The number of hospitalizations of patients with COVID-19 is nearing record highs in Quebec. Some 1,750 Quebecers infected with the virus were hospitalized, 116 less than at the worst of the pandemic, during the first wave. But how many of them end up in hospital for COVID-19 and not for another health problem? Between 30% and 50%, according to data obtained by The duty.
At the Jewish General Hospital on Wednesday, 23 of the 73 infected patients were hospitalized due to COVID-19, according to the Deputy President and CEO of the CIUSSS du Center-Ouest-de-l’Île-de-Montréal, Francine Dupuis. This represents 32% of cases. “The others also have COVID-19, but this is a secondary diagnosis,” she says.
At the CISSS de Laval, it is estimated that 50% of positive patients hospitalized at Cité-de-la-Santé are due to COVID-19. “For intensive care, it is 100%”, however specifies the spokesperson for the CISSS, Judith Goudreau.
The CIUSSS du Center-Sud-de-l’Île-de-Montréal, it indicates that as of Tuesday, 19 patients out of the 62 infected were admitted for COVID-19, or 31%. However, the establishment says it ignores the admission diagnosis for 11 other potential cases.
In pediatric hospitals, young patients admitted with complications from COVID-19 remain rare. ” Today [mercredi], of our 20 infected patients, there may be three or four who are sick with COVID-19, says Dr.r Marc Girard, Director of Professional Services at the Sainte-Justine University Hospital Center. The 16 others, they have another affection. They are hospitalized because they have appendicitis, because they have a stomach ache, a chronic illness. “
What about the situation across Quebec? Does the Omicron variant hit less hard? The Ministry of Health and Social Services says it is “working” to determine the exact proportion of patients who are hospitalized due to COVID-19 in Quebec.
At a press briefing on Wednesday, the national director of public health of Quebec, Dr Horacio Arruda, argued that “at least 30 to 40% of patients” hospitalized and suffering from COVID-19 had not been admitted to treat this disease. This means that 60% to 70% would be.
Some studies show that the risk of hospitalization is “lower with Omicron than with Delta”, according to Dr Gaston De Serres, doctor-epidemiologist at the Institut national de santé publique du Québec. “The robustness of the evidence is getting better,” he observes. It’s fair to say that yes, the Omicron causes fewer hospitalizations per 1000 cases than the Delta. “
The Omicron variant causes 25% to 40% fewer hospitalizations than the Delta, says the UK, according to a studyD Cécile Tremblay, microbiologist-infectious disease specialist at the CHUM. “But since the absolute number of cases is so much higher, the absolute number of hospitalizations is huge, as the current numbers show,” she said.
Longer in the hospital
Whether infected patients are hospitalized for COVID-19 or not “doesn’t change anything” to the reality on the ground, says Dr.r Hoang Duong, President of the Association of Internal Medicine Specialists of Quebec. Patients with the virus also stay longer in the hospital, he reports.
“All treatments are more complicated to administer,” explains Dr.r Duong. If the patient has to be transferred to the radiology department for an x-ray, it takes longer. If a physiotherapist has to come and provide physiotherapy care, sometimes it’s longer, sometimes it’s downright impossible because of the isolation. So, that means the patient will have to stay a few more days than if they were not COVID positive. “
This extension of stays affects emergencies. “Patients waiting for a bed in the emergency room cannot go upstairs, and that partly explains why emergencies for the past few days have been really crowded all over Quebec hospitals”, continues Dr Duong.
Faced with the skyrocketing hospital admissions, hospitals must rearrange their cold and hot units. Some centers have come to implement a “new model”, where asymptomatic positive patients find themselves on the same floor as negative patients, according to Dr Gilbert Boucher, President of the Association of Specialists in Emergency Medicine of Quebec.
“Patients who have symptoms and who need to be hospitalized, we keep them in a COVID-19 unit,” he explains. But all the other patients, we start to “cohort” them on normal units. “
He cites as an example the case of a positive patient, without symptoms and “with water on the lungs because of the heart” who will be admitted to cardiology. The unit is then divided into two. “Let’s say we have 18 beds, the six at the end, we put them in COVID”, says the Dr Butcher. Caregivers wear the “same protections” as in hot units, such as the N95 mask, he says. “It is sure that it is not an ideal model, agrees the Dr Butcher. But you have to understand, we have reached plan C. ”