A hot summer in Quebec emergency rooms

The long-awaited summer lull after two years of the pandemic never happened in Quebec emergency rooms. COVID-19 is now mostly felt on the employee side, who have to self-isolate by the thousands. Lower priority patients pay the price.

” The volumes [de patients aux urgences] have not decreased at all. It comes in constantly. It’s not ringing off the hook, “says the president of the Association of Emergency Medicine Specialists of Quebec, Dr.r Gilbert Boucher.

“We have a decrease of barely 10% on weekends, whereas usually, it decreases by 20-25%, he points out. Last Monday, we came close to the 17-18% of patients who go to the emergency room without being seen [par un médecin]. These are the patients [moins prioritaires] who suffer the most. »

Summer 2022 is so far ‘hotter’ in Montreal hospitals than summer 2021, according to government data obtained by The duty. Nearly 20,000 more patients were admitted to the metropolitan emergency room during the last month of June, compared to the same month last year.

Quebecers seriously ill with COVID-19 are rare in health centers, according to the health workers interviewed. Moreover, the majority of patients hospitalized and infected with SARS-CoV-2 are treated for other illnesses, specifies the latest report from the National Institute of Excellence in Health and Social Services.

The burden of the virus weighs above all on the healthcare teams. They must now juggle with surprise isolations of workers and the number of patients suffering from fractures, poisoning or infections of all kinds which have returned to their 2019 levels.

Quebec reported Monday that 6,544 health care workers were absent for reasons related to COVID-19, down slightly. Added to this is a proportion of about 20% of the total staff who take a well-deserved vacation during a summer period of 8 to 10 weeks.

Behind these figures hide teams each time disturbed by unforeseen absences of ten days. “We always have someone from the staff who is sick”, says the Dr Bruno Bernardin, emergency medicine specialist in Montreal. “Last week, we lost a nurse in the middle of her shift, he says. Her spouse had symptoms. She too, but, really weakly, barely a throat that tingles. She went for her test before her shift. A few hours later, she receives a call to tell her that she is positive. She washes her hands, gives her files to a colleague and goes home. We end the shift with one less employee. It delays patient care. »

In the Laurentians, for example, emergencies were operating Monday at 167% of their capacity.

“The staff vacation period and the lack of staff due to COVID-19 have increased the lack of staff, notes Dominique Gauthier, information officer at the local CISSS. […] The high number of tourists in the region also increases the needs for health and social services. »

Blow to morale

Quebec has axed this spring in the bouquet of “COVID-19 bonuses”. A dozen programs have ended, including the 4% and 8% wage increases offered to nursing staff, the “double time” pay for overtime and the “staircase bonus”, an amount intended to promote regular attendance at work. which could reach $1,000 per four-week period.

This decline in working conditions had “a significant impact on the morale of the troops”, indicates Jean-Sébastien Blais, president of the Fédération interprofessionnelle de la santé du Québec in Abitibi-Témiscamingue. “Some employees had taken overtime for the summer, but canceled it because they no longer saw the point of doing it. »

The “contingency plan” still in effect in Abitibi has already reduced the services offered “to the bare minimum”. Dozens of beds were closed in surgery and intensive care for lack of staff, just as activities were disrupted in public health, home care and family medicine groups.

With only a dozen nurses to keep the emergency room of the Temiscaming-Kipawa hospital at arm’s length, a few departures would be enough to sound the death knell for this crucial care in the region. “The next emergency will be 80 kilometers away. It’s quite complicated here, ”says the man who is also campaigning for his region to be recognized as a “remote region” by the public service.

It is also impossible to estimate the level of load shedding in establishments due to the pandemic, since these data have not been compiled for a few weeks by the Ministry of Health.

“The evolution of the pandemic allows us to propose a follow-up plan in order to learn how to operate with the fluctuations of COVID-19 cases and to authorize establishments to adapt their operations locally”, supports Marie-Claude Lacasse, coordinator to departmental media relations, in a written communication. “The priority remains to promote the resumption of activity and hospital fluidity despite the context of staff shortages. Institutions have adapted their way of doing things and are able to manage cases of COVID-19, both in terms of staff and patients. »

Since summer is already “hot” in emergencies, many fear that the situation will worsen with the return of the cold season.

” The next step [de délestage], in the fall, it’s the operating rooms,” says Jean-Sébastien Blais. Since March 2020, the number of surgeries pending for over a year has fallen from 4,643 to 21,343.

With Laurianne Croteau and Marie-Eve Cousineau

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