Saskatchewan’s hospitals, especially those in urban areas, are beginning to struggle with capacity issues as COVID-19 cases surge.
The Saskatchewan Health Authority (SHA) said Thursday that it is planning some service slowdowns in order to ensure it has the staff available to respond to increased needs caused by the recent spike in COVID-19 cases.
A record 49 patients are in hospital with COVID-19, the province said Thursday. Of those, 13 are in the intensive care unit. As of Wednesday, nine were on ventilators.
There were 111 new cases of COVID-19 identified Thursday.
The North Central Zone, which includes Prince Albert, reported eight new cases Thursday. Five people in the zone are receiving inpatient hospital care, while two additional zone residents are in the ICU.
The majority of the new cases reported Thursday were from the Regina (25) and Saskatoon (24) zones.
Each of the eight new north central cases were from the North Central 2 subzone, which consists of just the City of Prince Albert.
With the number of active COVID-19 cases rising, Saskatchewan’s Chief Medical Health Officer Dr. Saqib Shahab and the Saskatchewan Ministry of Health are considering additional public health measures to reduce transmission of COVID-19. Those new measures are set to be announced tomorrow at 11:30 a.m.
Like the record number of hospitalizations, the 13 patients in ICU is also the highest mark so far in the COVID-19 pandemic. The surge in hospitalizations follows a surge in cases. The CEO of the SHA has said that those numbers usually trail case counts by a week or two, meaning that the hospitalizations coming from the hundreds of new cases identified in the last few days are not likely included in Thursday’s hospitalization count. It’s also why the SHA is doing what it can to prepare for even more cases.
The Saskatchewan Health Authority (SHA) is planning to slow down some service areas in order to redeploy staff to accommodate a surge in COVID-19.
In a news release posted Thursday afternoon, the health authority said it was updating its readiness plan including surge capacity planning and full operations of the emergency operations centre (EOC) starting next week.
“We have both offensive and defensive strategies in place that our teams have been working on and adapting since the onset of the pandemic. Surge capacity planning has never stopped,” said Scott Livingstone, Chief Executive Officer. “But with the recent significant rise in cases and hospitalizations, we determined that a fully operational EOC will ensure strong central coordination of those efforts and to signal that we are mobilizing all available resources to combat COVID-19.”
The SHA said it continues to strengthen its response to the pandemic and is working to address pressures in areas such as testing, HeathLIne 811, contact tracing, entryway screening, lab processing and staff cohorting. So far, they have filled about 550 positions.
The health authority, though, said not all those positions can be filled from the job market alone.
“Unprecedented growth in demand in these areas as a result of COVBID-19 will not permit the SHA to meet these pressures solely through the labour market,” they wrote.
“Redeployment of staff, particularly to meet high demand for contact tracing and to address surges in our hospitals and safety in our long-term care facilities is required.”
That means, the province said, there will be targeted, localized, time-limited service slow downs “to support re-deployment of staff to high priority areas and to reduce pressures on acute care services.”
They said that guidelines have been developed to determine which services to slow down to support the COVID-19 response. The health system wants to ensure that it’s prepared for a sustained surge in cases through the winter months. Livingstone, though, said that those slowdowns will not be across the board, such as what happened in spring 2020.
“Those actions were taken out of an abundance of caution to respond to a virus we knew little about at that point,” he said.
“Our approach now will be to make any service disruptions targeted, localized and as time-limited as possible to ensure that Saskatchewan citizens are still getting the health services they need.”
What those disruptions will look like was not detailed, but announcements will be made as they are implemented.
The best way to avoid slowdowns and surges, the SHA said, is to follow public health advice such as masking and physical distancing.
“With the recent surge in cases, the SHA is reminding the public that the primary factor in enabling the health system to meet the demand created by the COVID-19 virus is actions taken by Saskatchewan residents to stop the spread,” the press release said.
“Please help us by physical distancing, washing your hands regularly, limiting your bubble as much as possible, abiding by all public health orders and wearing a mask whenever you are in public indoor settings. At this time, it is essential for all residents to stay home if they are feeling even the mildest symptoms as an increasing number of cases are residents going to work when sick.”
Province provides updated offensive, defensive strategies
The health authority also outlined its updated its offensive and defensive strategies in the release, which have been adjusted since initially planned out in the spring.
In addition to the 50-plus dedicated testing sites, the province has more than 20 rapid testing machines across the province to expedite results.
Right now, while more tests can be done, the provincial lab doesn’t have the capacity to increase testing beyond current volumes. The SHA said it’s currently in the process of recruiting and training 76 new laboratory positions to help alleviate workload pressures.
Contact tracing is also key to the province’s offensive strategy, and significant growth in cases in recent weeks is putting “extreme pressure” on the contact tracing public health teams, the province said.
New staff are being hired, resources from the federal government are being used and the SHA is looking at how to find efficiencies within its own services.
Managing outbreaks is the third prong of the offensive strategy. Since only three of 63 declared outbreaks to date have been in health care facilities, the province is confident in this part of its strategy, and has vowed to stay extremely vigilant to prevent the virus from infiltrating facilities such as long term care homes.
The defensive strategy, on the other hand, includes acute care, field hospitalization, PPE and service slowdowns. In terms of acute care capacity, hospitals in Saskatoon, Regina, Moose Jaw and Prince Albert are facing capacity challenges as increased loads of COVID-19 patients are added to regular health care services, which have resumed and are back to near pre-pandemic levels.
The SHA said it is focusing on improving patient flow, using surge spaces to accommodate higher volumes of patients, bypassing high volume health units, cohorting inpatients where possible, ensuring field hospitals are ready and identifying where service can be slowed down if possible.
Field hospitals, they said, are ready to be activated in Saskatoon and Regina if needed. The primary role of the field hospitals is to increase the capacity to care for stable COVID-positive patients that are unable to manage at home but don’t require the high level of care seen in an acute hospital setting.
For now, the province said, ventilator availability capacity is sufficient. There are 545 units available for use. In total, as of Wednesday, 82 patients, including nine COVID-19 patients, are on ventilators. The numbers change slightly day-to-day.
The province also has enough PPE, estimating a three-month supply. They’re aiming for a six-month supply.
