Patients in ‘nooks and crannies’ as hospital cope with viral surge

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A sharp rise in flu cases in Ottawa, along with COVID-19 and other viruses, is putting pressure on hospitals that is being felt in their hallways and emergency departments, where patients are waiting longer to be seen and admitted.

At CHEO, there are patients “in every single nook and cranny of the hospital,” said Tammy DeGiovanni, who is the pediatric hospital’s senior vice-president of clinical services and chief nursing executive.

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The hospital’s emergency department has reported a surge in patients with respiratory illnesses in recent days, more of whom have had to be hospitalized than is typical, DeGiovanni said. On Thursday, CHEO’s medical and surgical beds, where most patients are admitted, were at 130 per cent capacity, which meant other spaces had to be found around the hospital for them.

The hospital moved some patients into an overflow unit and other spaces. Even then, 12 patients had to remain in the emergency department because there were no beds available. That, DeGiovanni said, backed up the hospital’s already busy emergency department.

As of November, average emergency wait times at CHEO were the longest in Ontario, more than double the provincial average at 4.6 hours compared to the provincial average of 2.1 hours. Patients waiting to be admitted to CHEO were there an average of 16.7 hours, more than double the province’s targeted time of eight hours.

Patients are triaged so those in need of urgent care get seen the fastest. There is also a Kids Come First clinic which can take lower acuity patients. It is also running at full capacity.

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During busy viral seasons, like this year, emergency departments can struggle to operate in a timely way.

“When we back up, we just have nowhere to see patients and that impacts everything in terms of our wait times,” DeGiovanni said.

There was little sign of improvement as the past week progressed.

CHEO is not the only hospital feeling the pressure from the start of flu season, which officially began in Ottawa earlier this month.

At The Ottawa Hospital, the added pressure means patients are being treated in “non-traditional” spaces, including a gymnasium that also has been used in the past for patient overflow.

The hospital was already busy with COVID-19 and other viral illnesses when influenza cases began to spike earlier in January, said Dr. Virginia Roth, who is chief of staff at the hospital.

In December, the hospital saw about 80 patients come through its emergency department with viral illnesses. Now that influenza is rising, Roth said January appeared to be on track for similar numbers in emergency. About half of those patients are likely to need hospital admission.

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“We are now at the stage where we are putting patients sometimes in unconventional spaces,” Roth said. She added that the hospital had “absolutely” been able to care for everybody who came in and ambulance off-load time — which has been an ongoing issue in recent years — remains at under 30 minutes.

“But it is important to understand you might not get a typical room.” In addition, Roth said, patients are sometimes in hallways for a few hours after being admitted.

TOH has not cancelled any surgeries, she said.

Queensway Carleton Hospital has been operating between 102 per cent and 103 per cent occupancy since the beginning of January.

Twice since then the hospital has opened temporary surge beds to reduce pressure on the emergency department, spokesperson Natasha Curley said. That is in addition to 82 temporary beds the busy hospital opened during the COVID-19 pandemic and continues to operate at full capacity, in addition to 56 beds at an off-site retirement home.

Late this past week, the hospital had 21 admitted patients waiting in its emergency department for in-patient beds. The longest wait for admitted patients to get a bed was 40 hours.

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Curley said the hospital had been seeing more COVID-19, influenza, RSV and mycoplasma pneumonia cases than it did last year at this same time.

Ottawa’s Montfort Hospital was one of two in the city — the other was TOH’s General campus — where emergency department waits were close to provincial averages as of last November. The other hospitals were below average.

The second-longest waits in the province, after CHEO, were at Winchester Hospital, about an hour’s drive south of Ottawa. That hospital’s CEO has recently spoken out about the hospital’s financial struggles which have forced it to close one-fifth of its beds in recent years and to rely on a multi-million-dollar line of credit to keep operating.

Ottawa Public Health reported this past week that influenza levels were very high and increasing, COVID-19 levels were high and increasing and RSV levels were very high, according to wastewater surveillance.

Between Jan. 6 and Jan. 12, 23 new patients were admitted to hospital because of influenza, 56 were admitted with COVID-19 and 22 with RSV. Since the beginning of the respiratory season at the end of August, 83 people have been admitted with flu, 656 with COVID-19 and 195 with RSV. There were also eight new influenza outbreaks in long-term care, retirement homes and hospitals, seven new COVID-19 outbreaks and six other respiratory outbreaks.

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CHEO and other hospitals have advice on their websites for people seeking care for respiratory illnesses.

DeGiovanni advised parents to look at the website for advice about when or where to seek medical care for sick children and to do so early on in a respiratory illness so they would be prepared if their child’s condition worsened rapidly.

She said difficulty breathing was among the indications that they may need to go to the emergency department, along with age of the child. Children with high fevers who are under three months “we want to see right away.”

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