'Absolutely shocking': Saskatchewan considers next stage of triage amid COVID crisis

·3 min read

REGINA — The Saskatchewan Health Authority said Friday it may activate the next stage of its triage plan, as COVID-19 hospitalizations continue to overwhelm the health-care system.

Derek Miller, the authority's chief of emergency operations, said a committee made up of doctors and ethicists is set to prepare a formal recommendation to move to the second stage of triage.

The province has been operating under the first stage for several months, which has involved cancelling surgeries to free up bed space and health-care workers to focus on COVID cases.

The second stage involves doctors consulting with ethicists about who and who does not get life-saving care.

"It's absolutely shocking, and there's no other way to describe the direction Saskatchewan is headed," Dr. Katharine Smart, president of the Canadian Medical Association, said from her home in Whitehorse, Yukon.

Officials from the province's emergency operations centre wouldn't comment about when triage could start.

Data from the health authority for this month shows Saskatchewan had the most residents in intensive care units per capita than any other province at any point in the pandemic.

Earlier this week, the province released modelling that shows hospitalizations are likely to increase until December, unless restrictions are reintroduced, and health care might not return to sustainable levels until March.

On Friday, there were 308 COVID-19 patients in Saskatchewan hospitals, with 80 of them in intensive care. There were 3,135 active infections.

"The reason why we continue to struggle, and why our ICUs are not going to get relief in a sustainable way is because we don't have additional public health measures in place," said Dr. Alexander Wong, an infectious disease physician in Regina.

"Until those public health measures are going to be put into place, unfortunately, this is just going to drag on and on."

A spokesman for the Saskatchewan Party government said no further measures are being considered at this time.

The province has a mask mandate and proof-of-vaccine or negative test policy for theatres, event and entertainment venues, restaurants, bars and nightclubs.

However, Dr. Saqib Shahab, the province's chief medical health officer, said those measures don't go far enough.

"What I'm recommending, and the government needs to look at that — apply (vaccine policy) to all settings," including places of worship and other gatherings, Shahab said.

Shahab said vaccines are not enough to have an effect on the province's fourth wave, and more measures are needed to reduce transmission and hospitalizations.

"What we are seeing is something we have never seen before and that is ... cases are popping up in almost every small community of Saskatchewan," he said.

The federal government is expected to send health-care workers to Saskatchewan next week and the province has already transferred some COVID-19 patients to Ontario.

Wong said it makes no sense that Saskatchewan is flying patients out of its jurisdiction while not imposing gathering limits.

Smart added health-care workers in Saskatchewan are burned out, and that will have long-lasting impacts on the system.

She said she worries about their moral injuries — the psychological distress of having to choose who lives and dies during triage.

"Doctors in Saskatchewan have been warning about this since August. This is not news, this did not sneak up on anybody," Smart said.

"They're dealing with this level of hubris that's difficult to comprehend ... particularly when your job as a leader is to keep people safe, and protect the population.

"For some reason, the Sask Party (government) has completely abdicated from that responsibility."

This report by The Canadian Press was first published Oct. 22, 2021.

Mickey Djuric, The Canadian Press

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