SHA activating COVID-19 surge plan

Some services will be slowed down to allow for redeployment of staff, increased capacity

Saskatchewan Health Authority CEO Scott Livingstone. (Brandon Harder/Regina Leader-Post)

The Saskatchewan Health Authority (SHA) announced plans on Thursday to slow down specific services in order to respond to a surge in COVID-19 patients.

There are currently 128 people in hospital. 104 people are receiving inpatient care and 24 people are intensive care in hospitals across the province.

Services that will be slowed down include some primary health care services, elective surgeries in urban centres, endoscopy/cystoscopy procedures, women and children’s programming, diagnostics, therapies, ambulatory care, registrations resources, environmental and food and nutrition services, rehab services, and home care services.

These services will still be available just at reduced volumes or levels.

There are also limited exceptions where services will be temporarily paused in highly localized programs such as dental programs, therapeutic and rehabilitation programs and active living programs.

Derek Miller, executive director of infrastructure management at the SHA said decisions were not made lightly about what services could be slowed down.

“We asked our frontline clinical leaders and operational leaders to review each service line and assess it with a lens of what is the impact on patient care by reducing and slowing down that service and also what are the resources that become available by doing that in terms of numbers and also skill set,” Miller explained.

He added this is how the SHA identified what services could be slowed down with minimal impact on patient care.

“This is not a broad reduction of services like what was undertaken in the spring slowdown but rather much more finely tuned adjustments in multiple areas that allow us to achieve the capacity and resources that we need.”

The slowdown in services will result in the redeployment of 588 full-time equivalent (FTE) positions across the province. This number includes 175 registered nurses, 74 licensed practical nurses, and 15 continuing care assistants.

The SHA is also obtaining additional resources through supplementary workforces provided by provincial government staff, federal government staff, and Statistics Canada staff.

The nearly 600 FTE staff will be redeployed to contact tracing and hospitals to address a surge in COVID-19 hospitalizations.

As to where those staff will be deployed, Miller explained that if a hospital unit is converted to a COVID unit, the staff would continue to work in that unit as COVID support staff. Some new spaces are also being created in hospitals where beds didn’t exist before and will need to be staffed.

“They’re being matched based on their skill sets and what training they have as to where we can best deploy them as part of the response,” Miller said.

The need to slow down services and redeploy staff is due to a spike in COVID-19 hospitalizations and overall capacity.

In the last month there has been a 400 per cent increase in the hospitalizations, and 31 per cent of ICU capacity is being used for COVID-19 patients.

Considering the potential lab confirmed cases in the current timeline, Miller says we could see over 500 cases a day. Hospital census and ICU census will continue to rise over the next week as well.

“We are moving forward to immediately create capacity and resources that allow us to meet the demand,” Miller said.

The SHA is planning for up to 250 COVID patients in hospitals within the next two week period. This represents a capacity equivalent to the Cypress Regional Hospital in Swift Current and the Victoria Hospital in Prince Albert, combined.

They are also planning for 64 potential COVID patients in the ICU, which is equivalent to about 28 per cent more ICU bed capacity that currently exists in Saskatoon and Regina combined.

The SHA will be meeting this demand by creating additional spaces in hospitals to care for ventilated patients and surging resources like staff and physicians to care for patients.

Miller explained that capacity needs to be a step ahead of current demands.

“We don’t want to be in a situation where we’re riding the demand curve and where we’re at risk of quickly becoming overwhelmed by COVID demand,” he said.

When asked why the slowdowns are only occurring now even though cases and hospitalizations have gone up over the last two weeks, SHA CEO Scott Livingstone said existing resources have been used to deal with contact tracing.

Livingstone added that during the pandemic, and particularly in the summer, the SHA added 627 FTE to support COVID response.

“You’ve seen our testing capacity expand, you’ve seen our contact tracing expand, but we are pushing our teams to the limit,” Livingstone said on Thursday.

“We need to act now to not only strengthen their response both on the offensive and defensive strategy, but to build a labour pool that gives us more flexibility to deal with outbreaks that we can’t predict in long-term care facilities and hospitals where we’re required to immediately replace staff, because the only other option is to reduce services immediately if we can’t replace them.”

Livingstone also addressed the rising case numbers in northern Indigenous communities in Thursday’s press conference.

He said the SHA has been working with the federal government and First Nations leadership since the beginning of the pandemic to determine what supports they need.

Livingstone said a liaison was added to First Nations and Métis communities in the beginning of the pandemic to identify their needs and the SHA responds the best they can.

SHA officials were also asked how testing was going, particularly how busy it is and how people without transportation are accessing test centres.

Livingstone said the SHA is continuing to expand testing with drive-thrus in Saskatoon, Regina, and Prince Albert. They are looking at expanding hours, particularly in Saskatoon and Regina, putting more staff in place, and adding second drive-thru testing locations in both cities because of popularity.

“In the most extreme examples of the things that we’ve done to bring testing to people, in La Loche and in other communities, with communal living settings in the summer, we went door-to-door with testing to try to get as many people tested as we could.”

SHA official also said that they have plans in place to open field hospitals if required.

“I’ll just confirm at this point in time we are not in the process of opening the field hospitals, but we are preparing teams,” Livingstone said.

He added that as hospitalizations and specifically ICU numbers go up, the SHA will continue to use a stepwise approach and forecasting models in determining when to escalate services, including opening field hospitals.

Miller added that over the past few weeks the SHA has worked to reduce the amount of time it would take to activate field hospitals by ensuring equipment and oxygen systems are set up.

“We’re as close as we possibly can without actually pulling the trigger on activation,” Miller said.

The type of patient that would be admitted into the field hospital would be individuals who require care but not necessarily at the level received in acute care, Miller said.

Livingstone started his remarks on Thursday by asking the public to reach out to health care workers they know and thank them for the work they do every day.

SHA Chief Medical Officer Dr. Susan Shaw said the biggest emotion she and her co-workers are feeling now is concern.