Eastern Shore emergency rooms have seen a 35% increase in unplanned closures

News

1. Emergency Room closures

This item is written by Jennifer Henderson.

Hospital emergency rooms in rural Nova Scotia are closing more frequently, with operating hours across Nova Scotia decreasing from 91% of scheduled openings to 89% of scheduled openings. That is, admittedly, a small decrease, and moreover is concentrated in what used to be called “industrial Cape Breton” — Glace Bay, North Sydney, New Waterford. These smaller towns are within a short drive (about 20 minutes) of Sydney, and so while the closures of the local ER decreases service, it isn’t a dramatic story.

But a potentially more significant (and neglected) story is unfolding at three hospitals on the Eastern Shore.

In those hospitals, the increase in unscheduled ER closures from 2018/19 to 2019/20 was 1,548.2 hours, or an increase of 35.5%. Two of the three hospital ERs are open less than two-thirds of their scheduled hours.

And whether intended or not, there is a political overlay to the closures. Voters on the Eastern Shore between Musquodoboit Harbour and Guysborough are represented by Liberal Kevin Murphy. Twin Oaks Hospital in Musquodoboit Harbour and Eastern Shore Hospital in Sheet Harbour are in this riding. Twin Oaks Hospital saw an increase in closure of hours from one year to the next, but its ER remained open 94% of scheduled hours, while Eastern Shore Hospital actually saw a decrease in its ER’s closure hours, although it is still closed 37% of the time.

Meanwhile, the Musquodoboit Valley Hospital is located inland at Middle Musquodoboit, in Progressive Conservative Larry Harrison’s riding of Colchester-Musquodoboit Valley. The Musquodoboit Hospital ER saw a 180% increase in closed hours from one year to the next, and is now closed nearly half of its scheduled hours.

Musquodoboit Valley Hospital serves 5,000 people. It is about a 35-minute drive to Twin Oaks (the nearest ER) on a two-lane road. Should Twin Oaks also be closed, it is a 39-minute drive to the Colchester East Hants Health Centre in Truro, the next closest ER.

The boilerplate explanation given by Nova Scotia Health in its report for why ERs in rural communities close so frequently is as follows:

Typically, these closures are due to unavailability of emergency department staff (doctors, nurses, or paramedics). Twenty-two community hospitals experienced temporary closures in 2019–20.

Most of Nova Scotia’s 38 emergency departments operate on a 24/7 schedule, except for seven that have established different hours of operation after consultation with communities.

These facilities are considered to have scheduled hours of closure: for example, at Musquodoboit Valley Memorial the Emergency Room is scheduled to remain open from 8am to 8pm.

But often they don’t have the personnel available to staff the ERs during these hours and then the NSH issues a notice about an “unplanned emergency department closure” which happens almost every week in the eastern part of the province for residents along the Eastern Shore. For example, here’s the current list of unplanned closures:

Monday, Dec. 28

• Musquodoboit Valley Memorial Hospital’s emergency department closed opens at 8:00 a.m December 29
• Twin Oaks Memorial Hospital’s emergency department closed at 7 p.m opens at 7 a.m December 29

Tuesday, Dec. 29

• Eastern Shore Memorial Hospital’s emergency department is closed from 8:00 a.m to 8:00 p.m. today.

Wednesday, Dec. 30

• Eastern Shore Memorial Hospital’s emergency department closes at 8:00 a.m today and reopens at 8:00 p.m. on Friday, January 1.

Thursday, Dec. 31

• Eastern Shore Memorial Hospital’s emergency department is closed and reopens at 8:00 p.m. on Friday, January 1.

Friday, Jan. 1

• Eastern Shore Memorial Hospital’s emergency department is closed today and reopens at at 8 p.m. tonight.

“A new contract with the province’s doctors will help improve recruitment and retention, as well as access for Nova Scotians,” says the NSHA report on ER Closures issued December 22. “The agreement makes emergency department doctors in Nova Scotians the highest paid in the (Atlantic) region. An increase in the number of seats for nurse practitioner and physician training at Dalhousie University will ensure we can train more of these medical professionals here at home. Additionally, an emergency department locum program for doctors has helped keep EDs open. And continued progress on the QEII New Generation and Cape Breton Regional Municipality Health Care Redevelopment projects are making our health care system stronger.”

