MONTREAL — While Quebec Premier François Legault says he's hopeful about the COVID-19 situation in the province, doctors at Montreal-area hospitals are preparing for the number of patients in their care with the disease to keep rising.
Dr. Joseph Dahine, an intensive care physician at the Cité-de-la-Santé hospital in Laval, Que., said he and his colleagues are feeling a "mix of fatigue, apprehension, resignation and frustration" as the number of COVID-19 patients continues to rise.
There are about eight patients with active COVID-19 cases in the 22-bed ICU at his hospital north of Montreal. Another three ICU patients who were admitted with COVID-19 have been in the unit for more than 28 days, the point at which cases stop being considered active, but involve people too unwell to be discharged. One of his ICU patients has been in hospital since September.
"Some patients stay for a long time in our beds and they need mechanical ventilation weaning — that's a long process," he said in an interview Friday. "So, they add to the strain, because they're not going away any time soon."
Quebec's Health Department reported Friday a record 3,085 people in hospital with COVID-19, a rise of 91 from the day before. It was the 29th consecutive day the overall number of COVID-19-related hospitalizations in the province had risen.
The day before, Legault announced he would lift the provincewide curfew and reopen schools on Monday, because health experts, he said, estimated that the number of daily cases had peaked and hospitalizations would soon follow.
But at the same news conference, Health Minister Christian Dubé warned that this weekend could be the worst period in the pandemic for hospitals.
For Dahine, even if this wave of the pandemic has peaked, he expects another.
"If this weekend is the worst, it's just going be the worst until the next worst weekend," he said. "We've been in this for the past two years, there's no real finish line."
After 22 months, Dahine said he and his colleagues are better able to treat the disease. The challenge now, he said, is "just the sheer number. Where am I going to put the next one? Am I leaving a patient on the floor in the emergency that should come to the ICU?"
Dahine said he's also worried about the patients who have had cancer screening or surgeries postponed because of the number of COVID-19 patients who need treatment. While their care can be paused, their conditions can't, he said.
Provincewide, 30 per cent of surgeries are being postponed, according to the Health Department.
While Quebec doctors are a long way from having to triage emergency cases, Dahine said semi-urgent and elective care is being postponed. "Let's not kid ourselves: some people will die on the waiting list because they didn't receive their care in a timely fashion and those are decisions that are actively being made here in Quebec."
Dr. Laura Sang, a medical resident at St. Mary's Hospital Centre in Montreal, said doctors have to weigh the risk that a patient may expose other patients, or hospital staff, to COVID-19 — or be exposed to the disease themselves — when ordering tests and procedures.
"We're trying to make the best decision that we can for our patients," Sang said. "It's always that cost-benefit analysis of, is it worth the risk of waiting a week or two to do this test and decreasing the chance that they're exposed to COVID, or exposing other people to COVID, versus doing the test now?"
As she prepared for a Friday night shift at the hospital, Sang said she was optimistic she would be able to manage everything, but she said she was anxious about caring for ICU patients.
"There is always that fear of the bed shortage, that there's a bunch of sick people in ER waiting to come up and then I won't know where to put them," she said.
Quebec reported another 68 deaths linked to COVID-19 Friday and said 275 people were in intensive care, a rise of three from the day before. The Health Department reported 7,382 new cases of COVID-19 and said 15.9 per cent of tests conducted were positive.
This report by The Canadian Press was first published Jan. 14, 2022.
This story was produced with the financial assistance of the Facebook and Canadian Press News Fellowship.
Jacob Serebrin, The Canadian Press