Inside an Ontario hospital bracing for a surge in adult patients — while overflowing with sick kids | 24CA News

Lying with a stuffed monkey in his hospital mattress, with oxygen tubes connected to his tiny nostril, four-year-old Wolfgang lets out just a few scratchy chest coughs.

On this afternoon in early December, the little boy with massive eyes and tousled brown hair is without doubt one of the youngest sufferers at Markham Stouffville Hospital, north of Toronto. He was admitted a few days earlier to the power’s over-capacity pediatric unit for pneumonia — his third bout since beginning kindergarten in September.

As a baby with extreme bronchial asthma, Wolfgang — who often goes by “Wolfy” — is especially susceptible throughout this “brutal” viral season, says his mom, Mary Doering.

“It’s hard to see your little guy struggle,” she says.

This fall, the explosive return of respiratory viruses began placing immense stress on a health-care system that is lengthy been beneath pressure — a quiet disaster, enjoying out behind closed doorways. 

While sweeping pandemic measures saved quite a lot of pathogens at bay for months on finish, they’ve all roared again, from influenza to RSV, with COVID-19 now firmly within the combine. 

It’s no secret that youngsters like Wolfgang are at present bearing the brunt. But that could possibly be simply the tip of the iceberg of infections within the months forward.

Hospitals like Markham Stouffville at the moment are bracing for a possible surge of grownup sufferers as effectively, and anticipating stress from each ends of the age spectrum at a time when assets are already tight and employees shortages are a continuing battle.

“Our real concern is the severity of illness that we are seeing in the kids, and we are expecting to see more adult cases; usually they come two to three weeks after the kids cases peak,” says Dr. Jeya Nadarajah, an infectious ailments doctor with Oak Valley Health, who works at Markham Stouffville. 

“We are also predicting a more severe set of adult influenza, too.”

Staff maintain common briefings throughout virus surge

Inside the workplace of Oak Valley Health chief government officer Jo-anne Marr, she logs right into a digital name with employees from throughout the hospital. What was as soon as a day by day COVID-19 briefing is now a weekly check-in for the return of a broader, if reasonably uncommon, respiratory virus season.

Speaking first, for the an infection prevention and management crew, Nadarajah raises questions over how lengthy the height of this yr’s influenza season will final, and says native pediatric hospitals are nonetheless seeing excessive ranges of affected person admissions.

“The bottom line with modelling when you’re looking at a season with co-infections of COVID and influenza, is that our best weapon is still vaccination,” she says on the video name. 

“That seems to be the only thing in the modelling that will slow the peak and keep it [lower] so hospital capacity can keep up.”

After the briefing, Marr tells us that the hospital is doing all it might probably to handle affected person hundreds. 

“It is a challenge, there’s no question,” she says.

Across the nation, kids’s hospitals have equally raised alarms about their models being over-capacity, whereas emergency departments have reported prolonged wait instances. A hospice in Calgary briefly paused its companies and discharged its younger sufferers to redeploy employees to the Alberta Children’s Hospital; a pediatric hospital in Ottawa was pressured to usher in the Red Cross for staffing help. 

At Markham Stouffville, the children’ unit is now commonly overflowing. 

Pediatric unit commonly over-capacity

On at the present time, the pediatric division is working at round 220 per cent capability — whereas employees are taking up further shifts and looking for extra beds for the excessive variety of sick kids nonetheless being admitted. 

Walking via the hallways, you possibly can hear the faint cries and coughs of children dealing with every kind of respiratory bugs behind the closed doorways of their hospital rooms.

Behind the principle desk, chief of pediatrics Dr. Joe Wiley debriefs with Silva Nercessian, scientific director of the childbirth and kids’s program at Oak Valley Health. 

Staff are drained, Wiley tells us. The house is funded for 5 beds, however these days, the crew has been caring for a dozen or extra kids on any given day — nonetheless small numbers, nevertheless it all provides up.

This week alone, Wiley has taken on three further shifts to assist preserve the crew afloat.

“We are ready for 300 per cent-plus capacity here,” provides Nercessian. “But if we want to go higher than that, we have to start creeping into our adult spaces.”

That’s the place issues get difficult.

From her workplace elsewhere within the hospital, Nadarajah tells us Markham Stouffville is bracing for at the very least 20 per cent extra grownup admissions within the subsequent couple of months than throughout a typical flu season.

“The worst case scenario,” she stated, “is anything above that.”

The projection possible applies to hospitals elsewhere, because it’s based mostly on just a few elements, together with a cautious watching of the sooner flu season within the southern hemisphere — which began early, like Canada’s did this yr — coupled with Canada’s flu vaccination charges, which have lengthy been stubbornly low.

During the final three flu seasons, the variety of Canadian adults signing up for an annual flu shot hovered round 40 per cent. Even seniors, a bunch at increased threat of great sickness, did not hit the federal authorities’s aim of 80 per cent protection; solely round 70 per cent of Canadians aged 65 and up bought the shot between 2019 and 2022.

If this yr’s season follows that pattern, Nadarajah says loads of older people will wind up hospitalized — which might drive the hospital to shuffle assets and add beds in unorthodox areas, like ultrasound clinics.

But that is no simple job, notably if extra employees begin catching the flu as effectively, forcing them to take day off.

“Because of the steep climb, we just haven’t had a chance to expand our bed capacity, and after two years of a lot of staffing shortages in the health-care system, it’s just really compounded,” Nadarajah stated.

3,000+ visits to new COVID-19, chilly, flu clinic

To preserve individuals from needing a mattress within the first place — and to take stress off different groups — the hospital is banking on a brand new clinic to assist deal with individuals on an out-patient foundation.

It’s been dubbed the COVID-19, Cold, and Flu Care Clinic, or CCFCC, and simply opened just a few weeks in the past, transitioning from the hospital’s earlier COVID-19 evaluation centre.

As Dr. Cristina Popa, the CCFCC’s doctor lead, walks our crew via the clinic’s hallways, she explains how the house retains sufferers with respiratory signs safely separated from different sufferers, whereas offering non-public isolation rooms for households the place a number of members are battling comparable bugs.

It’s additionally appointment-based, she says, so individuals aren’t caught ready — and coughing — within the busy close by emergency division.

In just some weeks, the clinic has seen greater than 3,000 sufferers.

“It is really good for the emergency department because we can take all this volume away,” Popa says. “We allow the ED to take care of sicker patients.”

Given all of the efforts to spice up capability and transition to a brand new clinic mannequin, groups listed here are hopeful they’re going to climate the storm forward. But as Nadarajah says, it could possibly be an extended journey.

“We are essentially preparing for the worst, which is a high peak of [influenza], a sustained peak and then coming down … that way if we’re pleasantly surprised that it’s not as bad, then you know what, we over-prepared — but it’s for good cause,” she says.