Arguably, new highways and changes in technology — most obviously, the expensive LifeFlight helicopter — might mean that the province doesn’t need so many rural ERs. However, that’s going to be a tough sell for rural residents who see the local ER as a literal life-saver.

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2. Stadium

“The COVID-19 pandemic has not deflated hopes for a football stadium in Halifax, but some economists and politicians don’t think governments should get in the game,” reports Haley Ryan for the CBC:

Founding partners Gary Drummond and Jim Stapleton of Schooner Sports and Entertainment, the group behind the proposed Atlantic Schooners football team, say a lot depends on how the Canadian Football League does in 2021 with its comeback schedule.

The partners are optimistic they can drum up support for a Halifax stadium once it’s safe to travel between provinces.

If anything, Drummond said the pandemic and tough economic losses facing Nova Scotians means a high-profile project like a stadium could bring a lot of jobs, and be a boost to the province.

The pair pull out the old tropes like this:

Drummond said nearly all major public facilities around the world are built with government funds because that’s the only way they get done.

“The philosophy on how these sort of facilities get built goes back to … the Colosseum in Rome. I mean, the government built that,” Drummond said.

That’s not exactly what happened with the Colosseum. Following the disastrous reign of Nero — of fiddling while Rome burns fame — the emperor Vespasian eventually took control of Rome, and then:

The Flavian emperors, as Vespasian and his sons Titus (79-81) and Domitian (81-96) were known, attempted to tone down the excesses of the Roman court, restore Senate authority and promote public welfare. Around 70-72, Vespasian returned to the Roman people the lush land near the center of the city, where Nero had built an enormous palace for himself after a great fire ripped through Rome in A.D. 64. On the site of that Golden Palace, he decreed, would be built a new amphitheater where the public could enjoy gladiatorial combats and other forms of entertainment.

Moreover:

Construction was funded by the opulent spoils taken from the Jewish Temple after the First Jewish–Roman War in 70 CE led to the Siege of Jerusalem. According to a reconstructed inscription found on the site, “the emperor Vespasian ordered this new amphitheatre to be erected from his general’s share of the booty.”

So, we need a few things to duplicate the creation of the Colosseum:

1) A disastrous ruler who allows the city to burn;
2) for that disastrous ruler to usurp a large swath of the burned city for his own pleasures;
3) a subsequent reform-minded ruler who wants to establish restrained governance but nonetheless provides diversions to the common people, and yet requires
4) the conquest and looting of a foreign land in order to finance construction; and
5) a thriving tradition of murderous sport to populate the facility with events.

I’d urge caution before pursuing this strategy.

Besides the burning-the-city and pillaging-and-looting-a-foreign-land parts of the equation, the murderous sport thing might create social unrest and the need to execute 6,000 sportsmen on the Appian Way, which turns out to be a suburban street in Dartmouth:

Another trope that Schooner Sports and Entertainment uses to justify a stadium is that it will bring “$100 million in yearly economic impact around hotels, food and beverage industries, and other events hosted at the facility.”

SSE aren’t alone in using such specious arguments — I’ve heard similar claims from everything ranging from arts groups to convention centre supporters to spaceport enthusiasts, and each and every one of them are engaging in a logical fallacy. Thankfully, reporter Haley Ryan speaks to sports economist Moshe Landry, who explains:

Economic activity is the same, Lander said. When he’s in Halifax, Lander heads to his favourite bar on Thursday nights for dinner and drinks. But if there’s a CFL team in the city, he will skip a few of those outings to afford a game ticket.

Although team owners might say they created $50 in economic activity, Lander said they did, but by taking away $50 of activity for that bar.

“So what’s the net effect? Zero. You just moved it from one place to another,” Lander said. “The fact is that they’re not presenting the [counterpoint], which is there’s costs as well.”

And the public costs are, well, considerable.

