The meteoric rise in cases of COVID-19 linked to the Omicron variant is forcing hospitals in the province to resort to load shedding. But what exactly is load shedding? Should we fear a breakdown in service in our hospitals? Roxane Borgès Da Silva, professor at the School of Public Health at the University of Montreal, answers our questions.
• Read also: Quebecers caught in Cuba because of COVID-19
Here is what you need to know about load shedding in 5 questions.
What is load shedding?
Load shedding is the act of postponing or canceling certain medical appointments that are not considered urgent, such as certain surgeries, in order to make room to accommodate the most serious cases, explains Roxanne Borgès Da Silva.
“We don’t have an expandable or elastic number of beds in hospitals and intensive care, we have to operate with the capacity we have. In a context like the one we are in now, where the number of patients is constantly increasing, choices have to be made. There are patients in very urgent situations who need to be treated immediately. ”
The load shedding system was not born out of the pandemic. Even in normal times, health facilities sometimes have to postpone operations or other appointments in order to deal with cases deemed more urgent. But with the pandemic and the explosion of cases linked to the Omicron variant, the load shedding has reached record levels.
Joël Lemay / QMI Agency
Just in the past week, more than 1,160 people infected with COVID-19 have indeed been admitted to hospitals in the province. With this marked increase in hospitalizations, Quebec should reach alert level 4 of its load shedding plan, which is the highest level.
• Read also: Immunization passport soon required to enter the SAQ and the SQDC?
Why are we doing load shedding?
The level of load shedding practiced in Quebec is not only the result of the number of patients admitted, nevertheless underlines Mr.me Borges Da Silva.
“It’s a double problem. In addition to the increase in the number of COVID-19 patients who require urgent care, there is a lack of staff in hospitals [en raison des nombreux congés de maladie]. When we lack human resources, we have to close beds, ”continues the professor.
According to the Ministry of Health and Social Services, currently 11,600 workers are missing from the network, forcing hospitals to radically reduce their service offer.
Courtesy photo
For example, the CHU de Québec-Université Laval announced that the activities of its operating room would be reduced to 56%, which means that nearly 300 operations per week will be postponed. Nearly 10,000 outpatient medical consultations or treatments – care or surgeries that do not require hospitalization – will also be moved or converted to telemedicine.
Reached by email, the spokesperson for the establishment, Jean-Thomas Grantham, confirmed that these postponements are in part due to a lack of personnel, since “nearly 800 interveners are in isolation in connection with COVID-19, of which 434 are positive ”.
• Read also: We debunk 10 myths and fake news on COVID-19
• Read also: Is herd immunity by natural infection the solution?
Who is affected by the load shedding?
The load shedding affects thousands of patients across Quebec, whose situation is deemed non-urgent or semi-urgent.
“We can think of orthopedic surgeries, certain cardiac surgeries that are not considered urgent, or even screening appointments,” says Roxanne Borgès Da Silva.
If some patients in an emergency can be transferred from one hospital to another, they will always be treated, she assures. “People who are in urgent situations, such as those who have suffered a heart attack, will always continue to be cared for, even at the highest level of load shedding.”
What are the potential consequences?
The load shedding is not without consequence, insists the expert.
“I know someone who was waiting for a quadruple bypass which was postponed due to the load shedding. The simple act of walking was very taxing. He could have died of it, ”she says.
JOEL LEMAY / 24 HOURS / QMI AGENCY
Certain conditions that do not immediately seem urgent may hide something more serious, continues Mr.me Da Silva.
“Just think of images like scans or MRIs that are used to detect serious problems. To all cancer screenings, which are more or less put aside. The load shedding can worsen the situation of some people by postponing their coverage. The situation of these people can deteriorate and they can be taken with after-effects. ”
The expert specifies, however, that no one should hesitate to go to the hospital.
“You should not be afraid to go to the hospital if your situation is urgent, since you will be treated, even if there is a load. There is no problem there. But you should not go there for something that is not urgent, ”she advises.
What is the current situation and what can we expect in the coming weeks?
“The situation is already critical in several establishments. For the availability of beds, we should reach the highest level of load shedding today [4 janvier], since we were at 37 patients to reach it yesterday and that there are more than a hundred new cases per day ”, she warns.
At this level of load shedding, choices will be made in hospitals in the province depending on the survival potential of patients, she warns.
“If we get to the end of level 4, the prioritization protocol should be triggered. At this stage, the case of each patient admitted to intensive care is analyzed by a specialized team according to their prognosis, ”explains Roxane Borgès Da Silva.
Each case is then analyzed according to a multitude of factors used to determine the severity of the patient’s condition, and those with the best chance of survival are prioritized.
“The team responsible for making this decision is not in contact with the patient, in order to ensure that the decision is not influenced by the emotionality of the caregivers,” she explains.
As the Omicron variant continues to progress, we can therefore expect particularly trying weeks in Quebec hospitals. The only glimmer of hope: that the curve of new cases will come down as quickly as it has risen, as has been the case in other countries, notes the professor.