Ontario will need public health measures to protect hospitals from patient surges because of staffing shortages, science table says

Ontario will need to use public health measures to “mitigate influxes” of critically ill patients over the coming months and protect a healthcare system that is now struggling with “worsening staffing shortages” and “worker burnout,” a new report prepared by the group of scientists advising the Ford government argues.

The report from Ontario’s Science Table says that while the province has been able to accommodate past patient surges without having to turn to a triage system to ration critical care resources, it likely now “lacks the capacity” to accommodate the sort of uptick in hospitalizations it saw during the third wave of the pandemic this past spring when as many as 940 COVID-19 patients were in intensive care units simultaneously.

The scientists say that in addition to a “shortage of critical care nurses and staff” that has worsened through successive waves of the pandemic, hospitals may be less able to achieve “significant reductions in surgical and procedural activity” amid a “growing care-deficit.”

They also say that the “complete absence of influenza transmission” during the 2020-2021 flu season is unlikely to repeat itself this year, lending additional “uncertainty” to the healthcare system’s ability to withstand future waves of the pandemic.

“Going forward, it may be more challenging for the critical care system to rapidly increase capacity as it did during the height of Wave 3 due to staffing shortages, healthcare worker burnout, and a desire to preserve non-COVID clinical activity,” the report states. “It is imperative that public health measures that help to reduce transmission of SARS-CoV-2 as well as other infectious diseases with the potential to burden the healthcare system, including influenza, are in place over the coming months.”

Chief Medical Officer of Health Dr. Kieran Moore told reporters on Monday that he doesn’t anticipate introducing additional health measures at this time, even in the face of increasing concerns about the Omricon variant.

But the report from the science table says that it is “imperative” that public health measures that help to reduce transmission of COVID-19 be put in place for the winter months.

The scientists argue that there is now a “growing staffing shortages in critical care units” where nurse vacancy rates now exceed nine percent, up from 5.8 per cent prior to the pandemic.

They also say that Ontario hospitals could risk further exacerbating the staffing shortages by turning to some of the same strategies utilized during previous waves, such as giving nurses additional patients and redeploying acute care nurses from other areas of the hospital.

“Burnout has likely contributed to this staffing shortage,” the report notes. “Nurses in particular have been at increased risk for burnout during the pandemic for a variety of reasons, including heighted anxiety about risk of exposure to SARS-CoV-2 at work, an increase in patient acuity, increasing demands for overtime, reassignment to unfamiliar roles, and sustained exposure to the moral distress associated with caring for patients with COVID-19.”

The science table says that 9,096 Ontarians with COVID-19 were admitted to intensive care units between March 20, 2020 and October 31, 2021. They say that at the peak of the third wave the number of ICU patients on ventilators was at 180 per cent of the pre-pandemic norm.