As the third wave of the pandemic worsens, with COVID-19 cases soaring and critical care admissions reaching record highs, some health experts are calling on the province to quicken their vaccine distribution to combat unsustainable pressure facing hospitals and health centres.
“We’re at over 100 per cent constantly,” said Jamie Spiegelman, an internal medicine and critical care specialist at Humber River Hospital in Toronto.
On Sunday, Critical Care Services Ontario released a daily report showing record-high intensive care unit numbers in the province, with 467 people in ICU.
In February, provincial modelling showed that the province was heading for a potential disaster come early March if the government didn’t take heed of the science table’s advice to aggressively vaccinate and maintain stay-at-home orders.
This would “help avoid a third wave and third lockdown,” Dr. Peter Jüni, the scientific director of the Ontario COVID-19 Science Advisory Table, told CBC News at the time.
Now, he says that 50 per cent of all cases linked to the virus would be preventable if people just “did the right thing,” such as only going out when necessary and interacting only with those in a single household.
The other 50 per cent of COVID-19 cases, he said, are tied to essential workers and their families. “That’s another challenge to tackle,” he said on Rosemary Barton Live, calling on the government to do more for these workers who are at greatest risk.
Phase 2 of vaccine rollout to begin soon
Calls to bring vaccinations into factories and other essential workplaces have ramped up over the past few days as Ontario went into a provincewide shutdown, shuttering indoor and outdoor dining at restaurants and personal care services, but leaving essential businesses open.
On Sunday, Dr. Amit Arya, a palliative care physician at McMaster University and the University of Toronto, called out the government in a tweet for failing to make essential workers eligible for the vaccine while other people — part of an older cohort potentially facing less day-to-day risk — are prioritized.
Phase 2 of the vaccine rollout, which includes prioritizing essential workers, is set to begin in the coming weeks. As with the entirety of the vaccination campaign, however, it’s all contingent on adequate supply.
According to a statement from Ontario’s health ministry, every single vaccine dose received has been allocated to a waiting Ontarian who has booked an appointment.
That statement came as Arya, along with other health-care professionals, said on Sunday that over 985,000 doses of COVID-19 vaccines are currently sitting in Ontario freezers.
“To be clear, vaccines are not sitting in freezers,” Alexandra Hilkene, a spokesperson for the minister of health, said in a statement to CBC News on Sunday.
“Ontario received 225,600 doses of Moderna yesterday and today. Additionally, the province received 583,400 doses of the AstraZeneca vaccine on April 1. Pharmacy chains are delivering allocations to individual locations as quickly as possible and many locations have already started to administer doses.”
Last month, Premier Doug Ford said the province’s vaccine administration capacity will allow for over 150,000 doses a day, depending on supply. The province has yet to reach 100,000 vaccines per day, with the closest being 89,873 doses administered on a single day on March 31.
Shutdown overlooks biggest source of cases, expert says
On Saturday, Unifor National President Jerry Dias said protecting essential workers by providing paid sick leave and prioritizing them for vaccinations is a must in order to save lives.
“If you’re going to send people to work, then you better make sure they can go to work safely,” he said.
Dr. Sumon Chakrabarti, an infectious disease physician with Trillium Health Partners, said the province is seeing the lion’s share of cases that are happening in the third wave in essential workers.
He said people that “keep the lights on” such as farmers, factory workers and grocery store clerks are not protected by the shutdown because by definition, they are essential and cannot close.
“So the lockdown is exactly missing the biggest source of cases,” Chakrabarti said. “This is one of my biggest concerns.”
Targeted vaccination campaigns, paid sick leave, isolation support and targeted testing will mitigate the root of the problem in essential workers, Chakrabarti said. He said this population has been hit hard, yet they’ve been continuously overlooked, wave after wave.
He said prioritizing the safety of essential workers is what will help get this third wave under control.
Speaking on CBC News Network Sunday, Spiegelman said to care for one ICU patient on life support it takes a whole team of health care professionals, including at least five nurses in a 24-hour period, social workers, respiratory therapists, dietitians and more. This, as the health sector faces “a huge nursing shortage,” he said.
He said the government’s “emergency brake” to shut down the province is necessary, but only time will tell if it’s enough.
Jüni, for his part, said he will be advising the Ontario government in the coming days and weeks to pivot the vaccination campaign to essential workers.
“It’s a new pandemic now,” he said.
For this change to happen, Jüni said the province can’t continue to distribute the vaccine by population size or age cohort, but rather to people who need it most.
“We need not equality, we need equity now.”
Triaging patients is worst-case scenario, OHA says
President and CEO of the Ontario Hospital Association Anthony Dale said as of Saturday, critical care units received 38 new admissions, bringing COVID-19-related admissions to 467. There are around 1,800 people in critical care overall.
Dale said these numbers are crushing the capabilities of the hospitals and if the numbers continue to increase this way, the worst-case scenario would see physicians having to triage patients and make choices about how to use their resources based on patients’ overall health and probability of survival.
“The situation is extremely, extremely serious. I can’t put into words how concerned we are about what the next several weeks will bring,” he said.
The vast majority of new community cases are the B117 variant first detected in the United Kingdom, he said, which is proven to cause more hospitalizations, notably in younger people, and carries more severe longer-term consequences. The probably of death is also much higher, he said.
He said he will keep pushing the government to address the dire situation on the ground and will make it known that more aggressive action is needed to stem the tide.