Manitoba hospitals are ramping up critical care systems as an influx of patients in the past two weeks — many of them younger and sicker than in previous waves of the pandemic — is beginning to strain intensive care units.
The third wave of the coronavirus pandemic has put more people in hospital over the past two weeks, which has triggered the need to add more ICU beds and postpone some surgeries.
There are 502 new cases and COVID-19 hospitalizations shot up to 201 on Friday, said Dr. Jazz Atwal, acting deputy chief provincial public health officer. There were 144 people in hospital with COVID-19 two weeks ago.
Over half of the COVID-19 patients in hospital are under 70; one-fifth are under the age of 40.
The number of patients in ICU on Friday rose to 56, compared to 36 two weeks ago.
The province is currently staffing 115 intensive care beds (this requires using spaces outside of existing ICUs) and adding 19 more to four hospitals in the coming days, health officials said.
“The situation is changing rapidly,” Lanette Siragusa, chief nursing officer for Manitoba Shared Health, said during a Friday morning technical briefing on the evolving situation. “We are getting fairly close to our peak in wave two.”
The wave two intensive care peak was 129 patients in ICU.
The information was provided shortly before Manitoba Premier Brian Pallister said more restrictions will be announced Friday at a 6 p.m. news conference with Chief Provincial Public Health Officer Dr. Brent Roussin. CBC will live stream that news conference on the CBC Manitoba website, Facebook page, Twitter feed and CBC Gem.
Pandemic modelling data obtained by CBC News suggests the province expects the number of COVID-19 patients in its intensive care units to exceed the peak of the pandemic’s second wave by the end of the May long weekend, and the number could double again before summer.
On Sunday alone, 10 people were admitted to Manitoba hospital ICUs, which came as a surprise based on daily hospitalization averages and test positivity rates leading up to then, said another health official at the briefing. (The briefing was provided with the condition that only Siragusa be named and quoted, with others providing background information.)
Siragusa said Manitoba has prior planning to provide up to 173 ICU beds. That includes plans for required resources, such as ventilators, drugs and staff to monitor the beds.
Manitoba is also creating 60 full-time nursing positions dedicated to critical care in Brandon and Winnipeg. This will work out to about about three more nurses on staff 24/7 at the Brandon Regional and Grace hospitals, and four more at Health Sciences Centre and St. Boniface Hospital.
Those staff will first need to undergo an orientation and on-the-job training. In the meantime, nurses from other fields who helped out in ICUs during the second wave have already volunteered to pitch in, officials said.
Some non-urgent elective surgeries will be cancelled or postponed as surgery and medical staff are redeployed to help out in intensive care units.
Urgent surgeries will continue, but some people in Winnipeg, for example, may see their scheduled procedures moved to a facility outside of the city, an official at the briefing said. Half of the surgeries at Brandon Regional Hospital will be postponed.
“Unfortunately, the impact to surgery over the next coming weeks is likely to be very significant as we reduce our volumes to increase our critical care capacity,” an official at the briefing said.
A variety of other changes are being made to make space for the recent hospitalizations, including diverting some teens 19 and under requiring emergency care to the Children’s Hospital in Winnipeg.
Since April 20, older high-risk patients in hospital awaiting placement in a personal care home have been identified, and their placements are being expedited.
A virtual outpatient program for COVID-19 patients that’s been running since December is helping free up space in hospitals.
Patients who are sick but healthy enough to be in their homes are monitored remotely, unless their conditions worsen. There are 29 patients currently in this program, with 18 receiving oxygen at home, officials said.
Many patients in hospital are younger than in past waves, and they’re staying longer. The demographic change shows the success of immunization campaigns that prioritized health-care workers and older Manitobans early on, officials said.
Over two-thirds of new coronavirus cases lately have been people under 40, Atwal said.
Among people in hospital, 40 of the 201 patients on Friday were under age 40, Siragusa said.
The highest number of total COVID-19 hospitalizations on record is 404, on Dec. 16, during the peak of the pandemic’s second wave.
“Staff are tired and the prospect of a third wave … is extremely stressful and our plan is limited by the ability to keep our health care workers healthy,” Siragusa said.
Siragusa has not made an appearance at a COVID-19 briefing since February.
She spoke in court earlier this week, testifying at a court case launched by seven rural churches and three individuals who are challenging the public health restrictions imposed by the province of Manitoba in response to the COVID-19 pandemic. Roussin is testifying today.