By the end of next week, upwards of 500 non-urgent medical procedures will likely have been cancelled at Royal Victoria Regional Health Centre (RVH) in Barrie.
Most hospitals were ordered by the provincial agency Ontario Health to “ramp down” all non-urgent and elective surgeries as of Monday to help deal with a record number of people hospitalized and in intensive care units (ICU) with COVID-19.
Dr. Jeff Tyberg is Chief of Staff at RVH and he feels for those people who have been booked for surgery, such as hip and knee replacements, only to have them cancelled.
Ontario hospitals dealt with a similar “ramp down” of procedures during the first wave of the pandemic, and RVH was still working to clear the backlog from last spring when this latest one came into effect.
While there has been a significant increase in COVID-19 cases in Simcoe Muskoka, the Greater Toronto Area (GTA) remains the hotspot. Some might wonder why RVH is being asked to pull back on certain procedures when the majority of new infections are to our south.
Besides admitting local and regional patients, Dr. Tyberg said there is the Greater Toronto Area Incident Management Systems operations table that has been empowered by Ontario Health to be responsible for the whole GTA region, and that includes all of North Simcoe Muskoka, such as Huntsville, Bracebridge, Midland and RVH.
“It’s been made very clear this is a provincial problem,” explains Tyberg. “We have to load share across the province. Hospitals that have some capacity have to help out hospitals that are really suffering from a lack of either critical care capacity or just bed capacity.”
RVH has taken well over 100 patients in transfer from the GTA, both intensive care unit patients, ward patients that have COVID, and other types of patients.
“We and other hospitals in our region are working to help with some really hard-affected hospitals in the GTA,” said Tyberg. “It’s one system for all Ontarians to make the system as safe as possible by load sharing. RVH is doing that by accepting significant numbers of patients from the GTA.”
RVH has expanded its ICU from a base of about 16 to 23 and can go up to 37.
“We can go even above that if we expanded to other units and units that might normally be used by the operating room. We have already expanded our ICU capacity.”
By shutting down surgery, Tyberg said some of the recovery room nurses can take care of ICU patients because they have the right skill set.
Tyberg repeated several times that it is important for the public to understand that if a person has a life-threatening condition, needs cancer surgery or presents in the emergency department with appendicitis or an open fracture, you will get the operation you need.
He said at a provincial level there are record numbers of COVID-19 patients in hospitals and in intensive care units.
“We’re caring for patients that are younger. The B.1.1.7 variant is now the primary virus and it does seem to be somewhat different than the original virus in that patients are younger, and it appears patients get sick more quickly than what we saw in the first and second wave,” said Tyberg.
“That’s one of the reasons why we have to really be sure that we have the ICU capacity that we need because patients can come to the emergency department and seem like they’re not that bad, and a couple of hours later, they need to be in the intensive care unit. The trajectory of the illness seems to be sharper than it was previously.”
Tyberg said he knows people are tired, and it’s been hard on RVH staff. He encourages everyone to continue to follow public health guidelines.
“People have lost relatives and have relatives that are sick, have lost jobs and businesses. There is a lot of hardship out there. We’re just asking people to try to hang on and maintain that social distancing, wear masks and get vaccinated as soon as you are eligible. Hopefully we’ll get through this wave three and hopefully we can start to see a light at the end of the tunnel”