Memo says Ontario hospitals may avoid triage protocol


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Healthcare workers donate personal protective equipment as they prepare to enter the room of a patient suffering from coronavirus disease (COVID-19) at the Intensive Care Unit of Humber River Hospital in Toronto, Ontario on April 29, 2021 Huh.

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Ontario’s hospitals, despite facing an unprecedented strain from COVID-19, will likely survive the third wave of epidemics without resorting to a triage protocol, which would have forced doctors to decide whether to receive by globe and mail According to the memorandum, who lives and who dies.

Doctors and hospital officials have warned that weeks of strict public-health restrictions are still needed to keep the virus from spreading. Hospitals will continue to enhance their already developed intensive-care capacity, postpone non-emergency operations, and helicopter patients from jammed facilities to other beds in hot spots across the state.

As of Monday, Ontario had 881 COVID-19 patients in its ICU, more than double the total from a month earlier. But the rate of growth was slow. (In all, the province’s ICU had more than 2,000 patients of all types.)

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In a message to hospital chief executives on May 2, Andrew Baker, incident commander of the province’s critical care COVID-19 command center, says that recent provincial modeling is still “related”, as it underestimated COIDID’s The number shows 19 ICU admissions compared to two weeks earlier.

The memorandum calls for hospitals to place 284 more ICU beds, which are already set to go on short notice, to get more patients transferred to the operation. And it says the command center will monitor staffing levels, and the effect of recent steps to move more elderly patients into long-term care homes, to determine whether hospitals will be able to create even more critical care capacity Must try.

But the memo adds that now it seems that the worst situation can be avoided: “I also wanted to share with you and your teams that we are increasingly confident that we need to activate the Emergency Standards of Care or There will be no need to recommend its use. Triage protocol. “

Dr. A request for comment from Baker, who heads the Department of Critical Care at St. Michael’s Hospital in Toronto, was referred to Ontario Health, a government agency overseeing health care in the province.

Ontario’s executive vice president of health Chris Simpson, who is also a Kingston cardiologist, said the province’s worst is from the most recent modeling by an external COVID-19 science table – the potential for the province’s more than 1,400 COVID-19 patients. ICU by the end of the month – would mean triage may be necessary.

But the province monitors the mid-range landscape of Modeling, with the ICU slowly entering around 1,000 before landing.

“I think the scenario, if it were to appear, puts us out of the triage-tool area,” Dr. Simpson said. “But only because of the extra capacity we are able to bring online.”

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He cautioned that the quality of care on patients was already having an impact on the stress on the system. He also expressed concern that there could be “tremendous pressure” to quickly reopen the province if matters continued to plateau or fall. On doing so, he warned that the province could be submerged in the fourth wave.

Kevin Smith, president and CEO of University Health Network, which includes Toronto General, Toronto Western, and Princess Margaret Hospital, said even as the numbers appear to have flattened, hospitals and their staff are drawn more than their normal limits goes. To avoid the worst, he said Ontario needed to follow strict public-health regulations, get vaccinated as soon as possible and not let its guard down during the long weekend of May.

“I would certainly hate for anyone to think that it is time to rest,” he said. “Not at all like that.”

Ontario Hospital Association President and Chief Executive Officer Anthony Dale said the predictions of the science table are cause for hope, noting that daily new infection numbers have declined. (Ontario reported 3,436 new cases on Monday, down from a peak of more than 4,800 in mid-April.)

But he said that nothing can be taken about COVID-19. Even though these encouraging trends continue, he said, the health care system will still be in a state of mass disruption for months, noting that more than 250,000 operations have been postponed in the epidemic.

“There is nothing natural or normal about any of it,” Mr. Dale said.

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Ontario’s triage protocol is clouded by secrecy. Only one draft was made public after receiving a leaked copy by the Disability Rights Group. Under the plans, incoming patients will be evaluated for their survival probability after 12 months. Those with the best potential will be given preference for ICU beds.

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