resources are directed for COVID-19.

Having said that, if people have an emergency, you come to the hospital. The emergency rooms are still open; there's doctors here to look after you, don't delay coming in. We will take care of you. It just means that most of our resources are now being geared for caring for those with COVID-19. So, I think it's an extremely important point for people to know that if they're sick if they need help, COVID-19 or not, our hospitals are open, they don't close, and we are truly here to help anytime, day or night.

Having said that, we're seeing a ton of patients coming in with COVID-19, and of course, most resources are directed towards caring for that population coming in.

Craig Momney: Now we hear this third wave is less deadly, but everywhere we look, we're being told the healthcare systems are being overrun; what does this mean?

Dr. Isaac Bogoch: It just means that they don't function as effectively. I mean, you start to hear about patients being transferred often hundreds of kilometres away for an ICU bed, or you know, adults being admitted to a pediatric intensive care unit, or tents being set up outside hospitals to put patients in or bringing in personnel from other provinces so that we can actually help the hospital system throughout. Those are all unfortunate metrics that the healthcare system is stretched.

Craig Momney: New studies are also coming out detailing this virus is hanging out in the air, and people who are wearing masks and staying distanced are still getting infected. Is inhaling it the main way it's being transmitted?

Dr. Isaac Bogoch: I think it's fair to say that we know that that's been the case for a while and that touching surfaces and then touching your eyes, nose, or mouth is probable and extremely uncommon, maybe not zero per cent, but an extremely uncommon mechanism of transmitting the virus.

It's also important to recognize that most transmission and this is updated on the public health agency of Canada website. Most transmission is in close quarters with each other. Of course, there are cases where people get this who are distant from one another, and there's been a number of very impressive case reports outlining that, but I think it's fair to say that the vast majority of transmission is very likely within close contact with people who are infected.

Craig Momney: So, in this case, do we need better masks or different public health measures?

Dr. Isaac Bogoch: I think what you're hearing now is three things. Number one put on a mask, and the vast majority of people are putting on masks.

Number two is wear high-quality masks, which you can go on the Public Health Agency of Canada website and see what actually constitutes as a high-quality mask, like not using any little piece of material over your face, that's just probably not going to cut it, and the Public Health Agency of Canada actually has recommendations of what high-quality masks are.

And then the third point is putting the mask on right, meaning it should have a very snug fit over your nose and your mouth, not into the chin masking, not under the neck masking, not into just having like right across your face it actually has to fit snuggly over the face.

Craig Momney: Now the number of people being vaccinated is picking up; what are you seeing happening in the next couple of weeks?

Dr. Isaac Bogoch: We're more days than not, vaccinating over 100,000 people per day in Ontario. Yesterday (Wednesday), there were over 130,000. I think we're at about 120 - 130,000 per day over the last couple of days, it just depends on when you cut the data, and that's great.

A lot of this is driven by really using the AstraZeneca vaccine more effectively. Interestingly, we haven't heard about when our next shipment of AstraZeneca is going to be. We might get another shipment from the United States; we'll hopefully get some Johnson and Johnson vaccine into Ontario perhaps later this month. Unfortunately, the Moderna supplies are going to be limited, but the Pfizer supplies are essentially double. So short story long, we have more vaccines coming into the province; it's important that we mobilize this in the most efficient manner to get as many people vaccinated in the shortest period of time. I think we'll still be able to continue this regardless of what vaccines we have; we'll still be able to continue this throughout April and through May.

Craig Momney: Given that, how soon until there's enough supply that everyone can just go out, sign up and get a shot?

Dr. Isaac Bogoch: It's really hard to know because, quite frankly, even in the last couple of weeks, we've heard about supply chain issues.

So, Pfizer's fantastic because it shows up like clockwork, week after week after week, and in fact, in May, we're going to get double the amount of Pfizer that we've been getting in recent weeks, so that's certainly helpful. The other ones are a little more iffy, right?

We don't know when our next shipment of AstraZeneca is going to be. It's not entirely clear when we're going to get Johnson & Johnson, although we'll probably get a little of that at the tail end of this month, and Moderna, sometimes shows up late, and when it does show up, they've actually cut the number of doses. Having said that, the increase in the Pfizer vaccine that we get more than makes up for that. So we certainly have more vaccine coming in. All this, to say it's very hard to look someone in the eye and say exactly when anyone who wants a vaccine is going to get a vaccine because there's just changing rules throughout the last weeks about when we're going to get vaccines and how much vaccines we're going to get.

I think it's fair to say that throughout the month of May, we'll probably have given access to anyone who wants a vaccine in the second stage of the vaccine rollout; they'll probably all have at least been able to sign up for a vaccine, and it's probably gonna be sometime in June where, you know, anyone in the province who wants a vaccine will be able to get one but don't hold me to that because so much of this is dependent on supply that comes in.