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WATCH: ‘There will be choices’: Data suggests hospitals might have to decide who gets care and who doesn’t

Ontario's health care system in dire circumstances because of pandemic, dean of U of T School of Public Health says

The COVID-19 pandemic is hitting Ontario hospitals so hard that the day is soon approaching when Ontario doctors will have to make hard decisions about which patients get the benefit of an Intensive Care Unit (ICU) bed and which do not. 

That was part of the assessment provided today by Dr. Adelsteinn Brown, the dean of the Dalla Lana School of Public Health at the University of Toronto. He was speaking to reporters at Queen's Park to reveal how hard the pandemic is affecting Ontario and to provide modelling predictions on how Ontario's hospital and health care system is able to deal with it.

Under the current restrictions, projections show daily deaths from the virus will double to 100 by the end of February, Canadian Press reporting shows.

Data released today also shows a quarter of the province's hospitals now have no free ICU beds, while another quarter have only one or two beds free.

There could be some 500 COVID-19 patients in intensive care by the middle of this month, with more than 1,000 by February under more severe scenarios, should data predictions released today come to pass.

Case numbers not only continue to climb, but the data shows that the number of new cases is accelerating, not slowing down. On our “worst days” cases are growing at seven per cent a day.

This, Brown said, makes not associating with members of your household all the more important to avoid the spread.

The same projections released today show there are outbreaks at 40 per cent of Ontario’s long-term care homes. Since Jan. 1, 198 LTC residents and two staff have died from the virus.

Ontario Premier Doug Ford will respond to the modelling predictions later this afternoon.

Brown said the health-care system is working flat out to cope, but it is being overwhelmed by COVID-19.

"I know that people working in our hospitals will do everything to help cope with this crisis. Hallways will be used to house makeshift intensive care beds. Field hospitals will hold patients throughout the winter. But as we find closer to a 1,000 intensive care beds — about half of our capacity — filled with COVID-19 patients in February, we will have to confront choices that no doctor ever wants to make and no family ever wants to hear," said Brown.

"There will be choices about who will get the care they need and who will not," Brown added. "There will be choices about who will receive oxygen or be transported to hospital.”

He said these are the kind of decisions already being forced on ambulance crews in California where the virus is spreading wildly he said. 

Brown said the choices will affect all patients needing intensive care, whether they've had a heart attack, have been in an automobile crash, or have COVID-19 or any other serious disease. 

Brown said much needed surgeries will be delayed or cancelled as COVID patients take up hospital spaces. He said when care is delayed, patients get sicker, their prognosis gets worse and more patients will die.

"I want to be clear. The impact on our health system is already greater today than we have ever seen in Ontario's history," said Brown. 

-with files from Canadian Press

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Len Gillis, local journalism initiative reporter

About the Author: Len Gillis, local journalism initiative reporter

Len Gillis is a Local Journalism Initiative reporter at covering health care in northeastern Ontario and the COVID-19 pandemic.
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