TORONTO (Reuters) – Younger Canadians are carrying the heaviest of the country’s latest COVID-19 surge, creating a growing demand for artificial lungs and a struggle to maintain staff in critical care units as hospitals try to treat patients for the last time te red.
Treatment with artificial lungs, known as extracorporeal membrane oxygenation, or ECMO, will be much more likely to be used for patients younger than 65 years, explained Marcelo Cypel, surgical director of the extracorporeal life support program at Toronto’s University Health Network (UHN).
Last week, there was a record 19 ECMO patients at UHN, 17 of whom had severe COVID-19. When the lungs of the sickest COVID-19 patients are full of fluid and mechanical fans can no longer do the job, artificial lungs can save lives.
By Monday, doctors had weaned some of the machines and they were on 14 ECMO patients, 12 of them with COVID-19.
The need for these artificial lungs reflects a change in Canada’s epidemic, which has gotten worse, with new cases on the rise and outbreaks in workplaces and schools.
As many elderly people are vaccinated and new, much more contagious coronavirus variants spread widely, younger patients are increasingly coming into intensive care.
“It’s very different now than the first wave when we saw older people with illnesses,” Cypel said. “We’re seeing more … young essential workers.”
The ECMO situation is under control for the time being, but things can change very quickly, warns Cypel.
When hospital systems in other countries were overwhelmed, they had to stop using ECMO because it required a lot of staff – seven or more people to start treatment.
About 55% of the people who receive the therapy survive, Cypel said. However, they are often left with a severe physical limitation due to their prolonged hospital stay, he added.
Many of Canada’s provinces are in the grip of a deteriorating third COVID-19 wave as they struggle to speed up vaccine vaccination. The country reported more than 6,200 new cases on Monday, with the percentage of people tested positive for the virus up to 3.8%.
‘SEE BURNOUT’
In British Columbia, where hospitals are supporting an increase in the demand for intensive care unit beds (ICUs), caused by the very worrying P.1 virus variant first discovered in and now devastating, Brazil, the critical Dr. Del Dorscheid of Vancouver’s St. Paul’s Hospital is more concerned about staff than using artificial lung use.
According to a shift, a third of the staff worked overtime.
“They work so hard to find corpses to fill in the blanks,” he said. ‘I would not say that we see more mistakes. Not yet anyway. But we are definitely seeing burnout. ”
For ICUs, there is no end in sight. As of Tuesday, there were 497 COVID-19 patients in the ICUs in Ontario, a new high. Last week, experts advising the provincial government said it could rise to 800 by the end of April, even with a new stay-at-home order – or approaching 1,000 without it. The province stopped shortly before a new home order.
New restrictions implemented in Ontario last week change little for areas hardest hit. In Toronto, patios for bars and restaurants outside have closed, and a plan to reopen salons has been shut down. On Monday, the hard-hitting Peel, west of Toronto, pulled on its own to suspend personal classes at schools for two weeks.
Canada’s vaccination rate has increased after a slow start, with 15% of the population receiving at least one shot. But data from the Institute for Clinical Evaluation Sciences shows that the Ontario communities with the highest risk for COVID-19 transmission also have the lowest vaccination rates.
These communities tend to have a large percentage of residents who are unable to work from home, and many of them are non-white immigrants who expose their jobs to a high risk of exposure to viruses.
Some did not have cars to drive to vaccination sites, or they had time to get the vaccine, said Brampton doctor Amanpreet Brar. Some of the neighborhoods most affected do not have pharmacies that dispense COVID-19 vaccines.
“It really reflects systemic inequalities that we see in our society,” Brar said. “They are considered non-essential, while their work is considered essential.”
Edited by Denny Thomas and Bill Berkrot