There is good reason for optimism. Daily cases are dropping and the healthcare system slowly recovering. We can see a plan that will restart scheduled surgeries and we see the provincial stepwise approach to how businesses will reopen. It is much slower than we would like, but we are moving in the right direction.
So why is everything taking so long? Why can’t we move faster in re-opening? These questions require further insight into the impact of this pandemic wave across the province and at OSMH.
Before I attempt to answer this question, I want to acknowledge why we are in the position to be thinking about reopening. Vaccines work. Stay at home orders work. The stay at home order is a horribly blunt instrument that has lasting effects on our quality of life and the livelihood of local businesses. But reducing all unnecessary travel does work to reduce cases, hospitalizations and death from COVID-19. We have not yet put this third pandemic wave behind us so we need to continue with these measures as guided by our public health leaders.
At the time of writing this update, there are still over 715 COVID-19 positive patients requiring ICU care across the province. Every day, there are approximately 30 to 40 new patients with COVID-19 requiring this highest level of care and about the same number leaving ICUs across the province. This has had a profound impact on hospitals across the province as we all stepped up as one community, one Team Ontario.
During the peak of the third wave, OSMH expanded ICU capacity, creating a second ICU in a different location within the hospital and redeployed staff with ICU experience from locations right across the hospital. At our busiest, OSMH was caring for 12 ICU patients at one time with the majority coming from the GTA. This represents 150% of our typical maximum capacity. A total of 10 patients required support from a ventilator, a number similar to that of much larger hospitals in the epicenter of the pandemic. We are proud to be able to support the needs of our community and our region while receiving a steady stream of transfers from the GTA in support of our partner hospitals.
Recovery for these patients is a long and difficult path. It will take some time for the entire system to recover from this third pandemic wave. Any discussions of reopening access to services and care must be balanced against the ongoing needs of current patients and the ongoing possibility of future surges in cases.
The province recently announced we can gradually begin the process to restart surgeries. There are requirements such as selecting cases that do not require inpatient hospital resources and we must continue to keep capacity available for possible future surges. Nonetheless, we are all excited to start this process and there are a number of steps to take before we can begin the daunting task of addressing the needs of our community with the growing wait list for surgery.
We need to get our team members back to their home units after an extended redeployment. For many, it was an intense experience working in a high stress environment. They need a break.
Clinical staff are continuously reviewing their patient lists. We recognize all surgeries are important. Lead time is required for preoperative assessment and testing to ensure patients are ready for their procedure.
Our registration staff have been tracking all cancellations. We had cancelled approximately 80-100 cases per week on top of the backlog from wave one from which we had not fully recovered. Once the revised procedure date is determined, all aspects of the care plan must be scheduled and plans communicated.
At the same time, we must continuously be prepared to respond to any unanticipated surge in COVID-19 activity or any other emergency that comes through our doors.
This is a small window in the complexity of work ahead of us. We are ready to take this on. Everyone is eager to get back to providing all our usual services. Your patience as we work through this process is appreciated. For those waiting to be rescheduled, you will hear from your doctor’s office when the time comes for your procedure.
We know wait times in our community were long before the pandemic. We see this as an opportunity to restore care, recover from the backlog and we will aim to address some of the pre-existing inequities in access to care for our local community. As the entire province “reboots” their surgical programs simultaneously, we have a unique opportunity to better deliver care closer to home wherever possible and that will be our goal.
The principles around the gradual restart to surgical procedures parallel other aspects of restarting programs and services back to pre-pandemic levels. For example, we are regularly reviewing how we can expand our visiting policy to allow family and caregivers to enter the hospital in a safe way. We value the presence of family and caregivers in the hospital and look forward to your return as valued members of our team.
The underlying enabler to ending this pandemic is vaccination. The entire Couchiching community has rallied under the leadership of the Simcoe Muskoka Public Health Unit (SMDHU) and the Couchiching Ontario Health Team to reach out in many ways to get vaccines in arms. Mass vaccination clinics, pop up clinics, outreach to shelters, businesses and congregate living sites are just a few of the ways this community is working together. The results are encouraging as the number of Couchiching residents having received their first vaccine dose continues to climb.
This is our shot to move forwards with restarting surgeries, schools, recreation and businesses. Let’s all do our part.
President & CEO
Orillia Soldiers’ Memorial Hospital