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Local hospitals could face strain as early viral infections swamp pediatrics: CPS

An early surge in viral infections could indicate tough months ahead for already-struggling local hospitals, the Canadian Paediatric Society said Thursday, as some children's hospitals are running over capacity and reporting high wait times. Dr.
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The emergency sign of a Toronto hospital is photographed on Tuesday, Sept. 27, 2022. The Canadian Paediatric Society says the strain children's hospitals are seeing due to a resurgence of viral infections is likely to get worse in the months ahead and could spill over into already-struggling community hospitals. THE CANADIAN PRESS/Alex Lupul

An early surge in viral infections could indicate tough months ahead for already-struggling local hospitals, the Canadian Paediatric Society said Thursday, as some children's hospitals are running over capacity and reporting high wait times.

Dr. Sam Wong, the association's director of medical affairs, said pediatric units across Canada are seeing increased admissions and heavier workloads as hospitals report an earlier than usual season of common respiratory illnesses, combined with influenza and COVID-19. 

In communities without dedicated pediatric centres, Wong said local hospitals that are already strained by long waits and staff shortages could see more children coming through their emergency departments.

"So, I'm quite concerned that as we move further into the viral season that things are going to get worse," he said. 

"If you don't have a pediatric emergency and you're running a general emergency in a smaller centre, those increased numbers of kids coming through will stress the system." 

The Yellowknife-based pediatrician said some doctors believe the increase in admissions could be linked to a large number of kids, previously shielded by COVID-related public health restrictions, now being exposed to some viral infections for the first time. 

CHEO, the Ottawa pediatric hospital, said Wednesday it had to cancel some surgeries as it reports a higher number of patients with respiratory syncytial virus, on top of flu and COVID admissions. The hospital said its intensive care and inpatient units were at 129 per cent and 134 per cent capacity, respectively, on Tuesday.

Montreal's two dedicated children's hospitals were alsorunning well over capacity on Thursday afternoon, with Quebec leading the country in reported test positivity rates for respiratory syncytial virus, a common respiratory illness. 

It's concerning to see a surge of those infections hitting hospitals in October, Wong said,  when those infections typically "really start up in December."

"Honestly, I hope I'm wrong, but I have a bad feeling that we will have a rough, rough viral season this year," he said. 

The Quebec government announced this week it was setting up a crisis unit in the Montreal region to deal with overflowing emergency rooms.

At the Montreal Children’s Hospital, where some patients are waiting 16 hours to see a doctor, staff have been redeployed and some surgeries are being cancelled to help alleviate ER pressures, said Dr. Suzanne Vaillancourt. 

“Something we have to do, which is hard on everybody, is temporarily reduce the number of children that are going for surgery, because post-op, they take up beds as well, so the trickle-down effect is huge,” said Vaillancourt, associate director of the emergency department.

“It's really the RSV that seems to be giving us a run for our money now and that's mostly just because a lot of these children need support, they need breathing support, they need hospitalization to be hydrated or help with oxygen needs.” 

Vaillancourt said the hospital is prepared to help general hospitals in other parts of the province treat sick kids. Pediatric emergency physicians are available 24 hours a day to give colleagues advice, she said, and the two children’s hospitals in Montreal are able to take young patients who need more complex care than can be provided.

“It's a system that's well used, and hopefully, they really feel that they can get the advice and care that they need and when the child needs an escalation of care, then they come to us,” she said, adding that hospitals outside of Montreal may not have the ability to put a child on a ventilator.

ERs across Canada, and especially in smaller communities, have had to reduce hours and temporarily close, sometimes for days at a time, in recent months as the health-care system contends with labour shortages. 

Data released Thursday by Statistics Canada said health-care and social assistance sectors hit a record-breaking 152,000 job vacancies in August. 

"I don't think any of the systems, in particular acute care, have had a moment to even take a breath since the last two years of COVID," said Nancy Walton, a professor at Toronto Metropolitan University's nursing school. 

This report by The Canadian Press was first published Oct. 27, 2022. 

Jordan Omstead and Jacob Serebrin, The Canadian Press

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