Ontario pediatric ICUs operating above capacity, provincial data shows

Critical Care Services Ontario's daily census shows there are currently 122 children in pediatric ICUs, up from 111 the day before. Children's hospitals have said the majority of kids in intensive care are five years old and younger. (Evan Mitsui/CBC - image credit)
Critical Care Services Ontario's daily census shows there are currently 122 children in pediatric ICUs, up from 111 the day before. Children's hospitals have said the majority of kids in intensive care are five years old and younger. (Evan Mitsui/CBC - image credit)

New data shows Ontario's pediatric intensive care units are operating over capacity, with the number of children receiving care exceeding the number of available beds across the province as respiratory illnesses surge in kids.

Critical Care Services Ontario's daily census shows there are currently 122 children in pediatric ICUs, up from 111 the day before.

Ontario has a total of 112 intensive care beds for children.

"This is a point to what I would characterize a point of crisis for pediatric care across the province," said Dr. Lennox Huang, an intensive care physician and the chief medical officer at Toronto's Hospital for Sick Children.

"All of our predictions ... would indicate that things are going to get worse before they're better."

Huang says the number of children needing ventilators and respiratory support is about 50 per cent higher compared to the autumn of 2019, the last fall season before the pandemic hit.

While not the main driver of the surge, the shortage of children's medicine is also impacting emergency patient volumes, since parents rely on over-the-counter medicine to keep their children comfortable at home, Huang says.

Children and teens are arriving at emergency departments at a rate two-to-three times higher than usual this time of year, according to statistics from Acute Care Enhanced Surveillance, a real-time Ontario-wide system that monitors hospital registration records.

There's been an average of 1,414 children aged four and under visiting emergency departments over the last week in the province, compared to the historical seven-day average of 560. For those aged five to 17, there have been on average 1,210 visits to emergency departments over the last week, compared with a historical average of 325.

Last week, Ontario Health directed general hospitals to accept children 14 and older who need critical care in an effort to ease the burden on pediatric facilities.

WATCH | Toronto doctor talks about pressures on hospitals:

Hannah Jensen, spokesperson for the province's minister of health, told CBC Toronto in an email that the province is working with public health units to "monitor impacts on the health system" during "respiratory illness season."

"Our government is in constant contact with our pediatric hospitals, Ontario Health, and other health system partners to alleviate critical care pressures and ensure all patients receive the care they need," Jensen said.

Parents 'devastated' after surgery cancelled

Jolleen Thibert says she spent the past two weeks making sure her four-year-old son Sawyer, who has autism, would be ready for his surgery Thursday at Lakeridge Health in Oshawa, Ont.

Thibert says because of his obstructive sleep apnea, she needs to sit by his bedside to make sure he's breathing. He was scheduled to get his tonsils and adenoids removed to help him sleep better at night.

But upon their arrival at the hospital, the family was told the operation was cancelled, along with all other elective pediatric surgeries, because there were too many sick children in hospital and not enough staff to go around.

"We're devastated and we're scared because what if he gets what's going around? What's going to happen?" said Thibert.

"You're basically giving him a bed no matter what because if he gets a virus, he doesn't breathe, and he will likely end up right back there but an emergent case."

Keith Burgess/CBC and Submitted by Jolleen Thibert
Keith Burgess/CBC and Submitted by Jolleen Thibert

An email from Lakeridge Health says the hospital is just one of many across Ontario seeing a high volume of pediatric patients due to an increase in respiratory illnesses.

While all urgent and priority pediatric surgeries will continue, the hospital confirms it reduced the number of elective in-patient operations starting Thursday until Dec. 10 to "ensure the safest environment for patients, while balancing critical staffing resources and increased patient volumes."

Ontario Health's chief medical director Dr. Chris Simpson says hospitals will be using a "dimmer switch" on surgeries, rather than cancelling surgeries outright as they did during some of the worst waves of the COVID-19 pandemic.

There are some 250,000 surgeries backlogged, says Simpson. That's roughly the same number before the pandemic, he says, but that people are now waiting longer to get those surgeries — about 45 per cent are waiting longer than the clinically determined benchmark, despite progress made in tackling it.

Thibert says the cancelled surgery is part of a long-standing trend for her two children, who both have autism.

"This isn't the first time over the past few years that my children needed health care for severe problems and couldn't get it," she said.

Time for masks, vaccinations, doctors say

Dr. Fahad Razak, an internist at St. Michael's Hospital in Toronto and an assistant professor at the University of Toronto with research expertise in global health and health services, told CBC News Thursday that data from other parts of the world suggests it will be a difficult season for influenza, let alone COVID-19 and respiratory syncytial virus, or RSV.

He is recommending that Ontarians get vaccinated for both the flu and COVID-19 now if they haven't already, and to start wearing masks again in indoor spaces.

"There is a limit to what individuals can do, and this is where there is a need for collective actions — public health measures," he said.

Ben Nelms/CBC
Ben Nelms/CBC

Toronto emergency care physician Dr. Kashif Pirzada echoes that sentiment.

"Slow this down, buy the hospitals time to catch up," he said. "Buy a breather for our health system to catch its breath."

Pirzada also says parents should consider taking children to hospital when they have a fever that lasts longer than four to five days, if they won't eat or drink anything even when taking medication, or if they are breathing very quickly or have "very noisy breathing" with wheezing and crackles.

"Clearly something wrong is happening right now," he said.