Sask. modelling predicts 'unsustainable' rise in ICU admissions without further public health orders

The current high trend of COVID-19 patients in intensive care could continue into 2022 without the addition of any further public health orders, according to modelling provided by the Saskatchewan Health Authority (SHA).

The health authority said the province is at an “unsustainable” level in intensive care units at the moment – due to the high number of hospitalizations and their effect on other medical procedures.

Dr. Saqib Shahab, the province’s chief medical health officer, said a baseline level of 40 COVID-19 hospitalizations and 10 in intensive care is “sustainable” and allows for the health care system to provide care normally.

As of Wednesday, there are 323 people in hospital related to COVID-19, including 82 in intensive care.

“Once you start crossing that you reach the other line, which is the current unsustainable census and other services start getting delayed, and of course unfortunately now patients are transferred out of the province,” Dr. Shahab said.

The modelling provided scenarios that show the estimated effects of varying levels of decreased population mixing, along with booster shots for residents 60 years and older.

Based on current behaviours and COVID-19 restrictions, the modelling suggests hospitalizations could surge through the end of the year and continue into the second quarter of 2022.

Courtesy: Saskatchewan Health Authority

The second modelling scenario projects the provinces trajectory based on the current measures in and behaviours in place.

“While we see the benefits of booster doses, given today and over the next two three months, we see the benefits of that into February, March, but that is not enough to protect the acute care system,” he said.

Scenario five – the option with the most significant decline in projected ICU patients – includes a 28 day reduction in population mixing, which could be achieved through individual behaviour or public health orders and the administration of booster shots to those 60 years and older.

Shahab urged residents to consider reducing their contacts and continue to be vigilant about mask use and vaccination status in social situations.

“Otherwise, unfortunately, we could well see a surge in November and December,” Shahab said. “There’s no way, I think, that any health system could tolerate 250 people in ICU.”

Most scenarios, with a decrease in how much people are in contact with each other and the administration of booster shots show a return to a “sustainable” ICU level around March 1, 2022.

“If we can really push our case numbers down, it will still take several weeks for the ICU and hospital census to come down. But then if we can really see that coming down over November, December, that makes for a safe holiday season and lower number of cases into the new year,” Shahab said.

The province is projecting approximately 20,000 surgeries and other procedures will be cancelled, due to stress on the health care system. Under a best case scenario where the current COVID-19 situation is the peak, case loads begin to decrease and it only takes three months to bring down cases, Saskatchewan will not be back to “normal” until the start of 2022 at the earliest, according to the SHA.

While Shahab provided his recommendations for the public to reduce social contacts and focusing on mask use and physical distancing, he said it would be up to the provincial government to share what formal recommendations he has made about further restrictions.

"The advice that I give to the public is based on what I’m seeing based on the epidemiology. Advice that I give to the government goes to cabinet through the Minister of Health, [Provincial Emergency Operations Centre] and executive council,” Shahab said. “So it is up to cabinet to divulge what advice I give or don’t give, and I need to be very clear about that.”