Nova Scotia hospitals are pushed to capacity by Omicron

The entrance to Valley Regional Hospital, a red brick and beige concrete building.

Valley Regional Hospital in Kentville. Photo: Nova Scotia Health

The latest wave of COVID is putting pressure on every aspect of the health care system, including the postponement of surgeries due to lack of beds and longer than usual waits for patients arriving at overcrowded Emergency Departments.

That was the message to reporters during a Zoom briefing this afternoon by Dr. Nicole Boutilier, the vice-president of Medicine with Nova Scotia Health. The agency operates all hospitals across the province and employs 23,000 people.

Below is a short list of some of the pressures on the health system created by the highly transmissible Omicron variant.

Today, 739 employees of Nova Scotia Health are out sick or isolating because they are close contacts of someone with COVID. That number is “fluid” and has ranged between 600 and 700 this week.

“This is having a real impact and wasn’t present during other waves,” said Boutilier. “It is putting a lot of pressure on the health care system. We had anywhere between 14 and 39% vacancies in staffing, including nursing, before Omicron and that is causing significant pressure.”

That said, Boutilier disagreed with a reporter’s suggestion the health system is “in dire straits”; Boutilier said the system “continues to pull together.” The impact on patients varies from zone to zone, she said, but noted there have already been cancellations in non-essential outpatient and surgical services so staff can be re-deployed to Emergency Departments and other areas.

Update: “This is an evolving situation, but based on the latest information available, approximately 120 scheduled surgeries were postponed across the province this week as a result of the increased pressures and challenges we are experiencing, including COVID related pressure, high demands for beds and staffing issues,” said Nova Scotia Health spokesperson Krista Wood in an email. “These included general surgeries, orthopedic surgeries, ophthalmology surgeries, ear, nose and throat surgeries, dental surgeries, and others. Some endoscopy/gastroscopy procedures have also been postponed at some hospitals.”

Today, 144 patients in hospitals have COVID:

48 of these people were admitted and hospitalized as “new” COVID cases, as reported by Public Health — that is, the were admitted because they had COVID. Seven of these people are in ICU; the others are being cared for on COVID-specific units.
64 patients at eight hospitals around the province have caught COVID as a result of outbreaks on other wards where they were in-patients. These 64 remain in hospital for reasons other than COVID.
32 patients were admitted for other medical problems, but tested positive for COVID as part of the admissions screening

“This group of patients comes into hospital with something like a broken ankle, say, and because we actually test everyone who is admitted to hospital and because we have such a prevalence of COVID in the community, those numbers of patients are rising,” said Boutilier.

Boutilier said the daily total of inpatients with mild COVID symptoms fluctuates greatly but this also increases the pressure on staff in terms of the care required and the need to follow strict infection prevention and control measures.

On Wednesday, Nova Scotia Health announced new restrictions around visitation at all hospitals. Unless they are dying, in-patients at most hospitals are restricted to seeing only one designated visitor, who must be vaccinated. Patients on wards where there are COVID outbreaks cannot have any visitors. Outpatients are encouraged to come to hospital alone unless they require assistance.

Another 347 patients in Nova Scotia hospitals today cannot return to long-term care facilities because the homes are experiencing outbreaks and the same staff shortages as hospitals due to Omicron. The ambulance service known as EHS is also experiencing staffing shortages due to COVID.

“There are 94 patients in Emergency Departments waiting for admission to hospitals today,” said Boutilier. “The number has been as high as 125 patients earlier this week. In terms of the volume this December compared to December of 2020, we had an additional 2,100 visits across the Province”.

What is the impact on patients?

“There are people that may have been waiting for procedures or appointments that have been postponed and need to be re-scheduled,” said Boutilier. “There are long waits in emergency rooms because of the increase in the number of people coming in. It’s very stressful for patients who are sick, and stressful for staff who come to work and want to do the best job they can.”

Boutilier said hospitals are at “near capacity” today with ICUs and most hospital floors operating at approximately 97%. If the occupancy increases much more, she anticipates more operations and outpatient appointments will need to be cancelled in the next couple of weeks due to the shortage of beds.

Boutilier said the best thing citizens can do to prevent more rationing and to keep the health system running is to follow all Public Health guidelines, including masking up and keeping social groups small, and to book a booster shot ASAP.