The majority of Quebec hospitals are so strapped for COVID-19 beds that soon administrators will start having to make difficult decisions, warned Dr. Lucie Opatrny in a news conference on Monday.
Opatrny, Quebec's top hospital official, said that with elective surgeries already being delayed, things like colonoscopies, kidney transplants and hip replacements might be the next things to fall by the wayside.
"The choice of activities to be dropped, which is made by expert groups, is more and more difficult to do," said Opatrny, the associate deputy health minister who drafted the province's plan for prioritizing hospital activities in situations where they are stretched beyond capacity.
While Quebec's health network isn't at the point of having to choose which patients will get intensive care and which won't, Opatrny said the protocol does exist and what was "considered to be only hypothetical a few months ago" could become a reality if the numbers keep spiking.
Joining Premier François Legault, Public Health Director Dr. Horacio Arruda and Health Minister Christian Dubé, Opatrny added her voice to the government's plea that people, especially those aged 65 and older, respect the rules in order to reduce transmission of the virus.
She said that the situation is "critical pretty much in the entire Greater Montreal network," and that sending patients or staff from one hospital to another is no longer helping, as all facilities are facing the same issues.
Opatrny added that staffing shortages due to health workers being sick or pulled to work in CHSLDs and COVID-19 testing centres have made the capacity issues that much worse.
In discussing the limitations on capacity, Opatrny explained that it's more a matter of personnel than actual space in hospital rooms.
"We don't mean physical beds, we don't mean physical ventilators, we mean staffed beds," she said.
In an effort to help add hands to the frontline, Dubé said that the province is extending its offer to nursing students, inviting them to start working before their studies are complete.
"Each extra nurse who can come and help us right now would be welcome," he said.
The Health Ministry says nearly 8,000 health workers are currently absent because of COVID-19 — either because they are infected or in isolation because of exposure.
That number climbed around five per cent in a week, but is still shy of the more than 11,000 who were out of action in May during the first wave.
Watch: understanding the government's latest rules and restrictions
As of Monday, slightly more than three-quarters of regular hospital beds are full, and 63.7 per cent of intensive care beds are occupied across the province, according to the Health Ministry.
In Montreal, regular bed occupancy climbed to 77 per cent from 73.2 per cent last week. Montreal's intensive care situation is more precarious than that of the province as a whole, with 68.5 per cent of beds in use, up from 66 per cent last week.
Opatrny said that in the Greater Montreal region, "the number of hospitalizations has almost doubled since December."
Recent days have seen patients being moved across regions and between hospitals to relieve pressure and some hospitals are adding restrictions to address their current situations.
Radio-Canada has learned that a lack of intensive care beds for severe cases of COVID-19 has resulted in patients being shuffled across the map: from western Montérégie to Sherbrooke; from Laval to the Laurentians and Lanaudière; and from Longueuil to Saint-Hyacinthe.
(The regional public health authority for western Montérégie, the CISSS de la Montérégie-Ouest, noted that transfers can take place for reasons other than capacity issues.)
On Saturday, the Anna-Laberge hospital in Châteauguay and the Suroît hospital in Valleyfield, which are part of the CISSS de la Montérégie-Ouest, announced a ban on visits until further notice, with some exceptions, mainly for end-of-life situations. The emergency room occupancy rate of these hospitals is 141 per cent.
The ban is a result of several factors, the CISSS said in an email: the increase in COVID-19 cases within the population, sustained transmission in the community, outbreaks in some hospital units as well as high occupancy rates.
During the news conference on Monday, Legault urged Quebecers aged 65 and over to take extra care, reminding them that this age group accounts for 80 per cent of hospitalizations and 95 per cent of deaths.
He added that the province's new curfew measure are aimed at reaching this population, by cracking down on private gatherings.
"Most of these people, they don't work and they aren't in school. They are at home," said Legault.
Speaking directly to Quebecers, he begged them to buckle down now more than ever.
"We're in the last miles of our marathon, now is not the time to give up," he said.
Health institute warned of coming problems
On Jan. 7, Quebec's provincial health institute, known by its French acronym INESSS, warned of a potential increase in bed occupancy, and said the risk of exceeding dedicated capacity "within the next three weeks" was more than 50 per cent.
INESSS projections are based on data collected up to Jan. 3 and do not consider hospitalizations observed since that date.
In the Greater Montreal region, nearly three-quarters of regular beds and two-thirds of designated intensive care beds are already occupied. Elsewhere in Quebec, nearly 60 per cent of regular beds and 30 per cent of intensive care beds designated for COVID-19 patients are still occupied.