Ambulance shortages have ‘disappeared’ as hospitals emptied for COVID-19
Ambulance shortages that have plagued the health-care system for decades are no longer occurring during the COVID-19 pandemic.
It's pretty much disappeared," said paramedic Chief Michael Sanderson.
Hamilton has not had a code zero event - when one or fewer ambulances are available to respond to calls in the city - since Feb. 24. The city had its first confirmed case of COVID-19 March 12.
As a result, the time it takes ambulances to respond to calls has improved by about five per cent during the pandemic, according to the Hamilton Paramedic Service.
It's a far cry from last year when out-of-town paramedics had to respond to calls Oct. 20 because there were no Hamilton ambulances left to go to emergencies.
A big part of the reason for the shortages was ambulances stuck in the emergency departments of Hamilton's overcrowded hospitals where it could take more than two hours to off-load patients instead of the expected 30 minutes.
Hamilton's ambulances wasted 30,549 hours in 2019 waiting to transfer their patients to emergency department staff.
But off-load delays also disappeared as hospitals freed up hundreds of beds for potential COVID-19 surges by postponing surgeries, temporarily closing clinics and moving patients to the community.
We arrive at the hospital and typically we're off-loaded very quickly," said Sanderson. Off-load hours has significantly dropped. It's a world of difference. It reminds me of the 1990s."
Even when elective surgeries are expected to resume the week of May 25, the province is requiring hospitals to keep at least 15 per cent of their beds available for COVID-19 patients as opposed to their usual occupancy rates of more than 100 per cent. The extra capacity gets rid of the logjam that went all the way to paramedics in the emergency department.
Hospital off-load delays are temporarily reduced for reasons which are also temporary," said Mario Posteraro, president of the Ontario Public Service Employees Union Local 256.
Increasing call demands are likely to resume as isolation measures are eased and eventually lifted," he said. Unless transformational change occurs ... cascading back logs into critical care units and emergency departments will resume."
At the same time that hospitals temporarily have space, nine per cent fewer people are calling 911 for ambulances partly due to fears of visiting medical facilities during the COVID-19 crisis. Even patients who regularly call for paramedics have sought help less often.
Those are clients often in very challenged and fragile circumstances and some of them have ongoing medical conditions," said Sanderson. I think they have the same fears anyone else would have in terms of going to the hospital."
The city has expanded services and shelters for homeless people during the pandemic which makes a difference in paramedic calls, says Sanderson.
However, paramedics are having to spend more time at each call - in part because of a 30 per cent drop in patients taken to hospital because so many are refusing to go.
Three paramedics - instead of the usual two - are now sent for COVID-19 calls because of the personal protective equipment and precautions required.
Paramedics have also taken on an increased role during the pandemic by doing testing and remote patient monitoring.
The time spent on each call ... has increased significantly," said Posteraro. Anecdotally, I can confirm that our paramedics are feeling the strain and burden of working under the risk and threat of infection."
Joanna Frketich is a Hamilton-based reporter covering health for The Spectator. Reach her via email: jfrketich@thespec.com