Patient transfers between Ontario hospitals are increasing as the number of people with COVID-19 in ICUs reached a pandemic record of 790 Tuesday, with 566 requiring ventilators.

Ornge, Ontario’s air ambulance and medical transport service, and local paramedics have transported 570 patients so far in April to create ICU capacity, including 243 since April 14. That’s a 135 per cent increase from March when 242 patients were transported.

“We are now seeing ‘critical care hopscotch,’” wrote Dr. Michael Warner, medical director of critical care at Michael Garron Hospital, on Twitter. “This is very concerning. Options are running out.”

Hospitals are scrambling to create more ICU beds by cancelling elective surgeries, adding field hospitals and tents and accommodating adults in pediatric care facilities.

The province recently issued an emergency order allowing hospitals “at significant and immediate risk of becoming overwhelmed” to transfer patients without their consent to free up space in ICUs — the first time such an order has been issued in the pandemic.

The vast majority of patients are sent from overburdened hospitals in the Greater Toronto and Hamilton Area, and while most people are transferred to hospitals within the area, as ICUs fill up more and more patients are being sent to cities as far as Kingston, London and Ottawa. As of April 20, 66 patients have been transferred to Kingston General Hospital since January, 31 of which occurred in the past seven days. Fifty-seven patients have been transferred to London hospitals, and nine to Ottawa.

Ornge critical care paramedics are now working with York Region Paramedic Services to operate a multi-patient transport unit that can carry up to three critically ill patients at once. The bus’s first trip will be to Kingston on Wednesday, said Joshua McNamara, Public Relations Officer at Ornge. For privacy reasons, Ornge did not disclose which hospital the patients are being transferred from. Ornge has also added three more ambulances to its fleet of helicopters and ground transport vehicles due to increasing demand.

A Frontenac Paramedics crew completed its first round trip to the GTA Tuesday to pick up COVID-19 patients to be transferred to Kingston Health Sciences. Kingston is also off-loading patients to neighbouring Brockville and Belleville to help manage capacity.

Modelling released Friday by Ontario’s COVID-19 Science Table predicts the number of patients in ICUs will exceed 1,000 by the end of April, regardless of public health measures. The table’s co-chair Adalsteinn Brown said while stronger public health measures and more vaccines will help flatten the curve eventually, the ICU numbers are “baked in” for the next two weeks.

Even with “strong” public health measures and a six-week stay-at-home order, the number of COVID-ICU patients will reach 1,500 by mid-May. Weaker measures and a four-week stay-at-home order would push that number to 2,000, at which point Ontario may have to triage patients and decide who gets life-saving care, Brown said.



Lex Harvey is a Toronto-based newsletter producer for the Star and author of the First Up newsletter. Follow her on Twitter: @lexharvs

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