Ontario will transfer hospital patients without consent as COVID-19 cases surge

Patients in Ontario hospitals struggling with unprecedented COVID-19 admissions can now be transferred to other hospitals without consent as the Omicron surge comes to a head, the Star has learned.

A directive signed Friday by chief medical officer Dr. Kieran Moore clears the way for the practice, which has not seen since the pandemic’s third wave last spring when intensive care units rapidly filled, leading to 2,000 critically ill patients being transferred to other cities and away from their families.

“It’s sending a very strong message to the system that the functional integrity of the health-care system is in danger,” said Dr. Chris Simpson, a cardiologist at Kingston General Hospital and executive vice-president of Ontario Health, a provincial agency overseeing health care.

“Without a specific intervention, the health-care system might not be there for somebody who really needs it,” he added, citing situations such as stroke, heart attack and trauma patients needing immediate attention.

In a memo sent to hospitals Friday afternoon and obtained by the Star, Moore said the directive is necessary to “maintain health care for as many patients as possible.”

“Increased hospitalizations are expected throughout January,” the chief medical officer warned in the directive, noting the problem is compounded by nurses, doctors and other staff sick with COVID-19 or isolating at home.

Moore’s move came with the province reporting record hospitalizations for the eighth day in a row. Another 184 COVID-19 patients have been admitted, pushing the total to 3,814 — well above last April’s record high around 2,300 patients.

Unlike the tense situation when intensive care units were pushed to the breaking point last April, this time patients on hospital wards — not just the sickest patients in ICU — could find themselves being transferred to less crowded hospitals with better ability to care for them.

“Whether the biggest challenge is the wards or ICU will become clear in the next seven to 10 days,” said Dr. Peter Jüni, scientific director of the science table of experts advising Moore and Premier Doug Ford.

“We might have a problem at both.”

Simpson said ICU capacity seems “just fine for the moment” but cautioned that can change quickly. There were 527 COVID-19 patients in intensive care Friday, an increase of 27 from the previous day, and 517 beds still available despite another 1,337 adults in ICU for other illnesses and injuries.

“The crunch is going to be at the ward level,” he predicted.

It’s difficult to forecast which hospitals are more likely to have to transfer patients elsewhere, Simpson added.

“It changes a lot day-to-day who is busiest. This time we’ve got Omicron on the rise in every public health unit. There’s no hospital that’s not experiencing difficulty.”

To date, the Trillium hospital system in Mississauga, the William Osler system serving Brampton and north Etobicoke, and Scarborough Health Network are “particularly hard hit,” Simpson said.

Dozens of patients have already been transferred recently between hospitals, such as from Chatham to London.

While transfers can be made without consent, doctors typically consult with patients and their families, Simpson said.

Decisions on which patients to transfer will be made by doctors locally with guidance from the government’s health care incident management structure, which keeps an eye on the big picture at hospitals across the province to maximize capacity for care.

“Most reasonable people understand this may have to be done for the good of the system,” said Simpson. “Nobody likes to be transferred.”

Transfers can be by ground or air, depending on the circumstances and distance. Transferring ward patients is generally less complicated than ICU patients because their burden of illness is lower.


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