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Pandemic: Ontario ramping up ICU capacity, has ordered additional ventilators

Ontario's COVID-19 Command Table provides executive direction to pandemic response
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Health Sciences North. (Supplied)

Ontario's COVID-19 Command Table is keeping a close eye on hospital intensive care units across the province in an effort to ensure that there are enough bed spaces to go around as the province battles with the COVID-19 pandemic.

The Command Table was established as a single point of oversight to provide executive direction to Ontario's response to COVID-19; the group is co-chaired by Helen Angus, the province's deputy minister of health, and Matthew Anderson, president and CEO of Ontario Health.

The two held a teleconference on Friday, March 27, along with Dr. Kevin Smith, president and CEO of University Health Network, shortly after Premier Doug Ford's address on Friday afternoon.

Highlighting Friday's teleconference was the matter of ICU capacity, along with the number of ventilators at the province's disposal.

"We know from other jurisdictions that a small percentage of individuals become very ill after becoming infected with COVID-19 and these individuals need access to specialized technology, skilled resources and the expertise found in intensive care units," said Angus.

"That's why we're monitoring the capacity of the critical care system in Ontario, and that's why it's an important part of our regular report on the capacity of the system."

Further to just monitoring the capacity of the system, the Command Table is also looking at creating as much capacity as possible. Angus says that Ontario's Ministry of Health, in partnership with Ontario Health, is working closely with hospitals in Ontario on capacity planning, including access to critical care.

"The first step in the plan is that all hospitals are working together at regional tables to identify capacity across the health care system, whether it's in critical care, acute care or other care settings," said Angus.

"The second step is working with critical care leaders across Ontario and to help with this, Ontario Health has established a critical care COVID-19 table."

Members of the table include critical care physician leads from across the province, representatives from the Ministry of Health, Ontario Health, ORNGE, and the Emergency Medical Assistance Team (EMAT).

One of the earliest steps taken in an effort to create capacity was the direction from the province on March 15 to hospitals to ramp down elective surgeries.

"This created much-needed capacity in ICUs across the province," said Angus. "The occupancy levels for most specialized ICU beds, which we call level three, has dropped from mid-week levels of 95 per cent at the beginning of March down to about 85 per cent, freeing up capacity should we need it."

As of March 25, the overall occupancy in ICU in Ontario was at 68 per cent, with just over 400 available critical care beds. Across the province there are 2,053 adult critical care beds, with 1,321 equipped to provide mechanical ventilation.

Including pediatric critical care beds, Ontario has 2,142 critical care beds with 1,384 equipped for ventilation for adults and pediatric patients. 

"We also have 209 ventilators in our pandemic stockpile and Ontario Health has ordered additional ventilators which will be arriving shortly and be able to be re-deployed," said Angus. "In terms of overall capacity, Ontario hospitals are seeing increased bed capacity to care and treat patients."

Efforts to increase capacity have been working so far, as occupancy rates at hospitals around the province are down by a fair margin when compared to this time a year ago.

Last year at this time, Ontario's average hospital occupancy rate was 96.9 per cent, compared to 76 per cent this year. The province currently has 6,395 beds available.