Outside the metropolis, the number of hospitalizations and admissions to intensive care is at levels not reached since the start of the pandemic. This is the case in almost all regions of Quebec, which puts healthcare workers on a tight rope. Unlike previous waves, where Montreal concentrated the majority of admissions, there are currently only a third of total hospitalizations in the metropolis.
“We all broke our records. And unfortunately, these are unenviable records. There are many more patients on the floors, and we are understaffed. Fortunately, since many people are vaccinated, fewer patients end up in intensive care, ”says Dr.r Mathieu Simon, pulmonologist and head of intensive care at the Institut universitaire de cardiologie et de pneumologie de Québec – Université Laval, in the Capitale-Nationale region, which has 174 hospitalized patients, exceeding the threshold of 145 patients posted during the difficult third wave, experienced in spring 2021.
Quebec also broke on January 7 the record for the total number of patients admitted to intensive care since the start of the pandemic, with 257 patients requiring critical care, exceeding the peak of 231 patients admitted on January 14, 2021, reached at most strong of the second wave.
These figures say a lot about the power and geographic extent of the current wave, despite the fact that the Omicron variant so far seems to cause fewer severe symptoms, especially thanks to the vaccination of a large part of the population. says Dr Simon. “One in ten people end up in intensive care, rather than one in three with Delta, that’s what saves us,” he says.
Despite everything, hospitalization records are shattered in most regions, especially in some of them with lower vaccination rates. This is the case in Chaudière-Appalaches (77% vaccine coverage), where 114 patients were hospitalized on January 9, double the peak reached during the first wave (56), as well as in Mauricie – Center-du. -Quebec (77%), with 163 patients admitted, compared to 84 at the height of 2020.
“They face a severe tide of cases. We had to help these regions with transfers, they were overwhelmed by the fifth wave ”, adds Dr Simon.
Unvaccinated overrepresented
Other regions also suffer, in particular Montérégie which, with 460 hospitalizations in progress, has twice as many as in January 2021 (240).
Records are also shattered in the Laurentians, which has nearly three times as many hospitalized patients as at the peak posted in January 2021 (72), with 197 admissions to its hospitals. The Lanaudière region also breaks its own record with 124 patients hospitalized on January 9, twice as many as in January 2021 (67).
“Unvaccinated people are overrepresented in this picture, especially in intensive care. We are approaching the lack of resources. We have a lot less spring and staff than in the first wave. We can no longer help each other between regions, because now everyone is affected, ”says Dr.r Hoang Duong, intensivist at the Pierre-Le Gardeur hospital center, in Lanaudière, and head of the Association of internal medicine specialists in Quebec.
In this hospital, the Dr Duong has a front row seat to observe how quickly the Fifth Wave is sweeping through the network. “We had 15 COVID patients ten days ago, we have 68 this morning. It is difficult to redistribute staff to COVID zones. We see the exhausted nurses who go on for up to 16 hours in a row. Surgeons had to come and lend a hand and perform nursing duties in intensive care and emergency, ”he says.
“Patients have been transferred to us from Lanaudière and the Laurentians, and sometimes even further afield,” confirms Dr.r Joseph Dahine, head of intensive care at Cité-de-la-Santé in Laval. Although beds are in theory ‘available’, sometimes we don’t have the staff to use these beds, ”he explains.
The Montreal and Laval regions stand out, with fewer patients admitted than in the first and second waves. But with 914 hospitalizations, Montreal is still slowly approaching the record of 1234 patients set on May 12, 2020. With 90 hospitalized patients, Laval also did not exceed the peak of 142 experienced during the first wave.
But several small and medium-sized hospitals have already greatly exceeded the thresholds previously reached, in particular Notre-Dame hospital (59 patients), St. Mary’s hospital (64), Verdun hospital (41), Jean-Talon (28) and Fleury hospital (27). The CHUM, the MUHC, and the Sacré-Coeur and Maisonneuve-Rosemont hospitals did not reach the heights observed during the first wave.
Penalized patients
According to the Dr Joseph Dahine, the situation in the metropolis could be explained in part by the high rates of infection experienced during previous waves. “Those who have already been infected are not hit this time. We may have a little more immunity than other regions. But for [que le réseau] survive, we still penalize patients with urgent illnesses to be treated, ”he laments.
Even if the protocols for prioritizing access to intensive care are ready to be used in the event of network saturation, we are not there yet, say the doctors consulted. “We have 800 intensive care beds available, but they cannot all be mobilized because of the absences. The third is occupied by COVID patients. We can still treat urgent cases, because of the load shedding. Those who still claim their individual freedoms to the detriment of other patients must be vaccinated, it is the only solution. We hope that more severe measures will be taken so as not to have to choose between two patients, ”insists Dr.r Simon.
Outside Montreal, the regions of Saguenay – Lac-Saint-Jean, Côte-Nord and Gaspésie – Îles-de-la-Madeleine have also not yet surpassed the hospitalization records reached during the previous waves.