While Canada’s sixth wave of COVID-19 continues, hospitals caring for the country’s youngest patients face both high patient volumes and high levels of sick staff.
At this time of year, the Children’s Hospital of Eastern Ontario (CHEO) in Ottawa usually sees up to 150 daily patients in its emergency department, but lately it can be double that, with hour-long waiting times.
Tammy DeGiovanni, CHEO’s senior vice president of clinical services and executive nurse, said about two-thirds of these children come in with COVID symptoms.
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The hospital has also been forced to cancel some surgeries.
“The double inhibition for us is that we also have many employees, medical staff and volunteers who are also free due to COVID symptoms or COVID in the household,” DeGiovanni said.
She said that on any given day recently, about 10 to 15 percent of the hospital’s workforce has been off work – with each staff member taking 10 days off to recover.
“It’s causing the extra pressure on the system right now, unlike in previous waves,” she said.
According to hospital figures, CHEO’s one-day record for the number of staff, medical staff, students and volunteers restricted from entering for COVID-related reasons was 199 in early January – just as the initial Omicron wave picked up after the holiday season.
The second highest day was April 11 with 191, where the plant is still experiencing a large daily shortage of staff.
Children with COVID, other diseases
In Saskatchewan, health care facilities are also dealing with a surge of sick children along with record-breaking hospitalizations – Wednesday’s provincial data showed a new all-time high of 417 people in the hospital with COVID-19.
“There are just a huge increase in the number of children coming in with upper respiratory diseases and related complications. Many of those that you would suspect have COVID,” said Dr. Alexander Wong of the Saskatchewan Health Authority.
“It creates a lot of pressure on the acute side, both in terms of admissions and intensive care units as well as on the emergency department.”
Data provided by BC Children’s Hospital in Vancouver shows a mix of both COVID-19 and other respiratory diseases that emerged in young patients in recent months.
In February, 76 children were tested positive for COVID-19 in the hospital emergency room, while a further 29 were tested positive for other respiratory diseases. The following month, this situation changed, with 37 children having COVID-19 and 72 having other respiratory diseases, including a case of influenza. (The hospital did not provide April data.)
Healthcare professionals at children’s hospitals, like their adult counterparts, are “similarly affected by the spread of disease in their communities,” said Dr. Srinivas Murthy, a pediatric critical care physician and specialist in infectious diseases at BC Children’s Hospital.
At McMaster Children’s Hospital in Hamilton, Ont., The number of hospitalized COVID pediatric patients has remained low and relatively stable through the fifth and sixth waves, a spokesman for the hospital said in a statement to CBC News.
But the number of children coming to the hospital’s emergency room with respiratory symptoms – some of which are related to COVID – is very high. The spokesman said that combined with staff pressure has led to the system being “very challenged.”
Visit back to pre-pandemic levels
It’s a similar situation in one of Canada’s largest youth health centers, Toronto’s Hospital for Sick Children (also known as SickKids).
The entire hospital is “under load,” in part because about 10 to 30 percent of staff are on sick leave on any given day through the two Omicron waves, Dr. Jason Fischer, SickKids’ Head of Emergency Medicine.
Hospital admissions and ICU admissions remain high in Ontariojust as the number of patients coming to the emergency department at SickKids is expected to return to pre-pandemic levels, hospital data show.
There were more than 7,000 total emergency visits to the hospital in April 2019, but that number fell in April 2020, in the early days of the pandemic, when many health facilities experienced a large drop in visits.
The total number hit about 4,400 in April 2021, and nearly 4,000 young patients showed up in the first half of April this year – an average daily of 222 visits, roughly the same as before the pandemic.
Despite these amounts, Fischer said it is crucial to keep staff with COVID-19 at home for a full 10 days.
“We see a lot of children aged zero to five who are not immunized, and therefore we are particularly conservative in ensuring that no one gets sick at work,” he said.
Low vaccination rate among children
Across Canada, vaccination rates remain low among young people. The latest nationwide data show that only 40 percent of children aged five to 11 are fully vaccinated, 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 – it has led some parents to speculate on the best course of action if their child is given COVID-19.
Nicole Rajakovic, a Toronto mother of two, faced that dilemma last month. Her entire family ended up getting sick, with her five-year-old son the first to show symptoms back in late March. At the time, she said, he had only received one vaccine dose while the rest of the family was fully vaccinated.
“He had a really severe coughing fit which included inability to breathe and that was the most frightening moment for us,” she recalled. “Are we calling 911?”
Rajakovic ended up taking care of his son at home, and he has since recovered from his illness. But she said it was a difficult decision.
“Where we would normally go to a doctor or emergency room, we no longer make these decisions because we know they lack staff and we know they are exhausted.”
Fischer from SickKids agreed that healthcare professionals are often stuck and working long hours while families face long waiting times for care.
Still, he stressed that if parents are concerned about their child’s symptoms, they should still bring them to an emergency room, an emergency care center or use virtual care options.
According to the Canadian Pediatric SocietyMild symptoms do not require a hospital trip, but parents should seek medical attention if their child does not drink well, has a high fever, has difficulty breathing, or if their symptoms persist or worsen.