Ontario ICUs don't have capacity for another COVID-19 surge: Science Table

Ontario’s COVID-19 Science Advisory Table says ICUs in the province don’t have the capacity for another surge of COVID-19 patients like previous waves.

ICUs have been used as an indicator of the severity of COVID-19 in the province since the beginning of the pandemic. As ICUs filled up, new restrictions were put in place to help slow the spread and ease the strain on hospitals.

With the province now in its fourth wave of the COVID-19 pandemic, the Science Table has issued a stark warning: another surge of COVID-19 patients in Ontario ICUs could topple the system.

Ontario COVID-19 Science Advisory Table

Between March 2020 and October 31, 2021, more than 9,000 Ontarians have been admitted to ICUs in the province. At the peak of the third wave, ICU patients on ventilators were 180% higher than pre-pandemic historical averages, according to the report.

One reason for this is staffing shortages, the report says. With many staff leaving hospitals and ICUs due to burnout, critical care capacity has fallen.

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Prior to the pandemic, the average nursing vacancy rate in Ontario ICUs was 5.8%, according to the Science Table. By August 2020, that number had climbed to 9%. More than a year later, data on the current vacancy rate is not available, but the Science Table says the situation has worsened.

“Medical leads of some of the ICUs in the province have reported having an insufficient number of nurses to cover all shifts,” the report reads.

According to a survey, more than 60% of Ontario’s critical care nurses were feeling at least some symptoms of burnout. Of those, more than 90% said the COVID-19 pandemic was a direct cause of their burnout. This survey was conducted before the second wave of the pandemic.

It’s not just staff shortages impacting critical care capacity. The first waves of COVID-19 saw a pause to all non-emergent procedures. Doctors, surgeons, nurses and staff were redeployed. The Science Table says this can’t happen with each surge as there is a deficit of care in the province.

To further emphasize the care deficit, a new study conducted by the Canadian Medical Association says that 4,000 Canadians have died due to delayed treatments and surgeries. Cancer diagnoses are down 20-35% compared to pre-pandemic levels.

Recent modelling by the Science Table indicates that the future of COVID-19 is uncertain as cases quickly begin to rise as capacity limits are lifted.

The Science Table suggests that this year’s flu season could also negatively impact ICUs as people return to offices and socialize indoors. Now, with the Omicron variant detected in the province and around the globe, the situation could quickly get worse without additional public health measures.

“The ability of the Ontario critical care system to respond to an increased number of patients needing critical care over the coming months, either due to COVID-19 or influenza-associated respiratory failure, is uncertain,” the Ontario Science Table report reads.

On Tuesday, Ontario reported that 153 COVID-19 patients are currently in ICU.