Broader vaccination is needed in Ontario to minimize the impact of the fourth wave as COVID-19 hospital admissions rise, the province's hospital association said Wednesday, warning that more pressure on the sector could exacerbate an existing treatment backlog.
Anthony Dale, president and CEO of the Ontario Hospital Association, said increasing the vaccination rate will help limit the burden on hospitals and reduce any further disruption to non-COVID-19 services.
"The system is managing well enough at the moment, but it's the trend line that obviously is the most concerning — we're starting to see a rise in new admissions to critical care of people with COVID," he said Wednesday.
"We're really just starting the work of catching up on the backlog, so for us, you can imagine, the prospect of a fourth wave that places significant additional pressure on hospitals is the very last thing we want to see or hear about, because that means denying more people with non-COVID-related conditions access to the services that they so sorely need."
Hospitals are also preparing for the possibility that more children under 12, who can't be inoculated at this time, will need on-site care as a result of the Delta variant, he said. There are roughly 90 pediatric critical care beds across five or so children's hospitals in Ontario, he said.
"Those hospitals are working very, very closely right now with provincial authorities to make sure that they're prepared for any contingency," Dale said.
More than 90 per cent of COVID-19 patients in intensive care and more than 80 per cent of those hospitalized but not in an ICU are not fully vaccinated with two doses, Dale noted.
As well, uptake of vaccinations has "slowed significantly" as case counts increase, he said.
The province said slightly more than 82 per cent of Ontarians aged 12 and older have received one dose of a vaccine, and just over 75 per cent have had two shots.
A report released this week by Public Health Ontario suggests the emergence of the Delta variant requires a higher rate of immunization to achieve so-called herd immunity, meaning more people need to be vaccinated than are currently eligible for a shot.
"The Delta variant is more transmissible, reduces the effectiveness of a single dose of current vaccines, causes more severe disease and is currently the dominant strain in Ontario," the report said.
"The critical threshold for vaccination is likely at least 90 per cent of the Ontario population, and over 100 per cent of the vaccine-eligible population."
Ontario Health said that as of Sunday, surgeries in the province have returned to 88 per cent compared with the volume from 2019. Slightly more than 99 per cent of the most urgent patient surgeries were completed during the pandemic, it said.
"Provincial ICU capacity is monitored daily and should pressures increase, hospitals will work together as they have throughout the pandemic and leverage the provincial command table and regional Incident Management System structures to share capacity," it said.
The agency also said it has identified an additional 37 pediatric ICU beds that could be freed up if needed, which would increase capacity by 40 per cent.
Also Wednesday, Peel Region's top doctor said he's exploring options to create a local vaccine certificate program in the absence of a provincial one, saying such programs can help reduce transmission of COVID-19 and reduce the risk for unvaccinated people.
Premier Doug Ford has so far refused to bring in a provincewide vaccine certificate system.
Daily cases have been trending upward in Ontario with 660 new infections reported on Wednesday, 525 of those involving people who are not fully vaccinated or whose vaccination status is unknown.
The province said 283 people are in hospital due to COVID-19 — 253 of whom are not fully inoculated or with an unknown vaccination status.
It said 161 people are in intensive care because of the virus, seven of them fully vaccinated. Earlier in the pandemic, the province indicated that having more than 150 COVID-19 patients in intensive care could necessitate cutting back on surgeries.
On Tuesday, Ontario's top doctor, Dr. Kieran Moore, said the province currently has the capacity to care for those in intensive care, but will closely monitor what he considers a "key marker" of the pandemic situation.
Thousands of surgeries were postponed over the course of the pandemic, leaving the health-care sector with a significant backlog.
Data published in the Canadian Medical Association Journal last fall suggested more than 148,000 procedures were postponed in the first wave of the pandemic alone, creating a backlog that researchers said would take at least a year and a half to clear.
Last month, the province announced funding it said would allow hospitals to operate at 110 to 115 per cent capacity in an effort to tackle the backlog.
The government said the $324 million allocated would allow hospitals to extend operating hours to perform up to 67,000 more procedures per year and provide 135,000 more hours of CT and MRI imaging combined.
This report by The Canadian Press was first published Aug. 25, 2021.
Paola Loriggio, The Canadian Press