Surgery: load shedding is making a comeback in hospitals

Faced with the sharp increase in hospitalizations in Quebec and the shortage of nursing staff, all the hospitals in the province are “minimally” at alert level 3 – on a scale that has 4. Some regions are already overwhelmed by the influx. COVID-19 patients and have to postpone more and more operations.

Alert level 3 provides, depending on the region, that between 40 and 80% of available beds are allocated to COVID patients. Level 4 is the highest: more than 80% of beds are then targeted COVID-19 ”, writes the Ministry of Health.

Some regions are approaching it, in particular Chaudière-Appalaches, a region which Thursday had 48 hospitalizations attributable to COVID, including 12 in intensive care. “That’s 11 more hospitalizations in regular care compared to the day before and 5 more in intensive care,” says Geneviève Dion, spokesperson for the regional CISSS.

This is a high since the start of the pandemic, which exceeds the previous peak of 42 hospitalizations reached on April 20.

A sign that the situation is deteriorating rapidly, phase 3 of the load shedding was sufficient for less than 24 hours. In fact, the CISSS de Chaudière-Appalaches opened 10 additional beds on Tuesday, bringing the number of COVID beds in the region to 43. As of Thursday, this capacity was already lapsed, given the large influx of new patients.

“The surgeries maintained are those that are urgent, oncological surgeries and day surgeries,” explains Mme Dion.

To meet demand, the normal slowdown in activities for the holiday season, which was to end on January 5, will be extended until 10. “We will be happy thereafter, depending on the increase in hospitalizations”, writes the CISSS of Chaudière-Appalaches.

Faced with the general increase in hospitalizations observed in several regions of Quebec, the interregional transfer of patients is interrupted in Chaudière-Appalaches. “We are no longer transferring patients to other regions to preserve [leur] hospital capacity […], which is also decreasing on their side, ”adds Geneviève Dion, from the CISSS de Chaudière-Appalaches.

Staff shortage

In the contingency plan published Thursday, the Ministry of Health reports a staff shortage which “greatly weakens the teams”.

“At the dawn of this 5e wave that arrives with lightning, we read in the document, we already perceive a great fatigue, a weariness and difficulties to mobilize the teams despite all the efforts of the leaders. “

The absenteeism rate increases in the network due to the Omicron variant. The CISSS de Chaudière-Appalaches had 564 employees, from all trades, withdrawn from work, of which 415 are positive for COVID.

In the Gaspé, the number of absentees is close to 100, with 36 employees infected by the coronavirus and 58 placed in isolation out of just over 4,000 workers.

“We are ready to face the music,” explains Jean Morin, spokesperson for the CISSS de la Gaspésie.

The region is however “not made” to apply its “strong” contingency plan, specifies Mr. Morin, since the territory has no hospitalizations, despite a dizzying increase in cases observed in recent days.

An identical scenario is emerging on the North Shore, a region whose six COVID beds remain unoccupied even though the number of active cases, currently, is unprecedented.

Effects of load shedding

In Montreal, a city where 34% of hospitalizations in Quebec are concentrated, phase 2 of the contingency plan is in place.

Sacré-Coeur, Fleury and Jean-Talon hospitals maintain urgent and semi-urgent operations in addition to oncology cases. “Of course, the situation is closely monitored and is called upon to change if necessary,” explains Émilie Jacob, of the CIUSSS du Nord-de-l’Île-de-Montréal.

In the east and west of the metropolis, hospitals have reduced their activities in the operating room, a normal slowdown during the holiday season. “We mainly do the most urgent cases and oncological surgeries. With regard to outpatient consultations, we encourage teleconsultation, ”underlines the CIUSSS de l’Est-de-l’Île.

Ditto in the national capital, where the six hospitals of the CHU de Québec and the University Institute of Cardiology and Pneumonia have a reduced staff for the holiday season. “The situation is changing rapidly and it is the number of hospitalizations together with the situation of the workforce that will dictate the level of resumption of activities at the beginning of January”, explains Michèle Schaffner-Junius, of the CHU. .

For several patients, the load shedding is already being felt. In Laval, for example, COVID-19 reduced the number of operating rooms from nine to seven, forcing the postponement of 47 surgeries. On social networks, there are many testimonies describing the reception of the fateful call that postpones an operation that is sometimes long overdue.

Sylvie Roy was one of them. Suffering from a tumor, this Montrealer saw her surgery postponed sine die Wednesday – before an unexpected turnaround. “I just got a call from the hospital. Surgery tomorrow morning. They make me come home today, ”she wrote to the Duty midday Thursday.

A good fortune that may become rare in the coming weeks, since the projections of the National Institute of Excellence in Health and Social Services predict that the current load shedding levels will no longer be sufficient, within three weeks, to respond. the meteoric rise in hospitalizations.

The surgeries maintained are those that are urgent, oncologic surgeries and day surgeries

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