ERs are ‘stretched to the limit’ in N.S. thanks to Omicron at Christmas

‘Omicron came along and that’s really put things off the rails,’ says Halifax ER doctor

Jean Laroche · CBC News 

The aggressive Omicron variant that has led to a record number of COVID-19 infections in Nova Scotia is stretching already-strained emergency rooms to their limit, according to a Halifax physician on the front line.

Dr. Kirk Magee, who oversees emergency care at Halifax-area hospitals, said although the Omicron variant might not be sending more people to hospital, it is having a serious effect on the health-care system — starting with the emergency room.

“The emergency department is like a glass of red wine on a white table, linen cloth,” he said. “And when you’re close to the brim, even one more drop makes a terrible mess — and we really are close to the brim.”

The province announced one death and 678 new cases of COVID-19 on Friday. It said 48 people were in hospital, including seven in the ICU.

Dr. Kirk Magee is a Halifax emergency room physician who oversees emergency care at Halifax-area hospitals. (Nova Scotia Health)

Magee said the system is being “stretched to its limits” because of the fast-spreading virus — not because of the number of people needing hospital care, but because of the hundreds of hospital staff that have been reallocated or sidelined due to COVID-19 infection or the need to isolate.

• About 600 Nova Scotia Health employees off work due to COVID-related isolation

On Friday, more than 430 staff members were not available for work in the central zone, said Magee. That number does not include the 162 health-care workers who are off the job across the province because they did not provide proof of vaccination.

More strain on the system

“Emergency medicine is very cyclical,” said Magee, adding that emergency departments typically become especially strained around the holidays.

This year is different, he said.

“We have a health-care system that was already fairly tenuous…. Then we added on two years of COVID and then suddenly Omicron came along and that’s really put things off the rails.”

According to figures provided by the provincial health authority, nearly every acute care and intensive care unit bed in Nova Scotia that is currently staffed was occupied this past week.

Dr. Nicole Boutilier, vice-president of medicine for Nova Scotia Health, said there were 94 people waiting for admissions on Friday, but that figure was as high as 125 earlier this week.

There were 2,100 more emergency department visits across the province in December 2021 compared to December 2020, something Boutilier said reflects pressures that go beyond the current outbreak.

People will experience waits in emergency departments, but Boutilier said people who need services should keep coming and will be seen and assessed.

• Some essential services face staffing challenges as COVID-19 cases rise in Halifax

Other non-emergency units are closed due to COVID-19 outbreaks, said Magee.

“In a system that’s very fragile, taking all those beds out of the system means that patients in emerg have nowhere to go,” he said.

“It means we can’t offload patients out of the emerg, and that means that paramedics can’t offload patients into emerg, so it’s a cascading effect throughout the system.”

Care in hallways, longer waits

The result is emergency physicians handling acute care in hallways, and patients waiting sometimes for 10 to 12 hours, which Magee said “is really way outside any industry standard.”

“Really the only beds that are often available are beds for critical resuscitation and even then it’s tough,” he said.

Magee is calling on the province to find space in long-term care homes for the hundreds of people who no longer need hospital care but are in hospital beds.

He also urges Nova Scotians to only seek treatment at emergency rooms if they need urgent care.

Like everyone else, Magee said he and his colleagues are tired and frustrated by this latest wave in the pandemic, but he praised them for pushing ahead in a tough environment.

“It’s stressful because we can’t give the care that we want to give,” he said. “Our teams are people; they do this because they’re passionate about providing high-level care, and they know that the wait adversely affects our patients.”