Due to an increase in the number of COVID-19 patients and staff shortages, the William Osler health system declared an internal code orange on Monday just hours after Premier Doug Ford told Ontarians to “prepare to the impact ”of the Omicron spread.
An internal code orange signals that staff will need to be redeployed throughout the hospital in the face of an external disaster.
“We are facing a natural disaster that is slowly evolving ahead of us,” said Dr. Andrew Healey, chief emergency medicine at Osler Health, which includes the Brampton Civic and Etobicoke General hospitals. “Slowly might not be the right word when it comes to Omicron. But we are seeing this wave of infections coming through our door in a different way than we have seen in previous waves of the pandemic. “
There are fewer cases of severe COVID-19 pneumonia so far, but more people are walking through the doors. Brampton Civic has been one of the hardest-hit hospitals in the province throughout the pandemic. But Osler has never called Code Orange for COVID before.
“There are no empty beds staffed (and) waiting for patients, like Zero,” Healey said. “We really can’t afford to be away right now, so we need to limit the spread as best we can.”
Osler also designated 16 patients for transfer to other hospitals in the greater Toronto area on Sunday night for the first time in this fifth wave. Ontario’s patient transfer system was needed to prevent hospitals from being overwhelmed in Wave 3. But unlike previous waves, Osler is sending patients to hospitals that are also experiencing staff shortages.
“It’s all over the system,” Healey said. “There is no one sitting around the table to say, ‘We have empty staff beds, please send us 25 patients. It just doesn’t exist.
Osler has some intensive care capacity. But, according to Healey, Etobicoke General was down by more than half of its emergency room nurses on Sunday and the Brampton Civic emergency department was short by nearly half of its nurses. It is a combination of burnout, illness, positives or exposures to COVID and the effects of two years of the pandemic on the healthcare system. Nursing ratios are being pushed to their limits.
The hospital is switching to N95 masks for staff, and visitors are offered KN95 masks instead of surgical masks. Like critical care, emergency nursing is a specialist skill, but Osler has previously hired radiology nurses, labor and delivery nurses, and mental health nurses to help him. As the pressure increases, other services are diminished. And like in many hospitals, the understaffing causes more impatience and anger on the part of patients, and has been for some time.
“We’ve been seeing this for months, actually,” Healey said. “And we try to see this with as much empathy as possible. We want people to come if they are sick. But we want them to understand that the system is really strained and that we are really doing our best. “
Last week, the Queensway Carleton Hospital in Ottawa called an internal Code Orange for similar staffing issues. And earlier in the pandemic, other hospitals have resorted to the code, including St. Michael’s which has done so at least nine times.