Saskatchewan Health Authority CEO Scott Livingstone. (Brandon Harder/Regina Leader-Post)
The Saskatchewan Health Authority (SHA) announced plans on Thursday to slow down specific services in order to respond to a surge in COVID-19 patients.
There are currently 128 people in hospital. 104 people are receiving inpatient care and 24 people are intensive care in hospitals across the province.
Services that will be slowed down include some primary health care services, elective surgeries in urban centres, endoscopy/cystoscopy procedures, women and children’s programming, diagnostics, therapies, ambulatory care, registrations resources, environmental and food and nutrition services, rehab services, and home care services.
These services will still be available just at reduced volumes or levels.
There are also limited exceptions where services will be temporarily paused in highly localized programs such as dental programs, therapeutic and rehabilitation programs and active living programs.
Derek Miller, executive director of infrastructure management at the SHA said decisions were not made lightly about what services could be slowed down.
“We asked our frontline clinical leaders and operational leaders to review each service line and assess it with a lens of what is the impact on patient care by reducing and slowing down that service and also what are the resources that become available by doing that in terms of numbers and also skill set,” Miller explained.
He added this is how the SHA identified what services could be slowed down with minimal impact on patient care.
“This is not a broad reduction of services like what was undertaken in the spring slowdown but rather much more finely tuned adjustments in multiple areas that allow us to achieve the capacity and resources that we need.”
The slowdown in services will result in the redeployment of 588 full-time equivalent (FTE) positions across the province. This number includes 175 registered nurses, 74 licensed practical nurses, and 15 continuing care assistants.
The SHA is also obtaining additional resources through supplementary workforces provided by provincial government staff, federal government staff, and Statistics Canada staff.
The nearly 600 FTE staff will be redeployed to contact tracing and hospitals to address a surge in COVID-19 hospitalizations.
As to where those staff will be deployed, Miller explained that if a hospital unit is converted to a COVID unit, the staff would continue to work in that unit as COVID support staff. Some new spaces are also being created in hospitals where beds didn’t exist before and will need to be staffed.
“They’re being matched based on their skill sets and what training they have as to where we can best deploy them as part of the response,” Miller said.
The need to slow down services and redeploy staff is due to a spike in COVID-19 hospitalizations and overall capacity.
In the last month there has been a 400 per cent increase in the hospitalizations, and 31 per cent of ICU capacity is being used for COVID-19 patients.
Considering the potential lab confirmed cases in the current timeline, Miller says we could see over 500 cases a day. Hospital census and ICU census will continue to rise over the next week as well.
“We are moving forward to immediately create capacity and resources that allow us to meet the demand,” Miller said.
The SHA is planning for up to 250 COVID patients in hospitals within the next two week period. This represents a capacity equivalent to the Cypress Regional Hospital in Swift Current and the Victoria Hospital in Prince Albert, combined.
They are also planning for 64 potential COVID patients in the ICU, which is equivalent to about 28 per cent more ICU bed capacity that currently exists in Saskatoon and Regina combined.
The SHA will be meeting this demand by creating additional spaces in hospitals to care for ventilated patients and surging resources like staff and physicians to care for patients.
Miller explained that capacity needs to be a step ahead of current demands.
“We don’t want to be in a situation where we’re riding the demand curve and where we’re at risk of quickly becoming overwhelmed by COVID demand,” he said.
When asked why the slowdowns are only occurring now even though cases and hospitalizations have gone up over the last two weeks, SHA CEO Scott Livingstone said existing resources have been used to deal with contact tracing.
Livingstone added that during the pandemic, and particularly in the summer, the SHA added 627 FTE to support COVID response.
“You’ve seen our testing capacity expand, you’ve seen our contact tracing expand, but we are pushing our teams to the limit,” Livingstone said on Thursday.
“We need to act now to not only strengthen their response both on the offensive and defensive strategy, but to build a labour pool that gives us more flexibility to deal with outbreaks that we can’t predict in long-term care facilities and hospitals where we’re required to immediately replace staff, because the only other option is to reduce services immediately if we can’t replace them.”
Livingstone also addressed the rising case numbers in northern Indigenous communities in Thursday’s press conference.
He said the SHA has been working with the federal government and First Nations leadership since the beginning of the pandemic to determine what supports they need.
Livingstone said a liaison was added to First Nations and Métis communities in the beginning of the pandemic to identify their needs and the SHA responds the best they can.
SHA officials were also asked how testing was going, particularly how busy it is and how people without transportation are accessing test centres.
Livingstone said the SHA is continuing to expand testing with drive-thrus in Saskatoon, Regina, and Prince Albert. They are looking at expanding hours, particularly in Saskatoon and Regina, putting more staff in place, and adding second drive-thru testing locations in both cities because of popularity.
“In the most extreme examples of the things that we’ve done to bring testing to people, in La Loche and in other communities, with communal living settings in the summer, we went door-to-door with testing to try to get as many people tested as we could.”
SHA official also said that they have plans in place to open field hospitals if required.
“I’ll just confirm at this point in time we are not in the process of opening the field hospitals, but we are preparing teams,” Livingstone said.
He added that as hospitalizations and specifically ICU numbers go up, the SHA will continue to use a stepwise approach and forecasting models in determining when to escalate services, including opening field hospitals.
Miller added that over the past few weeks the SHA has worked to reduce the amount of time it would take to activate field hospitals by ensuring equipment and oxygen systems are set up.
“We’re as close as we possibly can without actually pulling the trigger on activation,” Miller said.
The type of patient that would be admitted into the field hospital would be individuals who require care but not necessarily at the level received in acute care, Miller said.
Livingstone started his remarks on Thursday by asking the public to reach out to health care workers they know and thank them for the work they do every day.
SHA Chief Medical Officer Dr. Susan Shaw said the biggest emotion she and her co-workers are feeling now is concern.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
