TORONTO (Reuters) – Doctors in the Canadian province of Ontario may soon have to decide who can and will not receive treatment in intensive care, as the number of coronavirus infections sets records and patients are packed into hospitals that are still off a December wave.
Canada’s most populous province is canceling surgery, admitting adults to a major children’s hospital and preparing field hospitals after the number of COVID-19 patients in ICUs rose 31% to 612 in the week before Sunday, according to Ontario data Hospital Association.
The sharp increase in hospital admissions in Ontario is also weakening tocilizumab, a drug often given to people who are seriously ill with COVID-19.
Hospital care is publicly funded in Canada, usually free to residents. But new hospital beds have not kept pace with population growth, and there is often a shortage of staff and space during bad flu seasons.
Ontario’s hospitals did relatively well during the first wave of the pandemic last year, in part because the province quickly canceled menus.
The College of Physicians and Surgeons of Ontario told doctors last Thursday that the province is considering “introducing the critical care protocol,” something that was not done during earlier waves of the virus. Triumph protocols help doctors decide who to treat in a crisis.
“Everyone is under extreme stress,” said Eddy Fan, an ICU doctor at Toronto’s University Health Network. He said no doctor wants to consider a triage protocol, but there are only so many staff.
“There will be a breaking point, a point at which we can no longer fill the gaps.”
The Ministry of Health said in a statement that Ontario had not activated the protocol. A draft from September suggests that doctors may withhold life-sustaining care from patients with less than a 20% chance of surviving 12 months. A final version has not been announced.
The scientific advice table from Ontario has been predicting the boom for months, said Laveena Munshi, a member of critical care. During a recent shift, she wanted to call the son of a patient to discover that he was in an ICU across the street.
“The horror stories we see in the hospital are like apocalyptic movies,” she said. “It’s not supposed to be the reality we’re going to see in a pandemic one year.”