As Canada's sixth wave of COVID-19 continues, hospitals caring for the country's youngest patients are facing both high patient volumes and high levels of staff off sick.
This time of year, the Children's Hospital of Eastern Ontario (CHEO) in Ottawa normally sees up to 150 daily patients in its emergency department, but lately, it can be double that, with hours-long wait times.
Tammy DeGiovanni, CHEO's senior vice president of clinical services and chief nurse executive, said around two-thirds of those kids are coming in with COVID symptoms.
The hospital has also been forced to cancel some surgeries.
"The double whammy for us is that we also have many staff, medical staff and volunteers that are off as well because of COVID symptoms or COVID in the household," DeGiovanni said.
She said that on any given day recently, roughly 10 to 15 per cent of the hospital's workforce has been off work — with each staff member taking 10 days away to recover.
"That's causing the additional pressure on the system right now, as opposed to in previous waves," she said.
According to hospital figures, CHEO's single-day record for the number of staff, medical staff, learners and volunteers restricted from entering for COVID-related reasons was 199 in early January — just as the initial Omicron wave was taking hold after the holiday season.
The next highest day was April 11, at 191, with the facility still experiencing major daily staff shortages.
Children with COVID, other illnesses
In Saskatchewan, health-care facilities are also dealing with a surge of sick kids, alongside record overall hospitalizations — Wednesday's provincial data showed a new all-time high of 417 people in hospital with COVID-19.
"There's just a huge increased number of kids coming in with upper respiratory illness and related complications. Many of them, as you would suspect, have COVID," said Dr. Alexander Wong from the Saskatchewan Health Authority.
"That's creating a lot of pressure on the acute care side, with regards to hospitalizations, as well as ICU admissions, as well as on the emergency department."
Data provided by BC Children's Hospital in Vancouver shows a mix of both COVID-19 and other respiratory illnesses showing up in young patients in recent months.
In February, 76 children tested positive for COVID-19 in the hospital's emergency department, while another 29 tested positive for other respiratory illnesses. The following month, that ratio shifted, with 37 kids having COVID-19 and 72 having other respiratory illnesses, including one case of influenza. (The hospital did not provide April data.)
Health-care workers at children's hospitals, like their adult counterparts, are "similarly affected by disease spread in their communities," said Dr. Srinivas Murthy, a pediatric critical care physician and infectious diseases specialist with BC Children's Hospital.
At McMaster Children's Hospital in Hamilton, Ont., the number of admitted pediatric COVID patients has remained low and relatively stable through the fifth and sixth waves, a hospital spokesperson said in a statement to CBC News.
However, the volume of kids coming to the hospital's emergency department with respiratory symptoms — some of which are related to COVID — is very high. The spokesperson said that, combined with staffing pressures, has led to the system being "very challenged."
Visits back to pre-pandemic levels
It's a similar situation inside one of Canada's largest health-care centres for youth, Toronto's Hospital for Sick Children (also known as SickKids).
The whole hospital is "under strain," in part because of roughly 10 to 30 per cent of staff being off sick on any given day throughout the two Omicron waves, said Dr. Jason Fischer, SickKids's division head of emergency medicine.
Hospitalizations and ICU admissions remain high across Ontario, just as the number of patients coming to the emergency department at SickKids are expected to return to pre-pandemic levels, hospital data shows.
There were more than 7,000 total emergency visits at the hospital in April 2019, but that tally dipped in April 2020, during the early days of the pandemic, when many health-care facilities experienced a major drop in visits.
The total hit roughly 4,400 in April 2021 and nearly 4,000 young patients showed up in the first half of April this year — a daily average of 222 visits, roughly the same as before the pandemic.
Despite those volumes, Fischer said it's crucial to keep staff with COVID-19 home for a full 10 days.
"We're seeing a lot of kids aged zero to five who are not immunized, and so we're particularly conservative in ensuring that no one's coming to work sick," he said.
Low vaccination rate among kids
Across Canada, vaccination rates remain low among youth. The latest country-wide data shows just 40 per cent of kids aged five to 11 are fully vaccinated, while younger children don't yet have access to an approved vaccine.
With millions of kids still vulnerable to infection — while hospitals are under pressure — it's left some parents wondering about the best approach if their child does catch COVID-19.
Nicole Rajakovic, a Toronto mother of two, faced that dilemma in the last month. Her whole family wound up falling ill, with her five-year-old son the first to show symptoms back in late March. At the time, she said, he'd only had one vaccine dose, while the rest of the family was fully vaccinated.
"He had a really serious coughing fit, which included an inability to breathe, and that was the scariest moment for us," she recalled. "Do we call 911?"
Rajakovic wound up caring for her son at home, and he's since recovered from his illness. But she said it was a tough decision.
"Where we would normally go to a doctor or urgent care, we're not making those decisions anymore, because we know they're short-staffed, and we know they're exhausted."
Fischer from SickKids agreed that health-care workers are often stuck working long hours, while families are facing long wait times for care.
Even so, he stressed that if parents are worried about their child's symptoms, they should still bring them to an emergency department, urgent care centre or use virtual care options.
According to the Canadian Pediatric Society, mild symptoms don't require a hospital trip, but parents should seek medical advice if their child isn't drinking well, has a high fever, is having trouble breathing or if their symptoms continue or worsen.