For the first time since the start of the pandemic hit, William Osler Health System doesn’t have any COVID-19 patients in its intensive care units — a milestone for its two hospitals since they serve some of the hardest-hit communities in Etobicoke and Brampton.
At the peak of the novel coronavirus pandemic in Ontario, Medical Director for Critical Care Dr. Brooks Fallis says, William Osler had about 30 people with the disease in its ICU. As of Tuesday, all of Ontario had 13 patients in the ICU, with 10 people on ventilators.
With fall approaching, many are wondering whether seasonal influenza will strain a system just recovering from COVID-19. Fallis says it depends on how well we keep up the basics.
“The principals that we use to prevent the spread of COVID-19 also work for the flu,” said Fallis.
“If you’re social distancing, masking, hand washing and avoiding indoor contact with people outside of your social bubble, all of those things will lead to a very low-impact flu season.”
Flu cases down in Australia during winter
That seems to be the case in Australia, says infectious disease specialist Dr. Michael Gardam. The country implemented physical distancing measures in March and has seen fewer flu cases during its winter.
“As they brought in their control measures, the rate plummeted and they’ve stayed down 60-80 per cent below what they normally are,” said Gardam.
The big test for COVID-19 in Canada could be the start of the school year, as many medical experts warn rates could start going up.
Dr. Dina Kulik, a pediatrician, says any time there are more people in an enclosed space for long periods of time, infection rates rise.
“That’s to be expected,” said Kulik. “However, some places around the world have gone back to schooling months ago and did not seem to see a huge surge.”
In part, that seems to be due to masking and smaller class sizes, she says.
COVID-19 testing ‘imperfect’ in children, doctor says
One of the challenges Kulik has faced when treating her own patients is confirming whether or not a child has COVID-19.
“The testing is particularly imperfect in young people,” she said.
“I’ve had hundreds of my own patients swabbed who have … had symptoms, even many of those with parents or siblings with confirmed COVID, but most of these kids are swabbing negative. I don’t believe they’re negative.”
Despite the upcoming challenges this fall and winter, doctors who have treated patients with the virus say public health units in the Greater Toronto Area are well equipped to handle spikes, or even a second wave, of COVID-19.
Hospitals share patients to prevent overwhelming system
Initially, the advice circulating around the medical community was to intubate those sick patients fast to get them hooked up to a mechanical ventilator — or risk watching their lung function suddenly plummet.
Dr. Fallis says the thinking has changed. Now health professionals will wait to see if there’s the potential for the patient to get better on their own or if they can benefit from a less invasive treatment, such as a high flow of oxygen through a nasal cannula —a tube attached to the nose.
Greater Toronto Area hospitals also have been working under the direction of a regional organizational table, says Dr. Fallis.
This enables the hardest-hit hospitals to send stable COVID-19 patients to facilities in the region with fewer cases, so one centre doesn’t get overwhelmed.
It’s a beneficial practice, says Dr. Fallis, as the staff in different hospitals become familiar with treating COVID-19 cases.