What is the COVID-19 tipping point for Saskatchewan?

·6 min read

Regina– Early on in the COVID-19 pandemic, Saskatchewan established two field hospitals, one in Regina and one in Saskatoon. There was also great concern around the world regarding the availability of ventilators to assist those with difficulty breathing due to COVID.

Asked about Saskatchewan’s hospital capacity, the availability of ventilators, and if we have the people to operate them, newly appointed Health Minister Paul Merriman said, “We're continuing balancing of the ongoing needs of the province with medical needs, to what the new needs are (for) COVID. And that balance is continually being adapted, on a daily basis, about also obviously looking out in the next two to three weeks, to see what's going to be happening on that side of things.

“But we want to make sure that we're continuing. We've obviously brought our surgeries back up, we've been increasing that over the summertime. And now we've had an influx of COVID patients in the hospital and in the ICU. So we're continually adapting that.

Saskatchewan Health Authority (SHA) CEO Scott Livingston said, “We are not in the same situation we were in March when we did a system wide shut down to immediately build capacity, both on the offensive and defensive side and the COVID strategy. So now, with a dual responsibility that we have to the COVID response, as well as take care of all non COVID patients, that certainly is where the pressure comes from.

“But it also gives us, as I said before, the opportunities to intervene and change services so that we can redirect our resources in turn in a response. So, with respect to the number of ventilators, with respect to the PPE (personal protective equipment) available in the province, we've been working on over six months to ensure that that capacity is there.”

Livingston continued, “But the reality is, and same with the field hospitals, if we need to have the field hospitals, we will put them in place. But the reality is, when that happens, and if that happens, is entirely dependent upon the number of cases that we see. Are we prepared to go from today to tomorrow? Yes, based on what we're seeing in case growth. But if we start seeing exponential case growth, that's where you're going to see major changes to the system. That's going to put, not just COVID patients, but other patients at risk, because we will reduce other types of health services to support the work. The cost would be to others, if the system starts having to actually gear up so much more of its capacity to deal with so many COVID patients, because we just don't have that luxury.

“We are going to have traumas, we're going to have heart attacks, we're going to have strokes, and we can't minimize the impact of that type of service reduction would have on people across this province, because we've already experienced it,” Livingston said.

SHA Chief Medical Officer Dr. Susan Shaw said, “We are supplied. We will be prepared. But I think our goal should be to never have to get to that point. And that’s dependent, not on the healthcare system, but on the actions of our public. And I know we've done it before. And I'm confident we can do it again.”

She urged keeping your bubbles of close contacts as small as possible.

On Nov. 13, Saskatchewan reported there were 53 people in hospital with COVID-19, including 15 people in intensive care.

According to the Saskatchewan Health Authority 2019-2020 business plan, Saskatchewan has 2,914 beds between five tertiary hospitals (1,556), six regional hospitals (578), nine district hospitals (274), 35 community hospitals (421) and four northern hospitals (85), as of March 31, 2018. That does not include 5,421 beds between 113 government-owned long term care facilities, 2,447 beds between 24 affiliate (private, not for profit) facilities, 649 beds between five contract (private, for profit) facilities and 319 beds in eight non-designated facilities.

Asked what is the pressure point for maxing out the system, Merriman said, “We are getting to that point where we are at what I would consider a tipping point within the healthcare system.

He added, “We only have so many healthcare professionals out there. And we have to keep constantly adjusting them, to moving them over from somebody that would normally be on an ICU unit to COVID. So we're continuously moving those people along that spectrum. And as more COVID patients come in, as Scott (Livingston) just outlined, we have to look at what services do we have to either reschedule or postpone to be able to take the complement of individuals from that area and put them in treating COVID patients.

“So we're pulling from one side of the system to help the other side of the system. And that's going to be continuously adjusting. But the best way of making sure that we don't have to pull those surgeries is to be, again, compliant with the public health orders and the pressure comes off, or lessens for the health care system. But that is not in my hands. It's not in Dr. (Saqib) Shahab’s hands, those are into the individuals hands are right there in the community.

“And if the media can push that out there that we have to re-adhere and get back to where we were months ago, in being vigilant with what we are doing, and now we're doing this. Because what we feared what could happen is starting to happen. And we have a very unique opportunity, right now, to be able to flatten that curve again, or bend it as much as we possibly can. Otherwise, we're going to have some challenges and then we will be pulling more from one side of the healthcare system to the other side.”

Livingston said, “We know how we can very quickly build capacity in the health care system, over and above all the other things we’ve talked about, in preparing with these tools, and that is by system-wide shut downs. We don't believe we want to go there.”

He continued, “On March 23rd, when we did a system wide shut down in the healthcare system, we grew capacity in one week, virtually immediately, across the system. We also have the single authority have eyes on acute care beds across the province. We've done training across the province for expertise. So it's not just based in Saskatoon and Regina. We have the ability to use beds outside of Saskatoon and Regina, in many of our facilities, to support COVID patients.

“You know, again, that comes with a cost, because the more patients we have that we are treating for COVID, the less opportunity we have to care for patients that are non-COVID. We know the elective surgeries, the elective procedures, we don't want to go down the path as we did in March, because of the collateral damage of it causes in the delay of diagnosis.

“But we do always have that capacity. But, as you've heard multiple times today, how do we avoid getting there? And we know what works for us. We've done it before. It’s how we double down and make sure that we don't put the system in a position that we have to make hard choices on large scale,” Livingston concluded.

Brian Zinchuk, Local Journalism Initiative reporter, Estevan Mercury