Hamilton Health Sciences facing most pressure since pandemic began

Hamilton's largest hospital network has significantly scaled back scheduled care to cope with overcrowding and staff shortages causing more strain than at any other time in the pandemic.

Hamilton Health Sciences (HHS) is down to 65-per-cent to 70-per-cent of its pre-COVID volumes, chief medical executive Dr. Michael Stacey told The Spectator Saturday.

It's a major step back for the hospital network, which had recently got up to 90-per-cent and was well on its way to being fully operational. This happens as HHS and St. Joseph's Healthcare are already facing a pandemic backlog of 14,585 surgeries.

We're operating well above capacity at the present time and on top of that we have this precarious staffing position primarily from people self-isolating due to COVID," he said. It really is challenging for us because we had been looking toward getting back to the pre-COVID levels of activity or possibly even above that to be able to deal with that backlog."

HHS put out an update to the community Thursday that spelled out the heavy burdens" it's up against.

We are facing the most significant capacity pressures we've experienced since the pandemic began," it stated. Units across all of our sites are straining as a result of significant staff shortages."

Occupancy was 115 per cent at Juravinski Hospital on Friday and 105 per cent at Hamilton General Hospital. Ideal is 85 per cent to 90 per cent.

As a result, it doesn't take many COVID patients to further strain the system. Hamilton's hospitals were caring for 146 infected patients on Friday, up from 114 on Wednesday.

We were on a knife's edge in being able to manage capacity," said Stacey. The pandemic has really shone a light on that."

Even before the pandemic, Hamilton's hospitals had to open up unfunded beds due to overcrowding, sometimes in unconventional spaces known as hallway medicine.

We still are running those unfunded beds," said Stacey. We've tried to stay away from unconventional spaces but we've been at times forced to do that because of the fact that we have no where else to put the patients."

Hallway medicine causes significant backlogs throughout the entire system, most visible in the emergency department (ED).

More patients are waiting longer in our EDs to be admitted, and it's taking longer for ambulances to get back on the road," stated HHS.

However, more beds requires a workforce to staff them and that has become the biggest challenge HHS faces. The hospital network currently has a staggering 300 to 500 vacancies, estimates Stacey.

We get very few applicants for those positions," said Stacey. There is a global shortage of trained health care professionals ... It really is causing very significant pressures."

On top of the vacancies, HHS also had 274 staff and physicians self isolating Friday while St. Joseph's had 168. It's one of the main reasons HHS had to ramp down.

We don't have the staff to do the work," said Stacey. Our concern is for those patients who've been waiting and now, because of this challenge, continuing to wait even longer for their procedures."

One of the strategies HHS is counting on to deal with the overcrowding is to discharge patients who no longer need to be in hospital. But there are also bottlenecks in the community, resulting in 200 beds at HHS taken up by those waiting for other services particularly long-term care.

It's driven by a number of issues and one of them is that throughout the Ontario West region there are over 100 long-term care homes in COVID outbreak which exacerbates the ability to move patients through the system and into those long-term care homes," said Stacey.

Hamilton alone had 19 outbreaks in long-term care and retirement homes on Friday. The city also had five outbreaks in hospitals, four at HHS and one at St. Joseph's. These make up the majority of the 31 active outbreaks.

The one saving grace for the health care system has been the small number of COVID patients in the intensive care unit during the sixth wave. Stacey credited vaccination for preventing severe illness while the more contagious BA.2 Omicron subvariant has now taken over. It's one of the reasons the hospital doesn't plan to backtrack on its mandatory vaccine policy that saw 178 staff lose their jobs in January.

Being vaccinated is absolutely essential to enable the health system to get through the various crises that we've had through this pandemic," said Stacey. Although, we obviously have a lot of ... COVID infections out there in the community, what we're not getting is the high level of very sick people in the hospital due to COVID. If we had that on top of what we have now, this would be unimaginable."

Joanna Frketich is a health reporter at The Spectator. jfrketich@thespec.com