COVID-19: B.C. hospital capacity concerns centre on staff, not beds

“We have a considerable supply of ventilators and we are not touching in any way our ventilator capacity or our bed capacity, but … when we move into surge beds, it puts significant additional pressure on staff.” – B.C. Health Minister Adrian Dix

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As pandemic-related hospitalizations hit record highs in B.C. on Thursday, the B.C. Nurses’ Union said staff shortages will compromise patient care if numbers continue to rise.

“Nurses repeat to me every day that they are working in an untenable situation,” said BCNU president Christine Sorensen. “Across the province, we are seeing capacity problems. Some of these problems are not new, but COVID-19 is increasing that pressure.”

Hospital occupancy across the province was at 92.4 per cent of total beds and 80.5 per cent of critical care beds on Thursday, according to Health Minister Adrian Dix. When “surge beds” are added, occupancy drops to 56.5 per cent of critical care beds.

There are 409 people currently in hospital with COVID-19, 125 of whom are in intensive care.

But the health minister admitted concerns around occupancy are less about beds and more about the ability to staff them.

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“The challenge is not equipment,” Dix said. “We have a considerable supply of ventilators and we are not touching in any way our ventilator capacity or our bed capacity. But what does happen, of course, is when we move into surge beds, it puts significant additional pressure on staff.”

File photo of BCNU president Christine Sorensen. Sorensen said nurses are “exhausted” as the third wave of the COVID-19 pandemic continues.
File photo of BCNU president Christine Sorensen. Sorensen said nurses are “exhausted” as the third wave of the COVID-19 pandemic continues. Photo by Jason Payne /PNG

Sorensen, who has access to data from individual hospitals, said several B.C. hospitals are already over capacity. She said Fort St. John Hospital was at 130-per-cent capacity of funded beds on Thursday, while the University Hospital of Northern B.C. was at 111 per cent earlier in the week. Abbotsford Hospital was at 101 per cent on Monday, while Campbell River was at 123 per cent, and Nanaimo was at 110 per cent.

“Across the province, we are seeing hospital capacity exceeding funded beds. … What that means is that there are people in stretchers in hallways, in shower rooms, people waiting in the ER to get a bed on a ward, and the ICU is stretched,” she said.

Sorensen said nurses have told her that hospitals are looking at ways they can move patients out of the ICU and into other wards, while people who can be discharged from hospital are being released with home care. That, in turn, is increasing the pressure on home care nurses.

“Our nurses are already exhausted,” she said. “If there are not enough qualified nurses to care for people, it won’t matter how many beds we have. Patient care will suffer … or be denied.”

Sorensen said the provincial health officer may need to impose greater restrictions on the public to drive case counts down and avoid a situation like Ontario, where at least one critical care doctor is urging the provincial and federal governments to begin coordinating the transfer of intensive care nurses from other provinces to Ontario.

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Provincial health officer Dr. Bonnie Henry said B.C. is following plans to support its health-care system that were released in September.

“Those plans are still in play,” she said. “We’re monitoring them regularly. We have the metrics that we are using.”

Henry said B.C. has a very strong provincial hospital network to support “pressure points.”

“We saw that in the last few months in the north, (where we were) able to decant people who needed care out of the north to other places, recognizing how challenging that is … on families who have a loved one who is sent to Vancouver Island, for example,” she said.

“This is something we’re paying attention to in a huge way, and why we put in the restrictions that we put in, why we’re focusing on the measures that we need to do in communities to prevent transmission, to reduce the risk of people needing hospitalization. It’s all looking at what we have in our networks and our supports and our health-care system here.”

The provincial government is expected to release more information on hospital capacity on Monday.

Earlier this week, Dix said that as some key Metro Vancouver hospitals approach 100-per-cent occupancy, eight critical-care-trained nurses have been redeployed to Fraser Health, while there has been a temporary halt to some surgeries at Surrey, Abbotsford and Royal Columbian hospitals.

“We’ll continue to monitor the daily occupancy rate and take specific actions to reduce stress on the health system as needed through this redeployment of staff,” said Dix. “This will not be like last year where we cancelled, en masse, our scheduled surgeries, but will be targeted, and for as short a period as possible.”

The increased cases and hospitalizations are being driven, in part, by a significant rise in virus variants of concern.

People at the emergency entrance at Lion’s Gate Hospital in North Vancouver on Thursday. Hospital beds are filling up across B.C.
People at the emergency entrance at Lion’s Gate Hospital in North Vancouver on Thursday. Hospital beds are filling up across B.C. Photo by Jason Payne /PNG

-With Postmedia files

gluymes@postmedia.com

twitter.com/glendaluymes

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