Children’s hospitals under pressure in the 6th wave of COVID-19 in Canada

As the sixth wave of COVID-19 in Canada continues, hospitals caring for the country’s youngest patients are facing both high patient volumes and high levels of staff on sick leave.

At this time of year, the Children’s Hospital of Eastern Ontario (CHEO) in Ottawa normally sees up to 150 patients a day in its emergency department, but lately that can be double. , with waiting times of several hours.

Tammy DeGiovanni, senior vice president of clinical services and chief nursing officer at CHEO, said about two-thirds of those children arrive with symptoms of COVID.

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The hospital was also forced to cancel some operations.

“The double whammy for us is that we also have many staff members, medical staff and volunteers who are also absent due to COVID or COVID symptoms in the household,” DeGiovanni said.

She said on any given day recently, around 10-15% of the hospital’s workforce was off work – with each staff member taking 10 days to recuperate.

“This is causing additional pressure on the system right now, as opposed to previous waves,” she said.

According to hospital figures, CHEO’s single-day record for the number of employees, medical staff, learners and volunteers barred from entry for COVID-related reasons was 199 at the start of January – just as the initial wave of Omicron was setting in after the holiday season.

The next highest day was April 11, at 191, with the facility still experiencing significant daily staffing shortages.

Children with COVID, other illnesses

In Saskatchewan, health care facilities are also dealing with a surge of sick children, alongside record overall hospitalizations – provincial data on Wednesday showed a new historic record of 417 people hospitalized with COVID-19.

“There are just huge numbers of children coming in with upper respiratory disease and related complications. Many of them, as you would expect, have COVID,” said Dr. Alexander Wong of the Saskatchewan Health Authority.

Esther Shi Berman, 10, receives a dose of a COVID-19 vaccine at a clinic in Toronto on November 25, 2021. (Evan Mitsui/CBC)

“It creates a lot of pressure on the acute care side, in terms of hospitalizations, as well as intensive care admissions, as well as on the emergency department.”

Data provided by BC Children’s Hospital in Vancouver shows a mix of COVID-19 and other respiratory illnesses emerging in young patients in recent months.

In February, 76 children tested positive for COVID-19 in the hospital emergency department, while 29 others tested positive for other respiratory illnesses. The following month, that ratio changed, with 37 children with COVID-19 and 72 with other respiratory illnesses, including one case of influenza. (The hospital did not provide data from April.)

Healthcare workers at children’s hospitals, like their adult counterparts, are “equally impacted by the spread of disease in their communities,” said Dr. Srinivas Murthy, a pediatric critical care physician and infectious disease specialist at BC Children’s Hospital. .

At McMaster Children’s Hospital in Hamilton, Ont., the number of pediatric COVID patients admitted remained low and relatively stable during the fifth and sixth waves, a hospital spokesperson said in a statement to CBC News.

However, the volume of children presenting to hospital emergency rooms with respiratory symptoms – some of which are COVID-related – is very high. The spokesperson said that, combined with staffing pressures, the system was “very difficult”.

Return visits to pre-pandemic levels

It’s a similar situation inside one of Canada’s largest youth healthcare centers, Toronto’s Hospital for Sick Children (also known as SickKids).

The entire hospital is “under pressure”, in part because around 10-30% of staff are off sick on any given day during the two waves of Omicron, said Dr Jason Fischer, chief from the emergency medicine division of SickKids.

Hospitalizations and ICU admissions remain high across Ontariojust as the number of patients presenting to SickKids emergency room is expected to return to pre-pandemic levels, according to hospital data.

There were more than 7,000 total emergency room visits to hospital in April 2019, but that number dropped in April 2020, at the start of the pandemic, when many healthcare facilities saw a significant drop in visits.

Dr Jason Fischer, head of the emergency department at SickKids, says the entire hospital is “under pressure”, in part because around 10-30% of staff are on sick leave during on a given day during the two Omicron waves. (SickKids/provided)

The total reached around 4,400 in April 2021 and almost 4,000 young patients presented in the first half of April this year – a daily average of 222 visits, about the same as before the pandemic .

Despite these volumes, Fischer said it was crucial to keep staff with COVID-19 at home for 10 full days.

“We see a lot of children aged zero to five who are not vaccinated, so we are particularly careful in ensuring that no one comes to work sick,” he said.

Low vaccination rates among children

Across Canada, vaccination rates remain low among young people. The latest national data shows that only 40% of children aged 5 to 11 are fully immunized, while younger children do not yet have access to an approved vaccine.

With millions of children still vulnerable to infection – while hospitals are under pressure – some parents are wondering what is the best approach if their child catches COVID-19.

Nicole Rajakovic, a mother of two in Toronto, faced this dilemma last month. His whole family eventually fell ill, with his five-year-old son being the first to show symptoms in late March. At the time, she said, he had only received one dose of the vaccine, while the rest of the family was fully vaccinated.

“He had a very severe coughing fit, which included an inability to breathe, and that was the scariest moment for us,” she recalls. “Should we call 911?

Nicole Rajakovic, right, and her family have all caught COVID-19 this year, one by one, starting with her five-year-old son. (Provided by Nicole Rajakovic)

Rajakovic ended up taking care of his son at home and he has since recovered from his illness. But she said it was a tough decision.

“Where we would normally go to a doctor or urgent care, we’re not making those decisions anymore because we know they’re understaffed and we know they’re burnt out.”

Fischer of SickKids agreed that healthcare workers are often stuck working long hours, while families face long wait times for care.

Even so, he stressed that if parents are worried about their child’s symptoms, they should still get them to an emergency department, urgent care center or use virtual care options.

According to the Canadian Pediatric Societymild symptoms do not require hospitalization, but parents should see a doctor if their child is not drinking well, has a high fever, has trouble breathing, or if their symptoms persist or worsen.