TORONTO — Ontario will allow hospitals to transfer patients without their consent and redeploy home-care workers to the facilities as the number of COVID-19 patients in intensive care units hits new highs.
The government issued two new emergency orders Friday evening – which are effective immediately – to address the capacity crunch many hospitals are facing.
Health Minister Christine Elliott said the third wave, fueled by more transmissible COVID-19 variants, has pushed the province's hospitals to their limits and the government had to act.
"We are taking the steps using these tools in order to get to the point where, as more patients come into hospital with COVID, we will be able to safely care for them," she said in an interview.
The move came hours after Premier Doug Ford said ramping up the province's vaccine rollout will help address the pressure on hospitals, and that "things are looking really, really positive out there."
Ontario set new records Friday for both daily cases and the number of COVID-19 patients in intensive care.
Elliott said the province knew it had to go "a step further" in light of the latest data.
"We have a very resilient health-care system that we can expand and we have the tools to do that with the emergency orders that have just been declared," she said.
Patients will only be transferred to an alternate site without consent when a hospital experiences "a major surge event" and when the same quality of care provided can be assured, Elliott said.
The province has been transferring patients between hospitals for months to accommodate a growing number of COVID-19 cases, but those transfers were done with the patient's permission.
The province will also be able to redeploy dozens of workers from home-care organizations and Ontario Health - the body that oversees the health system - to hospitals during a surge.
Both orders, which will be in effect for at least two weeks, come as Ontario hospitals prepare to start ramping down elective surgeries and non-urgent procedures next week to ensure they have the capacity to treat COVID-19 patients.
Elliott said the orders and the ramping down of elective surgeries could increase ICU capacity by up to 1,000 patient beds.
Hospitals were instructed in a memo from Ontario Health on Thursday night to ramp down non-urgent procedures starting Monday.
"Given increasing case counts and widespread community transmission across many parts of the province, we are facing mounting and extreme pressure on our critical care capacity," Matthew Anderson wrote.
Hospitals in northern Ontario are exempt but Anderson said they should prepare to ramp down quickly in the near future.
The memo also asked hospitals to identify staff who may be redeployed to other sites if necessary.
Ontario Health will continue to monitor the situation with a view to bring back surgical capacity for deferred services as soon as possible, Anderson said.
That guidance came as the regulatory body for Ontario physicians shared a message of support for doctors who may have to decide which patients will receive life-saving treatment if intensive care units are overwhelmed.
The province's critical care triage tool has not been enacted, with Ontario's health minister saying this week that the protocols were not yet finalized.
The College of Physicians and Surgeons of Ontario told doctors they will be supported if the measure takes effect.
"We firmly believe physicians need to be supported if they are required to make extraordinary decisions about which of their patients will be offered critical care resources that are in short supply," Nancy Whitmore, registrar of the college, said in a message to the profession Thursday night.
The college will be there to provide clarity if the protocol is enacted, she said, acknowledging the "unprecedented situation" in intensive care units and noting that "physicians may soon be faced with making incredibly difficult decisions that they never imagined having to make."
There were 552 patients with COVID-related critical illness in Ontario intensive care units as of Friday morning, according to the Ministry of Health.
Ontario also reported a record high of 4,227 new cases of COVID-19 Friday and 18 additional deaths from the virus.
The Ministry of Health said an earlier record of 4,249 cases reported on Jan. 8 had included 450 cases from previous days because of a data delay.
NDP Leader Andrea Horwath said the Ford government started to reopen the province too soon after the second wave, which has led to the "devastating" situation in hospitals.
"Doug Ford marched us right into this crisis with his eyes wide open," she said. "Now people need to know how the Ford government is going to get us out of it."
The CEO of the Registered Nurses' Association of Ontario said soaring COVID-19 cases represent the "biggest crisis" of the pandemic for the province.
Doris Grinspun said the government must empower more primary health-care workers to deliver vaccines, and should cut down on bureaucracy holding the home-care sector back from giving doses to clients.
"We need to make things simple, and emphasize speed, speed, speed," she said. "We must move faster, have less focus on perfection."
This report by The Canadian Press was first published April 9, 2021.
Shawn Jeffords, The Canadian Press