But besides all that, can we not recognize that there is a devastating global pandemic that is leaving lots of people impoverished, jobless, and worse, and it will take many years’ worth of government expenditures to address these issues? And that it would be beyond irresponsible to divert hundreds of millions of dollars away from those necessary expenditures?

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3. COVID-19

The province took a holiday break from reporting new cases of COVID-19, although we’re assured testing and contact tracing continued uninterrupted. And Public Health did issue two sets of potential COVID exposure advisories, as follows:

Dec. 24, 1:05pm:

Out of an abundance of caution and given the current testing capacity available, anyone who worked or visited the following locations on the specified dates and times is asked to immediately visit https://covid-self-assessment.novascotia.ca/en to book a COVID-19 test, regardless of whether or not they have COVID-19 symptoms. You can also call 811 if you don’t have online access or if you have other symptoms that concern you.

If you have symptoms of COVID-19 you are required to self-isolate while you wait for your test result. If you do not have any symptoms of COVID-19 you do not need to self-isolate while you wait for your test result.

• Giant Tiger (1658 Bedford Hwy, Bedford) on Dec. 16 between 9:30 a.m. and 1:30 p.m. It is anticipated that anyone exposed to the virus on the named dates may develop symptoms up to, and including Dec. 30.
• Lululemon (5445 Spring Garden Rd, Halifax) on Dec. 16 between 6 p.m. and 8:30 p.m. It is anticipated that anyone exposed to the virus on the named dates may develop symptoms up to, and including Dec. 30.
• Shoppers Drug Mart (Cole Harbour, 4 Forest Hills Pkwy, Dartmouth) on Dec. 18 between 6:30 p.m. and 7:30 p.m. It is anticipated that anyone exposed to the virus on the named dates may develop symptoms up to, and including Jan. 1.
• Canadian Tire (Dartmouth Crossing, 30 Lamont Terrace, Dartmouth) on Dec. 18 between 5 p.m. and 8:00 p.m. It is anticipated that anyone exposed to the virus on the named dates may develop symptoms up to, and including Jan. 1.
• Pet Smart (Dartmouth Crossing, 65 Countryview Dr, Dartmouth) on Dec. 20 between 1 p.m. and 4 p.m. It is anticipated that anyone exposed to the virus on the named dates may develop symptoms up to, and including Jan. 3.
• Walmart (Mumford Road, 6990 Mumford Rd, Halifax) on Dec. 20 between 8 and 9:30 p.m. It is anticipated that anyone exposed to the virus on the named dates may develop symptoms up to, and including Jan. 3.
• HomeSense (Dartmouth Crossing, 110 Gale Terrace, Dartmouth) on Dec. 20 between 12 noon and 2:30 p.m. It is anticipated that anyone exposed to the virus on the named dates may develop symptoms up to, and including Jan. 3.
• International Paint (Burnside, 250 Brownlow Ave, Dartmouth) on Dec. 21 between 9 a.m. and 11:30 a.m. It is anticipated that anyone exposed to the virus on the named dates may develop symptoms up to, and including Jan. 4.
• Industrial Safety World (Burnside, 55 Akerley Blvd, Dartmouth) on Dec. 21 between 9 a.m. and 3:30 p.m. It is anticipated that anyone exposed to the virus on the named dates may develop symptoms up to, and including Jan. 4.
• Sobeys (Cole Harbour, 2 Forest Hills Pkwy, Dartmouth) on Dec. 22 between 6 p.m. and 8:30 p.m. It is anticipated that anyone exposed to the virus on the named dates may develop symptoms up to, and including Jan. 5.

