Published December 15, 2022

Flu season may have peaked, Ontario's top doctor says

Respiratory illnesses have overwhelmed children's hospitals across the province over the past two months

By Liam Casey in Toronto

The flu season may have peaked in Ontario, and that should relieve some pressure on children's hospitals in the near future, the province's top doctor said Thursday.

Chief medical officer of health Dr. Kieran Moore believes flu season hit its apex in recent days. The number of people testing positive for influenza decreased last week and test positivity has also gone down, he said.

"That again, gives me some hope that we're at a flex moment where we may be on a decline and see decreased burden of illness in our communities from influenza," Moore told The Canadian Press.

Respiratory illnesses have overwhelmed children's hospitals across the province over the past two months, with the flu accounting for the bulk of recent admissions at many of the country's pediatric hospitals.

Major pediatric hospitals have cancelled surgeries in order to redeploy staff to help out intensive care units and emergency departments.

"There is some good news, and I know our health system is working day in, day out to provide care to Ontarians, but from my vantage point looking at data at a population level in Ontario, some of the trends are heading in a better direction and I do think that there may be less pressure on the acute care sector in the coming days," Moore said.

Toronto's Hospital for Sick has said it is preparing for a second wave of respiratory illnesses, which could last until March, and that its internal testing has shown a hard-hitting influenza A strain on a marked upswing. CHEO has warned that the large volume of influenza patients it's seeing could continue to climb in the coming weeks.

Data released Thursday shows there are 117 children across the province in intensive care with 131 available beds. There were 125 children in intensive care two days ago, the highest it's ever been.

Moore said there has also been a slight decrease in respiratory syncytial virus, or RSV, circulating, although he warned that virus will persist for months and continue to put pressure on children's hospitals.

"RSV is continuing though to be a threat and we're not seeing it decrease at a population level or a testing level just yet and that, to me, is one of my biggest concerns," he said.

He said they hit a peak of about 200 total hospital admissions across Ontario on Dec. 1 for children aged 0 to 4. That has dropped to about 170 admissions.

"Over the holidays, we really have to be very protective of our children," Moore said.

Provincial data shows there has been a sharp decline in emergency department visits across the province for children with respiratory illnesses.

There were, on a seven-day average, 763 children aged 0 to 4 who went to the emergency department for a respiratory illness as of Wednesday compared to the historical average of 691 over a week.

That average hit a peak of 1,264 children visiting an ER on Nov. 11, compared to the historical seven-day average of 505 children visiting the ER, data from Acute Care Enhanced Surveillance, a real-time Ontario-wide system that monitors hospital registration records, show.

Children aged 5 to 17 saw its peak on Nov. 8 with a seven-day average of 1,146 ER visits for respiratory illnesses, four times higher than the historical average.

That rolling average has since dropped to 495 ER visits as of Tuesday compared to the historical average of 357 visits over te same time frame.

"The number of children getting admitted to hospital has shown a steady decline, which I watch on a daily basis and only hope that that continues to take pressure off families and children and our health-care system," Moore said.

He said he expects a sharp decrease for the flu to continue if it behaves like it did in Australia and the Southern Hemisphere in their winters.

Dr. Fahad Razak, an internist at St. Michael's Hospital and professor at the University of Toronto, said he'd be cautious about declaring the flu has peaked.

"The severity of the rise in flu cases this year has far outstripped what we typically see,' he said.

"And there's an unpredictable element of it because we don't have clear reporting as well about the vaccination rates in susceptible adults or children."

He said it's also even more difficult to predict because there are three main viruses circulating, including COVID-19 and the approaching holiday season could cause increases as kids and the elderly -- who are both at higher risk of contracting respiratory illnesses -- have more contact.

"You have a perfect environment for an enhanced degree of spread coming within the next one to two weeks," Razak said.

He also said it will not take much to overwhelm children's hospitals again.

"Even a small further increase further taxes the system which is already over capacity," Razak said.

COVID-19 has also been on a steady decline since its peak in late October.

The number of people in hospital with COVID-19 peaked in October with about 2,000 patients, he said. Now there are about 1,100 to 1,200 people in hospital with the disease over recent days, Moore said.

There were 165 adults with COVID-19 in ICUs on Oct. 23. Today there are 105 in ICU, provincial data shows.

"I really have to thank Ontario for coming forward to get immunized," he said, nothing that they just hit 50 per cent of those 70 and older who have received their bivalent COVID-19 vaccine.

But he said only one in five adults in the province have received their bivalent booster shot.

"We have a ways to go," he said.

They usually see about 30,000 Ontarians a day getting their shot, but now it sits at 18,000 a day.

"Please give yourself the gift of a vaccine to protect your loved ones this winter season," Moore said.

Moore said the province has distributed 5.2 million flu shots and have 900,000 shots in reserve. He does not know how many flu shots have been given out because the data recording system is out of date. He said they planned to fix the system in the next year.

This report by The Canadian Press was first published Dec. 15, 2022.

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