'It really hit home': ICUs overflowing, doctors raise concerns as B.C. officials stay the course
Provincial health officials defended their ongoing strategy for dealing with COVID-19 infections, despite worrying signs B.C.’s health-care system is increasingly coming under strain as new variants of the disease grow in numbers.
On Tuesday, the provincial health officer announced 207 of the day’s 1,072 cases had officially tested positive as variants of concern. It came on the heels of Royal Columbian Hospital revealing its intensive care unit is overflowing with coronavirus patients.
“Our medical floor has as many COVID patients as we’ve seen in the past year, so we’ve had to expand our cohort and we’re running at capacity issues where sometimes we don’t quite have space then to fit in them all in our traditional ICU and HAU. Therefore they sometimes have to wait in emerg. or we use other areas of the hospital to try to take care after critically ill patients,” said Dr. Gerald Da Roza, head of medicine at the hospital in New Westminster.
Lions Gate Hospital on the North Shore is under similar strain in its ICU, and doctors all over the region are sounding the alarm about more young people in hospital.
In fact, several front-line hospital doctors who spoke with CTV News said that nearly all their hospitalized patients are now under the age of 50, and emphasized it’s important for the public to understand the demographic shift.
“When you hear about COVID for an entire year and you hear, ‘You can get sick,' but most of the time you weren’t getting that sick if you were younger, I think at some point people stopped believing that,” said Da Roza. “I’ll tell you that it really hit home when we had to transfer a 30-year-old individual with young children from an ICU to our (specialized) ICU to provide critical care support with (extracorporeal membrane) oxygenation. To me, that was scary, because it tells me anyone can get really sick with these new variants, and we just have to really be vigilant until we can get the vaccine rolled out to more of the general population.”
In stark contrast to the dire warnings from Da Roza and his peers, Dr. Bonnie Henry emphasized the small percentage of overall numbers variants represents, and while officials were “watching carefully,” she said she didn’t see a need to change the province’s approach in the face of more contagious and virulent forms of COVID-19.
"We're treating all of these (positive cases) as if they are variants, so we are doing aggressive case management. That is something we have been doing from the beginning,” she insisted.
She pointed to contact tracing and selective asymptomatic testing for close contacts in the case of certain outbreaks.
“That's how I know that people are having more contacts now than they were having a few months ago. We are doing extra testing of people.”
But publicly available data doesn’t support that claim. The province has been averaging about 9,000 tests a day since early February. The rolling seven-day average then was about 420 cases per day at that time, but has now mushroomed to 961. Testing simply has not ramped up as infections have soared.
The variants are driving the third wave of infections according to various experts and Canada’s top doctor.
“Variants of concern are contributing to the current resurgence,” said Dr. Theresa Tam. In early February she had warned provinces “the current community-based public health measures will be insufficient to control rapid growth, and resurgence is forecast.”
And yet, British Columbia did little to change the approach to variants, focusing instead on promoting the vaccine rollout, which has had its own challenges.
It wasn’t until March 29 that indoor dining at restaurants was suspended, along with group fitness activities.
Henry insists that the recent surge happened over a period of a few days prior to that order, despite the warnings of academics and other medical experts over the course of many weeks. She is doubling down on the current restrictions, contact tracing efforts and testing strategies.
“We are doing all of those things as aggressively as we can to try and prevent that rapid takeoff, and we had been finding a relative balance. But unfortunately what we're seeing is that the numbers of contacts that people are having in those social networks have been expanding in the last little while, so we need to work together on this,” she implored.
The rise of the P.1 variant in particular has put B.C. in an uncomfortable spotlight and highlighted the emergence of what is widely considered by scientists as the “most concerning” mutation of the COVID-19 virus — and the province’s ability to report in a timely and accurate fashion what’s happening.
One of British Columbia's own advisors believes variants have now outpaced the initial form of COVID-19 in B.C., while one of the province’s biggest laboratories has been identifying cases of the ultra-contagious strain many days before health officials report the figures to the public.
“Chief medical officers of health regrouped just to discuss the evolving situation with a P.1 variants, including the clusters in British Columbia, Whistler,” said Tam on Tuesday, though she didn’t get into details of the discussion. Later in the day, the premier of Alberta confirmed suspicions that the sudden appearance of P.1 in that province was linked to travellers coming home from B.C.
When asked to address whether vaccines would have an effect on P.1, which has a mutation scientists believe makes it able to re-infect COVID patients while evading vaccines, Tam gave an unsettling response.
“There are only mainly laboratory antibody studies, which shows in some of them some reduced ability of the antibodies from a vaccine to neutralize this P.1 virus, which is a signal of concern,” she said. “We do not have an actual vaccine effectiveness estimate that is even solidified in terms of the evidence, and if Canada is seeing the evolution of spread of the P.1, we might be a country where we will be able to produce some of this data.”
As public health officers debate the best path forward, Da Roza is bracing for a fresh influx of patients he fears could come after Easter long weekend gatherings; they’ve typically seen an uptick in COVID-19 patients 10 to 14 days after long weekends or holidays.
“We do have contingency plans but it comes at a price… If COVID were to start to increase you’d start to get into a situation where we might have to start to compromise the care we can provide to non-covid patients,” he said. He pointied to a backup plan to shut down operating and recovery rooms as well as preventative medical procedures.
“It does give us more capacity, but at a price. And what happens then is we are potentially impacting other patients in the immediate term because surgeries they’ve been waiting for are delayed, but in the long terms you have this delay that occurred in the first wave where then you have to catch up and you’re behind — and the system is already stressed in a general sense, so that makes it even more challenging.”