Ontario reports record-high 4,456 new COVID-19 cases Sunday

Ontario reported another 4,456 cases of COVID-19 on Sunday — a new record in the province.

The daily case count is also up from 3,813 cases on Saturday and 4,227 on Friday.

The province is also reporting 21 additional deaths.

New cases reported Sunday include 1,353 in Toronto, 860 in Peel Region, 444 in York Region, 329 in Durham Region, and 377 in Ottawa, according to health minister Christine Elliott.

As of 8 p.m. on Saturday, 3,139,743 vaccine doses were administered.

The seven-day average climbed again to 3,573 cases from 3,371 on Saturday.

Nearly 600 patients in ICUs with COVID-related illness

There are now 593 patients in intensive care units (ICUs) across the province with COVID-related illness as of Saturday, according to Anthony Dale, president of the Ontario Hospital Association.

The number of patients grew by 77 on Friday and 61 on Saturday, Dale said.

The latest OHA figure comes one day before the provincial order for hospitals to halt non-emergency surgeries comes into effect.

A memo was sent to hospitals Thursday night telling them to postpone their non-emergency surgeries, effective Monday, everywhere but in northern Ontario. Pediatric specialty hospitals are excluded from the order.

As a result of the first such postponement in March 2020, the province has a backlog of more than 245,000 procedures.

"The impact of the third wave of the pandemic on scheduled surgeries and procedures will depend on the severity and duration of the current COVID-19 surge," a spokesperson for Ontario Health told CBC News via email.

"These are very difficult and challenging times for all Ontarians," the spokesperson said. "We are monitoring continuously and will ramp up again as soon as safely possible."

Bring out-of-province ICU nurses to help GTA, says Toronto critical care doctor

Dr. Michael Warner, medical director of critical care at Michael Garron Hospital in Toronto, posted a video to Twitter on Saturday asking Ontario to lift jurisdictional barriers so that critical care nurses from across the country could be brought into the GTA to help.

On paper, Warner said, Ontario has roughly 2,300 ICU beds.

However, in practice, there are "far fewer" because the province doesn't have enough specially-trained ICU nurses to staff them.

"Unfortunately, the situation is going to get much worse," he said.

As of Sunday morning, SickKids Hospital now has five adult patients in its ICU with COVID-19 and the hospital's president and CEO, Dr. Ronald Cohn, said he expects up to two more adults by day's end.

"I'm afraid it will get a little bit worse before it will get better," Cohn said on CBC's Rosemary Barton Live program.

Cohn reassured listeners that SickKids has done careful modelling and that there will be "a very minimal impact on anything related to children's health care."

He said the hospital is used to treating older teenagers with respiratory issues so "from a physiological point of view it's not that huge of a difference" to care for adults.

However, Cohn said, the children's hospital has many neighbouring hospitals.

"Whenever we feel like we need help… they're just a phone call away," he said.

Critically ill patients can be moved to SickKids or to hospitals in Kingston and further afield, said Warner, but, "eventually we will run out of places to move patients because we won't have enough trained staff to care for them."

Warner urged the province "to get ahead of this," saying a scenario in which places like Halifax are offering elective surgery while the Greater Toronto Area is in triage "just can't happen."

The re-deployment of healthcare workers is "a real reality we may have to face," Cohn said, although that is not currently a concern for SickKids.

Warner's proposal is "interesting for sure," Mélanie Gauthier, president and director of the eastern region for the Canadian Association of Critical Care Nurses, told CBC News on Sunday morning.

"One of the main things that we have to understand is critical care nurses across the country are actually trained quite differently," said Gauthier, who, herself, works as a critical care nurse clinician with the Royal Victoria Hospital at the McGill University Health Centre.

"I'm not saying that it's not possible, however, there are a lot of different aspects to it that we would have to consider," she said.

ICU nurses are 'overburdened' and 'exhausted,' says association president

It's important to recognize the toll more than a year of pandemic critical care has wrought on ICU nurses across the country, Gauthier said.

While many strategies have been implemented to support them, she said the reality is that most of the responsibility for caring for critically ill patients falls to them.

"It's a lot of responsibility," Gauthier said, adding that they're feeling "overburdened" and "it has taken a toll on them."

Recognition for that work is nice, she said, but many have now gone more than a year with very little time for themselves and there is some concern about an "exodus of nurses" after the pandemic.

"A lot of them have actually left during the pandemic just because of the emotional toll and the physical exhaustion," she said.

If there was at least one thing that could help, Gauthier said it would be for the general public to continue to respect and abide by public health guidelines.

"Take it seriously," she said. "It is quite discouraging for some nurses to see large gatherings in parks, especially with nicer weather."

Percentage of ICU admissions for people aged 18-39 doubled nationwide January-March

In a statement released Sunday afternoon, Canada's Chief Public Health Officer Dr. Theresa Tam urged people that a "high degree of caution must be maintained until vaccination programs are further expanded."

The country is seeing an increase in the number of adults under the age of 60 requiring hospital treatment for COVID-19, Tam said.

In particular, she said, the number of adults between the ages of 40 to 59 who required ICU care and mechanical ventilation in March 2021 was on the rise.

People between the ages of 18 and 39 made up 15 per cent of ICU admissions that same month, Tam said, double from just 7.4 per cent two months earlier, in January.

"This is a reminder that serious illness can occur at any age," she said. "Evidence indicates that variants of concern can be associated with more severe illness and increased risk of death."

Nearly 25,000 cases involving variants of concern have been reported nationwide as of April 8, per her statement. The vast majority are B.1.1.7 variants, which originated in the U.K.

"A combination of strong and sustained community-based public health measures and strict adherence to individual precautions is crucial in order to suppress rapid epidemic growth," Tam said.

Tam urged Canadians to:

• Maintain the greatest possible distance with other people

• Wear the best-fitting mask they have

• Aim for the fewest interactions with people

• Aim to interact with the fewest number of people