Increased COVID ICU and Hospital Admissions Continue
Saskatchewan Health Authority (SHA) is hitting new highs in intensive care unit (ICU) and non-ICU COVID admissions this week, as it continues to redeploy staff to critical care areas and other required COVID services. These adjustments are required as a result of unprecedented hospitalization rates, with overall hospitalizations and admissions to ICU due to COVID nearly tripling over the last month.
A review of Saskatchewan’s COVID-19 data continues to show that unvaccinated people are six times more likely to test positive for COVID-19 than a fully vaccinated individual, and five times more likely to be hospitalized for COVID-19 than fully vaccinated people.
“As COVID cases continue to increase, teams are working hard to move staff to where we anticipate the surge to be in the coming days and weeks. This means some communities are going to see disruptions to their hospital services, including temporary emergency department closures,” said Derek Miller, SHA’s EOC Commander. “We have already seen facilities experience these disruptions, and we appreciate all those involved for supporting our provincial response to deal with this onslaught.”
ICU/Acute Care Capacity
Over the last few days, COVID hospitalizations have hit new highs with over 300 individuals, including more than 60 COVID ICU patients. Adult admissions into the pediatric intensive care will continue, as that department continues to provide care for COVID critical care patients under the age of 11.
“I cannot stress how critical it is that if you are eligible to get vaccinated, you must do so to protect young children in your household,” said Dr. Johnmark Opondo, SHA’s Medical Health Officer and Offensive Chief for Public Health. “We are seeing more children getting sick with COVID in households where adults and other caregivers remain unvaccinated, and they are getting COVID at home. In the last few weeks, one in five cases in children in Saskatchewan reported were under the age of 12. We must take responsibility and create a needed circle of protection for our children who do not yet have access to a vaccine.”
Unvaccinated people remain the primary driver of hospital pressures
For adults who remain unvaccinated, aside from a larger risk of becoming admitted to the ICU than those who are vaccinated, a recent analysis is showing the length of stay in ICU is two and half times longer for unvaccinated COVID patients compared to vaccinated COVID patients. The median length of stay for fully vaccinated patients is 3.1 days in ICU compared to 7.6 for unvaccinated or partially protected patients.
Those who are vaccinated in the ICU are typically older individuals with other pre-existing health complications. Unvaccinated patients in ICU appear to only have their vaccination status as the common denominator.
The SHA has now made accessible 30 additional ICU surge beds across the province, up from last week’s previous 24, with the month’s early goal remaining to surge up to care for 125 ICU beds for COVID patients while maintaining care up to 50 for non-COVID ICU patients. However, teams are already seeing pressure to try and maintain this level of non-COVID ICU care as demand for COVID critical care grows daily. The SHA continues to prepare to care for up to 350 COVID non-ICU patients through Saskatchewan hospitals in response to this fourth wave.
It is important to note that the number of ICU and non-ICU COVID patients will change frequently throughout the day as patients are admitted or transferred/discharged. For daily information about COVID-19 patients in hospital and intensive care, please refer to the provincial dashboard.
Service Slowdowns and Labour Redeployment
Service slowdowns continue around the province as health care teams are deployed to other areas to strengthen the SHA’s surge response. This includes in surgical areas where the goal remains to resume elective procedures as soon as transmissions come under control and the health system is able to safely resume normal volumes.
This latest wave is affecting Saskatchewan residents’ wait time for procedures. There has been a 32 per cent increase in overall wait times across the province affecting 33,078 individuals since March 22, 2020 until September 26, 2021. The largest growth of those waiting their elective procedures is over 18 months, from approximately 1,283 individuals last September to 3,697 this September.
With more than 80 per cent of new positive COVID cases in the province in unvaccinated individuals, and these cases expected to continue to drive up hospital admissions, staff from both operating areas and pre- and post-surgical care areas are some of the skilled individuals needed to help care for growing COVID hospital and ICU cases. This is why surgical areas continue to be so hard hit with COVID surges.
Based on the current trajectory of COVID cases, staffing needs for both acute and ICU surge provincially is anticipated to require between 400-500 highly-skilled full-time equivalents (FTEs). This includes registered and licensed practical nurses, respiratory therapists, continuing care aides and physiotherapy. In addition, movement is occurring among unit clerks, unit assistants and other support workers to create a team response to assist with hospital units’ growing COVID demands.
To date, approximately 64 FTEs have been redeployed to ICU. As well, the SHA is adapting staff-to-patient ratios and is allowing for double occupancy in some ICU areas in an effort to support safe patient care with an increasingly stretched workforce.
At the same time as supporting hospital care, the SHA is aiming to deploy 340 FTEs to support contact tracing and 150 FTEs to testing to support the mitigation of COVID transmission in Saskatchewan.
“The challenge remains that the pool of those able and skilled in the right areas is finite,” said Miller. “Individuals need to be oriented, and in some cases require refresher training. We know being asked to move to these areas is causing stress and anxiety for our staff. We are so appreciative of their commitment and ongoing sacrifice.”
Patient Transfers
Patient transfers across the province are anticipated to increase in the coming days to level load care across Saskatchewan hospitals. Those patients whose care needs can be safely met in lower acuity hospitals will be transferred. However, this may not be the hospital closest to home or match their preferred location.
Family Presence
The SHA enacted this week additional measures to protect long-term care residents, expanding family and visitor masking requirements from common areas to all areas within a long-term care home.
Acute care facilities and long term care homes are experiencing increased restrictions based on current local COVID risk of transmission. The SHA reminds the public to check on current restrictions in their community prior to visiting, and is asking everyone to follow all protocols for that facility or long-term care home. Most of all, do NOT visit if you have any symptoms or have been in close contact with a COVID-positive individual.
COVID Immunization
The SHA is doubling its vaccine clinic capacity over the month of October to support a blend of bookable, outreach, and walk in vaccine clinics. Teams will also be balancing these clinics with the need to operate this fall’s influenza clinics.
All eligible Saskatchewan residents are encouraged to get their COVID immunization and protect yourself, and those around you. The SHA updates clinic information regularly for both booked and pop-up clinics on the SHA website. As well, COVID immunization continues to be offered at participating pharmacies across the province.