A new study by some of Ontario’s leading medical researchers paints an alarming picture of the strain on the health-care system as the number of COVID-19 cases continues to rise, suggesting the province will run\u00a0out of intensive-care\u00a0beds and ventilators in just 37 days, even if it manages to cut current infection rates in half.<\/p>\n
The study, by a team from the University of Toronto, University Health Network and\u00a0Sunnybrook Hospital, among other institutions, warns of “significant strain” on crucial health-care resources in the weeks ahead, calling for measures to “rapidly identify and create opportunities for additional capacity to care for critically ill patients.”<\/p>\n As of Thursday, Ontario has\u00a0258\u00a0confirmed cases. Of those, five are considered resolved, with the virus linked to two deaths.<\/p>\n Over the past eight days, since March 12, the daily increase in new COVID-19 case numbers in Ontario has averaged 26 per cent.\u00a0Since Monday, the rate of increase has slowed, but has still averaged 15.6\u00a0per cent daily over the past four days.<\/p>\n “Our simulation using a ‘conservative scenario’ of a daily 7.5 per cent increase of cases predicts that Ontario’s ICU bed and ventilator resources will be depleted in approximately 37 days,” says the report published Wednesday evening.<\/p>\n “Ward beds will be full and unable to accommodate new patients in approximately seven weeks.”<\/p>\n It’s a startling conclusion, but one that\u00a0Beate\u00a0Sander, lead study author and\u00a0scientist at the University Health Network, says isn’t meant to spark panic.<\/p>\n Instead, she says, the goal is to put the pressures on the healthcare system into context so that medical and political leaders can make informed decisions.<\/p>\n The study authors acknowledge their modelling is based on a number of key assumptions:<\/p>\n With those assumptions in mind, they predict the following outcomes:<\/p>\n The models don’t account for the impact of the recent border restrictions or school closures\u00a0\u2014 measures Sander hopes will slow the rate of infection and ease\u00a0the pressure on\u00a0Ontario’s already strained health-care system.<\/p>\n “I think if we are really diligent with all the public-health measures, I think we can do better\u2026 What we call the ‘conservative scenario’ might be the likely scenario\u00a0\u2014 but I’m hoping for something even less severe.”<\/p>\n So far, the daily growth rate has fallen below the 7.5 per cent mark only once since March 10. That was on Tuesday, when only 12 new positive cases were confirmed, an increase of 6.8 per cent from the previous day.<\/p>\n Flattening the curve of infection and increasing the province’s access to beds and ventilators could extend the life of the system to two months, says Sander.\u00a0But expect to remain in your home for at least another four weeks, she adds.<\/p>\n “All my epidemiologist colleagues will tell you we probably need to have it in place for much longer …\u00a0 For sure, more than four weeks and probably more than two months,” Sander said.<\/p>\n Health Minister Christine Elliott insisted Ontario is “building capacity,” when asked about the study at a news conference Thursday.<\/p>\n “We don’t know exactly what’s going to happen but we do know that the pressures on our health-care system are going to increase,” Elliott said.<\/p>\n Elliott said the province is working to increase the number of available beds, and recently increased its\u00a0in-house supply of ventilators by 300. The province is also in talks with auto-parts manufacturers about possibly retooling their equipment to help produce ventilators.<\/p>\n “Were also looking at other alternative measures where we can perhaps place some people who are at an alternate level of care that are currently in our hospitals to a setting that is going to be safe for them and appropriate for them,” Elliott added.<\/p>\n Dr. Anand Kumar, a critical-care doctor at Winnipeg Health Sciences Centre, conducted similar modelling during Canada’s H1N1 outbreak of 2009 with a group of medical professionals with the\u00a0Critical Care \u2013 Infectious Diseases Network, Canada.<\/p>\n But there was one key difference. With H1N1, an anti-viral was available almost immediately and a vaccine was ready\u00a0in about five months.<\/p>\n Without them, he says, the modelling looked very much like Sander’s.<\/p>\n “I think the results are well within\u00a0the realm of possibility,” Kumar said of the COVID-19 study.<\/p>\n Kumar pointed out in a recent newspaper op-ed that Canada’s hospitals\u00a0typically operate at 90-to-95 per cent capacity and were stretched with\u00a0this year’s flu season alone.<\/p>\n “This is a really risky situation and we need to be prepared for exactly the kind of predictions\u00a0that this group\u00a0is suggesting,” he said, calling for a more coordinated approach to social distancing practices across the country.<\/p>\n The researchers behind the COVID-19 study add their model doesn’t take into consideration what happens if Ontario can boost its resources. If the province’s ventilator stockpile grows, the modelling could become much more promising.<\/p>\n One other factor they don’t account for has to do with human resources. The study assumes all beds are fully staffed. Nurses, doctors and medical staff becoming ill could throw the projections out the window.<\/p>\n “A ventilator alone isn’t that helpful. So there needs to be ventilator and there needs to be an ICU bed and there needs to be a qualified staff \u2026 Just the technology alone, it’s not going to do it,” Sander pointed out.<\/p>\n Asked about the study Wednesday afternoon, Ontario’s Associate Medical Officer of Health Dr. Barbara Yaffe\u00a0suggested treating the results with caution.<\/p>\n “At the end of the day they are modelling, and that may or may not reflect what happens,” she said.<\/p>\n The study authors advise caution too, saying their model is preliminary and evolving, with new data every hour that could change the odds. And with much of Ontario doing its part to self-isolate, the goal is that those odds change for the better.<\/p>\n Asked if Ontario can bring the daily growth rate of new cases below 7.5 per cent, the province’s Chief Medical Officer of Health\u00a0Dr. David Williams responded, “I’d like to think we can.”<\/p>\n CBC<\/p>\nGoal to help leaders\u00a0make informed decisions<\/h2>\n
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Social-distancing likely needed for 2 months or more<\/h2>\n
Province working to increase capacity<\/h2>\n
‘A really risky situation’<\/h2>\n