Collingwood General and Marine Hospital’s lead staffer is looking ahead to January with both hope and concern.
On one hand, cases and hospitalizations are rising in most corners of the province. As of Dec. 28, there are two patients at CGMH with COVID-19.
On the other hand, there are now two vaccines against COVID-19 approved by Health Canada and at least one is already being distributed to area health care workers.
“It’s a light at the end of a very long, dark tunnel. People feel like there’s hope,” said Norah Holder, president and CEO of Collingwood General and Marine Hospital (CGMH) in an interview with CollingwoodToday. “We’re also very cognizant of the fact that … looking at the modelling anticipated for January … it doesn’t look good for COVID-19 cases.”
Provincial modelling data released by Ontario Health on Dec. 21 projected more than 1,500 COVID-19 patients could be hospitalized with COVID in the province by mid-January unless more control measures were implemented. The modelling data was released prior to the province announcing a month-long shutdown.
Holder said CGMH is bracing for a tough January.
The hospital has already seen a greater demand this year. Holder has observed there are more people in the hospital’s catchment area right now, which includes Grey Highlands, The Blue Mountains, Collingwood, Wasaga Beach, and Clearview Township.
Snowbirds that may have gone south for the winter have stayed. Seasonal residents are deciding to stay in Collingwood area.
“There are more people here we need to care for and they are coming in and they are very ill when they’re admitted,” said Holder.
Earlier this month, the hospital experienced a 36-hour rush of inpatients that quickly tied up the available beds and left more than a dozen patients in the emergency department waiting for a bed.
On the weekend of Dec. 5 and 6, the hospital ended up with six patients admitted with COVID-19 and an influx of patients without COVID-19, but who were acutely ill with other diagnoses, according to Holder.
The hospital’s 77 beds were full and there were another 13 patients in the emergency department waiting for a bed.
“It can change on a dime,” said Holder. “We have a surge, then we’re OK, then we have a surge. Our biggest worry is if people don’t follow recommendations … two weeks after Christmas, we’ll get a surge of inpatients with COVID-19.”
CGMH has increased its baseline staffing by 14 per cent since the pandemic began with 62 new hires, and another 19 positions to fill.
The new staff include entrance screeners and greeters, increased environmental services teams, security, dietary aides, nurses, personal support workers (a new position at the hospital this year) and more for enhanced infection controls.
“We’re trying to make sure we’ve got additional capacity in the hospital,” said Holder.
The increased capacity is there to provide a contingency plan for if staff are ill, and also to make sure the hospital can continue caring for non-COVID patients who require acute care and elective surgeries and procedures.
In mid-March shortly after the World Health Organization declared COVID-19 a global pandemic and the provincial and federal governments declared states of emergency, the Collingwood General and Marine Hospital and all Ontario hospitals were forced to scale-down non-emergency surgeries and procedures.
The hospital’s emergency department remained open for anyone requiring acute care, and one operating room stayed open for urgent emergency cases and endoscopy procedures.
A study published in the Canadian Medical Association Journal in November estimated there was a backlog of more than 145,000 surgeries and procedures in Canada by June 13, and suggested it will take about 84 weeks to clear that pileup.
By mid-June, the CGMH, with permission from Ontario Health, started rebooking and ramping up elective surgeries.
Also in June, CGMH revealed its alternative health facility (a field hospital) set up at the Collingwood Legion. The temporary set up can include up to 25 beds, can be stored in a C-bin container, and could be set up in three days from storage. The facility was unused until December.
Eighteen beds at the field hospital were activated in early December for patients who are awaiting transfer to other facilities such as rehab, long-term care, a retirement home, or palliative care.
Patients at the alternative health facility have tested negative for COVID-19 and they must be ready to be transferred to another facility. They must also be able to walk with minimal assistance.
“Right now because of human resources, we are able to provide staffing to be able to care for 12 patients,” said Holder.
Last week, there were eight patients at the Legion facility.
“Over the past three weeks, the occupancy rate of the hospital has been 102 per cent and that was with running the alternative health facility,” said Holder. “If we shut down elective in-patient surgeries, it’s only going to provide one or two beds … a lot of surgery is same-day surgery.”
Elective procedures continue, as do diagnostic imaging appointments.
“This time we’re going to try hard to maintain elective surgeries and procedures … people still need it,” said Holder. “Elective doesn’t mean you’ve chosen it because you want it done. It means if you get it done now, you will not be living with terrible chronic pain.”
Elective surgeries include things like hip and knee replacements and removing gallstones.
There is still a backlog for elective surgeries and procedures from the March/April/May shutdown. Specifically, the hospital is trying to catch-up on knee and hip replacement surgeries. If CGMH staff can continue performing the surgeries and procedures as they have been over the last several weeks, Holder said the hospital can meet its allotted cases for the year.
Putting off an elective surgery can lead to an emergency, and, noted Holder, the outcome is not usually as good once a condition develops into an emergency situation.
“It’s really important for our patients to still come to the hospital,” said Holder. “Please come for your mammogram … we still need to care for ourselves regardless of COVID-19 happening.”
At the moment, however, the hospital has no vaccines against COVID-19 to offer. Holder said they’ve fielded several calls asking for such a vaccine.
“There are no public vaccine centres open in the province right now,” noted Holder.
The Simcoe-Muskoka District Health Unit, together with the Royal Victoria Regional Health Centre, has set up an invitation-only vaccine clinic in Barrie. They are currently inoculating long-term care workers in the region, as per the provincial government’s vaccine roll-out plan.
“The ethical framework has been very well thought out,” said Holder. “I would expect by September/October everyone will have the opportunity to have the vaccination.”
As Collingwood and the rest of Simcoe-Muskok and southern Ontario continue through the current month-long shutdown, Holder is asking the community to follow public health rules.
“I only want our community to stay home and stay healthy,” she said. “We’re here for them, but everybody needs to do their part. It’s always a team effort.”
