Learning to live with COVID comes with a booster shot
Learning to live with COVID takes a lot more shots in arms, as Hamilton's overcrowded hospitals have painfully illustrated.
The pandemic has really shone a bright light on deficiencies in our health-care system," said Rob MacIsaac, CEO of Hamilton Health Sciences (HHS) Deficiencies that existed in many respects long before the advent of COVID."
Ontario's hospitals were so stretched before the pandemic that it was common to have more patients than funded beds - coined hallway medicine" because care often had to be provided in unconventional spaces.
Making the situation worse was long waits for home care and long-term care. Nearly one in five Hamilton hospital beds is taken up by those waiting for community care, creating logjams that result in cancelled surgeries and ambulances held up in emergency departments.
The fact is we need more beds both in hospital and in community," said MacIsaac. Our hospital infrastructure is aging, emergency departments and wards were not built for the patient volumes and infection control standards that are needed today, and we need more skilled people in our workforce."
By the time COVID hit, Ontario's hospitals had almost no extra capacity after years of cost-cutting due to frozen budgets or increases well below inflation. HHS alone axed roughly $130 million from its $1.2-billion budget over roughly six years by 2019.
As a result, preventing as many COVID hospitalizations as possible has been crucial to keeping the health-care system from becoming overwhelmed and unable to care for cancer, trauma, heart attacks and other urgent cases.
At the beginning, lockdowns and postponed care were the only way to keep the system running. But now vaccines can do the job of preventing severe illness and surges of hospital admissions.
We are asking people to get vaccinated," said MacIsaac. Vaccines continue to be a key weapon in our battle against the pandemic and we have a long road ahead."
The problem is too few are taking up the hospital network's call to arms, making a return to normal that much more difficult.
More than one in 10 eligible Hamiltonians haven't had any COVID shots. Certain groups have particularly low uptake, such as age five to 11 with only 50 per cent having one shot.
To kick-start vaccination, Hamilton public health nurses will give out COVID shots during the school day for the first time to eligible students with parent approval. They plan to visit every elementary school by March break.
Booster shots are particularly key to learning to live with the virus. While two doses help prevent severe illness, they're not enough to stop the spread of Omicron. But three shots decrease the risk of transmission by 60 per cent.
The province's COVID-19 Science Advisory Table released modelling Tuesday showing a nearly threefold difference in hospitalizations if more than 10 million Ontarians get their boosters compared to eight million.
Three doses is so much superior to two doses against risk of transmission and severe outcomes that I hope more Ontarians embrace it," said Ontario's chief medical officer of health, Dr. Kieran Moore.
So far, just 54 per cent of eligible Hamiltonians have had a booster shot. For ages 18 to 29, it's just over 35 per cent.
Demand for the shot has plummeted - with fewer than 1,000 doses a day given out this past Sunday and Monday compared to more than 10,000 daily on Dec. 21 and 22.
Public health is closing its vaccine clinic at the Centre on Barton at the end of the day Sunday after seeing shots per day drop to 170 from 2,700 in January. Instead, it will focus on bringing the shot to neighbourhoods with the lowest uptake. Recent data from Ontario research institute ICES shows a vast divide between different parts of the city.
Vaccine is a critical tool right now to really get us through this Omicron and get us back to a different place," said Michelle Baird, director of the epidemiology, wellness and communicable disease control division at public health.
The fast-spreading variant has raised questions about whether vaccine passports need to be scrapped or upped to three doses.
I think we have to reassess the value of the passports in the coming weeks and months," said Moore. It does protect the unvaccinated person well against transmission and severe outcomes by not being able to access mass gatherings and/or many of these venues."
Data from the city of Hamilton shows how important it is to keep the unvaccinated from getting infected. Those with no shots are 5.3 times more likely to end up in hospital than those with two doses. Their risk of being admitted to an intensive care unit (ICU) is 10.3 times higher.
The staggering differences are one of the reasons hospitals have been urging the unvaccinated age 60 and older - it's age 50 for Indigenous adults - to get tested for COVID as soon as they have symptoms so they can get treatment that will keep them from getting severely ill.
Eight Hamiltonians a day are still being admitted to hospital for COVID, despite the fifth wave appearing to have peaked - or at least plateaued.
Hamilton's hospitals were caring for 186 COVID patients Tuesday, including 23 in the ICU. While the numbers are decreasing, it's still high enough to contribute to severe overcrowding.
Juravinski Hospital had an occupancy rate of 123 per cent, while Hamilton General Hospital was at 107 per cent. The ideal maximum occupancy is between 85 per cent to 90 per cent.
The stakes are high with 31 critically ill residents transferred out of the Hamilton, Burlington, Niagara, Brant, Haldimand and Norfolk area from Jan. 9 to Feb. 6 to manage what MacIsaac called an extraordinary surge in patients."
Both HHS and St. Joseph's Healthcare are having issues keeping up with urgent and emergent surgeries and expect it will be weeks before they can bring back postponed care. HHS has temporarily closed the West End Clinic, while reduced hours at the King Campus have come to an end with the urgent care back to its usual 8 a.m. to 10 p.m. daily starting Wednesday.
It has been a precarious situation," said Melissa Farrell, president of St. Joseph's.
At the same time, Hamilton has seen a spike of 66 COVID deaths since Jan. 19 to bring the pandemic toll to 502. Two new deaths reported Tuesday were seniors in their 70s.
A death was also reported in an outbreak at Caroline Place Retirement Residence, where eight have been infected. There was also a second death at Idlewyld Manor in an outbreak involving 16 cases that was declared over Feb. 4.
The city's largest ongoing outbreak is at Heritage Green Nursing Home where 119 have tested positive.
Of the 39 active outbreaks, 16 are in seniors' homes, eight in shelters, seven in group homes, assisted living and community living, four are in hospitals and one at a rehabilitation centre. There is also an outbreak at the Dr. Bob Kemp Hospice, the Piccioni Bros. Mushroom Farm in Dundas and at the Hamilton-Wentworth Detention Centre.
Joanna Frketich is a health reporter at The Spectator. jfrketich@thespec.com