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Ontario hospitals may have to withhold care as COVID-19 fills ICUs

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By Allison Martell and Anna Mehler Paperny

TORONTO (Reuters) – Doctors in the Canadian province of Ontario may soon have to decide who can and cannot receive treatment in intensive care as the number of coronavirus infections sets records and patients are packed into hospitals still stretched from a December wave.

Canada‘s most populous province is canceling elective surgeries, admitting adults to a major children’s hospital and preparing field hospitals after the number of COVID-19 patients in ICUs jumped 31% to 612 in the week leading up to Sunday, according to data from the Ontario Hospital Association.

The sharp increase in Ontario hospital admissions is also straining supplies of tocilizumab, a drug often given to people seriously ill with COVID-19.

Hospital care is publicly funded in Canada, generally free at the point of care for residents. But new hospital beds have not kept pace with population growth, and shortages of staff and space often emerge during bad flu seasons.

Ontario’s hospitals fared relatively well during the first wave of the pandemic last year, in part because the province quickly canceled elective surgeries.

The College of Physicians and Surgeons of Ontario told doctors last Thursday that the province was considering “enacting the critical care triage protocol,” something that was not done during earlier waves of the virus. Triage protocols help doctors decide who to treat in a crisis.

“Everybody’s under extreme stress,” said Eddy Fan, an ICU doctor at Toronto’s University Health Network. He said no doctor wants to contemplate a triage protocol but there are only so many staff.

“There’s going to be a breaking point, a point at which we can’t fill those gaps any longer.”

In a statement, the health ministry said Ontario has not activated the protocol. A September draft suggested doctors could withhold life-sustaining care from patients with a less than 20% chance of surviving 12 months. A final version has not been made public.

Ontario’s Science Advisory Table had been forecasting the surge for months, said member and critical care physician Laveena Munshi. During a recent shift she wanted to call the son of a patient only to discover he was in an ICU across the street.

“The horror stories that we’re seeing in the hospital are like ones out of apocalyptic movies,” she said. “They’re not supposed to be the reality we’re seeing one year into a pandemic.”

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Ontario reports 653 new COVID-19 cases, 6 more virus-related deaths – CP24 Toronto's Breaking News

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Ontario is reporting another week-over-week decline in its daily COVID-19 case count with fewer than 700 new infections confirmed over the past 24 hours.

Provincial health officials logged 653 new COVID-19 cases today, up slightly from 640 on Saturday but down from 715 one week ago.

The seven-day rolling average of new cases continues to drop, hitting 620 today, down from 709 last Sunday.

Of the new cases confirmed today, 499 are in individuals who are not fully vaccinated or have an unknown vaccination status and 154 are in those who are fully immunized.

With 31,063 tests processed over the past 24 hours, officials are reporting a provincewide positivity rate of two per cent, compared to 2.3 per cent seven days ago.

The province says there are now 177 people with COVID-19 receiving treatment in Ontario intensive care units, declining by five since last Sunday.

Six more virus-related deaths were reported over the past 24 hours but the province says three of those fatalities occurred last month.

Ontario’s active COVID-19 caseload now sits at 5,591, down from 6,396 last Sunday.

More than 80 per cent of eligible Ontarians have now received both doses of a COVID-19 vaccine.

In an effort to boost vaccination rates, the city is holding vaccination clinics in a variety of locations with high foot traffic, including malls across Toronto this weekend.

Dr. Omar Khan, an assistant professor with the University of Toronto’s Institute of Biomedical Engineering, said Ontario’s high vaccination rate will help keep ICUs from filling up.

“By having people vaccinated, that keeps them out of the hospital, keeps them out of the ICUs, and then lets the medical system catch up with everything that’s been piling up,” he told CP24 on Sunday morning. 

The numbers used in this story are found in the Ontario Ministry of Health’s COVID-19 Daily Epidemiologic Summary. The number of cases for any city or region may differ slightly from what is reported by the province, because local units report figures at different times.

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COVID-19: N.B. reports person in 40s has died, as province adds 82 new cases – Globalnews.ca

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A person in their 40s is New Brunswick’s 54th COVID-related death.

The province said in a news release Sunday that the person was from Zone 1 (Moncton region).

The news marked six COVID-related deaths in the province since last Wednesday, under a week ago.

“Each life taken in New Brunswick by COVID-19 is more than a number,” said Premier Blaine Higgs in a news release.

“These are people’s parents, children, friends, neighbours and coworkers.”

The death was announced on the same day the province reported 82 new cases — 64 of which involve people who are not fully vaccinated.

Read more:
Lifting COVID-19 restrictions in New Brunswick was ‘not the right decision’: doctor

There are now 33 people in New Brunswick hospitalized due to the virus, 15 of whom are in the ICU.

With 33 recoveries reported, the number of active cases is now 628.

Public Health data shows 79.2 per cent of eligible New Brunswickers are fully vaccinated against COVID-19 and 88 per cent have received their first dose of vaccine.

New cases breakdown

The new cases are:

Zone 1 (Moncton region) – 27 cases

  • 12 people 19 and under
  • one person 20-29
  • three people 30-39
  • two people 40-49
  • two people 50-59
  • two people 70-79
  • three people 80-89
  • two people 90 and over

Eighteen cases are under investigation and nine are contacts of a previously-confirmed case.

Zone 2 (Saint John region) – four cases

  • a person 20-29
  • a person 40-49
  • a person 60-69
  • a person 70-79

Three cases are contacts of previously-confirmed cases and one is under investigation.


Click to play video: 'COVID-19: the upward trend in cases among children'



4:53
COVID-19: the upward trend in cases among children


COVID-19: the upward trend in cases among children

Zone 3 (Fredericton region) – 30 cases

  • 16 people 19 and under
  • six people 20-29
  • one person 40-49
  • three people 50-59
  • four people 60-69

Twenty-two cases are under investigation and eight are contacts of previously-confirmed cases.

Zone 4 (Edmundston region) – 14 cases

  • four people 19 and under
  • two people 20-29
  • six people 30-39
  • two people 80-89

Thirteen cases are under investigation and one is a contact of a previously-confirmed case.

Zone 5 (Campbellton region) – two cases

  • a person 30-39
  • a person 70-79

Both cases are contacts of previously-confirmed cases.

Zone 6 (Bathurst region) – four cases

  • three people 30-39
  • one person 40-49

Three cases are under investigation and one is a contact of a previously-confirmed case.

Zone 7 (Miramichi region) – one case

  • a person 30-39

This case is under investigation.

State of emergency reinstated

On Friday, the province reinstated a state of emergency due to the current level of COVID-19 hospitalizations.

Physical distancing, indoor masking and a proof of vaccination policy for certain services and businesses are now in effect.

Anyone entering New Brunswick must also pre-register through the New Brunswick Travel Registration Program.


Click to play video: 'New Brunswickers react to reinstated state of emergency'



0:41
New Brunswickers react to reinstated state of emergency


New Brunswickers react to reinstated state of emergency

© 2021 Global News, a division of Corus Entertainment Inc.

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Outbreak declared at Prince George's University Hospital of Northern BC – BC News – Castanet.net

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A COVID-19 outbreak has been declared at Prince George’s University Hospital of Northern BC Sunday.

Northern Health says nine patients and one staff member on the hospital’s Primary Care Medical Unit have tested positive for the virus, and more testing is currently underway.

As a result, the hospital has restricted the unit to essential visitors only.

The condition of the infected people was not disclosed.

An outbreak at the same hospital last December through January left eight people dead, after 33 people tested positive.

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