Dec. 24, 9:52pm:

In an abundance of caution and given the current testing capacity available, anyone who worked at or visited the following locations on the specified dates and times is asked to immediately visit https://covid-self-assessment.novascotia.ca/en to book a COVID-19 test, regardless of whether or not they have COVID-19 symptoms. You can also call 811 if you don’t have online access or if you have other symptoms that concern you. If you have symptoms of COVID-19 you are required to self-isolate while you wait for your test result. If you do not have any symptoms of COVID-19 you do not need to self-isolate while you wait for your test result. Public Health is currently in the process of notifying all businesses listed below:

• Superstore (1650 Bedford Hwy, Bedford) on Dec. 21 between 1:30 p.m. and 3:00 p.m. It is anticipated that anyone exposed to the virus at this location on the named date may develop symptoms up to, and including, Jan. 4
• Shoppers Drug Mart (4 Forest Hills Pkwy, Cole Harbour) on Dec. 22 between 7:30 p.m. and 8:40 p.m. It is anticipated that anyone exposed to the virus at this location on the named date may develop symptoms up to, and including, Jan. 5.
• Costco (137 Countryview Drive, Dartmouth) on Dec. 19 between 2:30 p.m. and 4:30 p.m. It is anticipated that anyone exposed to the virus at this location on the named date may develop symptoms up to, and including, Jan. 2.
• WestJet Flight 228 from Fort McMurray Calgary to Halifax on Dec. 22, anyone seated in rows 1 through 5. It is anticipated that anyone exposed to the virus at this location on the named date may develop symptoms up to, and including, Jan. 5. [the details for this flight were corrected on Dec. 27]
• NSLC (1 Forest Hill’s Parkway, Cole Harbour) on Dec. 23 between 9:15 a.m. and 10:30 a.m. It is anticipated that anyone exposed to the virus at this location on the named date may develop symptoms up to, and including, Jan. 6
• Dugger’s Mens Wear (Spring Garden Road, Halifax) on Dec. 23 between 1:00 p.m. and 2:00 p.m. It is anticipated that anyone exposed to the virus at this location on the named date may develop symptoms up to, and including, Jan. 6
• Lee Valley (150 Susie Lake Crescent, Bayer’s Lake) on Dec. 23 between 3:00 p.m. and 4:00 p.m. It is anticipated that anyone exposed to the virus at this location on the named date may develop symptoms up to, and including, Jan. 6
• The Vegetorium (2900 Hwy 2, Fall River) on December 23 between 3:30 p.m. and 4:30 p.m. It is anticipated that anyone exposed to the virus at this location on the named date may develop symptoms up to, and including, Jan. 6

Anyone who worked or visited the following location during the specified dates and times is required [emphasis added] to immediately visit https://covid-self-assessment.novascotia.ca/en to book a COVID-19 test, regardless of whether or not they have COVID-19 symptoms. You can also call 811 if you don’t have online access or if you have other symptoms that concern you. Regardless if you have symptoms or not, you are required to self-isolate while you await your test results.

• Canadian Tire (30 Lamont Terrace, Dartmouth Crossing, Dartmouth) on Dec. 21 between 8:30 a.m. and 4:30 p.m and Dec. 22 between 7:30 a.m. and 3:30 p.m. It is anticipated that anyone exposed to the virus at this location on the named date may develop symptoms up to, and including, Jan. 5.

I’ve updated the potential COVID exposure advisory map:

I expect a news release will be issued later today with the details of new cases detected over the holiday. Premier Stephen McNeil and Chief Medical Officer of Health Dr. Robert Strang have signalled that there will be a COVID briefing tomorrow, but as of this writing it hasn’t been scheduled.

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Government

No meetings.

On campus

No events.

In the harbour

Monday
04:30: APL Gwangyang, container ship, arrives at Pier 41 from Port Klang, Malaysia
05:00: Tampa Trader, container ship, arrives at Pier 42 from Kingston, Jamaica
15:00: MSC Rochelle, container ship, arrives at Berth TBD from Sines, Portugal
16:30: Tampa Trader sails for New York
18:00: Niovi.gr, buker, sails from Pier 28 for sea
18:00: Algoma Verity, bulker, arrives at Berth TBD from Sydney
18:30: Acadian, oil tanker, arrives at Irving Oil from Saint John
22:30: APL Gwangyang sails for sea

Tuesday
00:20: Atlantic Journey, arrives at Imperial Oil from New Orleans

Footnotes

It will be, hopefully, a slow week. I’m on Morning File duties all week, and hope to opine a bit more than usual and get to some stories that for a variety of reasons have fallen by the wayside.

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