Canada’s health care workers brace for the painful blow of a punishing third wave

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Original author: Paula Newton

Published: April 18, 2021


(CNN) For days now, as the Covid-19 case count mounted and hospital admissions surged, Canadians seemed dismayed and asked: How could this happen here, where most people dutifully followed public health guidelines?

But many of Canada’s health care workers had warned that some provincial governments reopened too quickly after a difficult post-Christmas surge.

“So we’re stuck where we have cases out of control, hospitals completely full, not enough vaccine supply available and months of difficult public health measures ahead of us,” Dr. Michael Warner, director of critical care at the Michael Garron Hospital in Toronto, told CNN.

Provincial governments across the country are now reckoning with a damaging Covid-19 third wave that might imperil the universal health care system of which Canadians are so fiercely proud.

From coast to coast, across thousands of miles and hundreds of hospitals, many provinces are now anxiously watching the case count rise. That’s happening as variants of concern spread a more contagious virus to younger Canadians and send more people in hospital.

And nowhere in Canada is the hospital situation as critical as it is in Ontario, the country’s most populous province.

“The government didn’t listen to scientists, they didn’t listen to epidemiologists, they didn’t listen to doctors other than their chief medical officer of health. And because they failed to listen to scientists, they thought they could negotiate themselves out of this virus. But the virus is too strong, the variant is a different disease,” Warner said, before adding that his ICU was operating at 115% capacity on Friday.

Ontario Premier Doug Ford defended his actions Friday as he announced new restrictions, including extending a stay-at-home order until at least mid-May, prohibiting indoor and outdoor gatherings, and restricting non-essential travel in and out of the province.

At a news briefing Friday, Ford insisted he has always acted on the science, adding that in the case of recent rising critical care admissions, he drafted the stricter public health policies “the second” he found out.

“Whatever we put into place though, it’s going to take time to take effect. So right now, the trajectories of Covid rises are really baked in, and I think the next two to three weeks for Ontario and Canada are going to be very, very, tough,” said Dr. Fahad Razak, who treats coronavirus patients at St. Michael’s Hospital in Toronto.

On Saturday, Ontario again shattered fresh records for both hospital and ICU admissions. Modeling released by the province’s expert advisory panel Friday detailed a dire snapshot of the crisis already unfolding in hospitals and how the situation is likely to get even worse. “Notice that our hospitals can no longer function normally — they are bursting at their seams,” said Dr. Adalsteinn Brown, Ontario’s science advisory co-chair. “We’re setting up field hospitals, and we’re separating critically ill patients from their families by helicoptering them across the province for care. Our children’s hospitals are now admitting adults as patients. This has never happened in Ontario before. It’s never happened in Canada before.”

Brown was strikingly blunt about a worst-case scenario: Ontario could be forced to ration care, especially for critical care spots.

“There may just not be the ability to put them into these types of beds,” Brown said. Health care workers are “beyond angry” about the situation, Warner said.

“We will be there, we will do our best, but I’m trained to save people, not to use a checklist to decide if people are going to live or die. But that’s where we’re headed, and that’s my biggest fear,” Warner said.

Throughout most of Canada, the epidemiological data has been alarming. The exception has been the Atlantic provinces that created a bubble, with some of the lowest rates of Covid-19 in all of North America.

Health Canada reported a 35% increase in hospitalizations — and a more than 20% increase in ICU admissions throughout Canada in the week ending April 11. More troubling is the mortality trend, with a 38% increase in deaths in the last week alone.

Some public health professionals say many provinces eased restrictions too fast and too soon. And in Ontario, many health care providers say that, given their scarcity in Canada, vaccines should have been more quickly allocated to marginalized communities.

In many of Canada’s largest cities, essential workers in factories, meat processing plants and distribution centers have suffered through dangerous outbreaks.

Dozens of Ontario’s doctors have demanded on social media that these workers have safer working conditions and easy access to sick pay when they contract the virus or must be tested for it.

Most provinces — including British Columbia, Alberta and Quebec — are beginning to concentrate on these workplaces and community hotspots with mobile testing and vaccination clinics.

Some health care workers, however, are resigned that those programs were not put in place quickly enough to spare them and their patients from the ravages of a third wave that’s much worse than the first two.

“It’s clearly a crisis, we’re in the midst of a crisis now. It’s not a week away — we’re in it right now,” Razak said.