As CHEO continues to struggle, Ottawa's adult hospitals brace for viral illness impact

As non-clinical Red Cross staff began working overnight shifts at CHEO this week to help with an unprecedented surge of severely ill children, adult hospitals in the city were preparing for their own tough viral seasons.

The respiratory viruses that have pushed CHEO and other children’s hospitals to the brink are also expected to strain adult hospitals. Influenza, in particular, which is both early and severe this year, is beginning to put even more pressure on both paediatric and adult health systems.

In Ottawa, adult hospitals are putting their own surge plans in place and preparing to put patients in parts of the hospitals usually used for other purposes. Having enough staff to care for patients will be a key challenge.

Influenza cases are already spiking in Ottawa and across Canada and transmission is expected to increase in coming days as more people get together indoors, unmasked, for seasonal gatherings.

In Ottawa, 28 per cent of people tested were positive for influenza, according to the most recent data from Ottawa Public Health. That compares to an average of 2.6 per cent positivity for the same week over the past three years.

Queensway Carleton Hospital has seen 32 patients over the past 30 days who were positive for influenza. Nineteen of them were admitted to hospital — four to intensive care — said Yvonne Wilson, the hospital’s vice president of patient care and chief nursing executive. The hospital’s occupancy has been over 100 per cent in recent weeks.

“That is a very early and a very severe season compared to previous years,” she said.

Based on experiences in the southern hemisphere during their winter and early indications in Ontario, it is likely to be an extremely severe year for influenza at a time when COVID-19 and other viruses are also continuing to circulate. The combination is expected to wallop hospitals that are already dealing with staff shortages, backlogs and high levels of COVID-19.

“We anticipate we are just at the start of what is going to be a very difficult season,” said Dr. Samir Sinha, director of geriatrics at Mount Sinai Hospital as well as director of health policy research and co-chair of the National Institute on Ageing.

He is among those who have been urging people — especially older Canadians — to get influenza vaccines ahead of flu season. Typically, about 70 per cent of older Canadians, and 40 per cent overall, get immunized against flu. That leaves too many people vulnerable to potential serious illness and death, he said.

“I don’t think we have done as good a job as we could have to encourage vaccination to prevent people from getting seriously ill,” Sinha said. “Now we are seeing the consequences.”

Flu typically kills 3,500 people in Canada each year, mainly older adults. Young children can also become severely ill from the flu, and die. In November, a toddler in Carleton Place died after testing positive for influenza and at least five children in British Columbia are reported to have died from influenza so far this year. Ontario’s chief coroner’s office said this week it is investigating the sudden unexpected death of a young child at a hospital in Pickering.

Sinha said older adults are also vulnerable to severe outcomes from RSV, the virus that has put so many babies and very young children in intensive care this fall.

At The Ottawa Hospital, the city’s biggest, preparations are underway for a surge in flu patients, said President and CEO Cameron Love.

That is something the hospital has experience with. It typically sees a spike of patients with influenza between December and about February. The question this year is whether adult hospitals will see something akin to what paediatric hospitals have already seen — unprecedented numbers of patients with serious respiratory illnesses.

“It is hard to predict accurately whether it will be on the same order of magnitude as what CHEO has seen,” said Love. “We are not sure.”

But TOH is getting ready. That includes moving some patients to a new off-site transitional care unit. The hospital opened one earlier at a west-end long-term care home for so-called ALC or alternate level of care patients — those who not longer require acute care but might be waiting for a long-term care bed or other supports.

The hospital has, in the past, set up beds in non-traditional spaces including the rehab gym to cope with surges. Love admits ongoing staff shortages and staff illnesses could make it a challenge.

Hospital officials across the region meet regularly and look at forecasts to understand what to expect and how to make best use of hospital beds, Love said.

Montfort Hospital has also seeing more cases of influenza than usual at this time of year and the numbers are growing, said communications director Genevieve Picard.

As of Dec. 5, 26 patients were hospitalized who had tested positive for influenza, she said.

“We are getting ready, as we always do during influenza season by enforcing best practices in infection prevention and control, offering the influenza vaccine to staff and patients and working closely with Ottawa Public Health,” she said.

“We are also preparing for increased visits to our emergency department, increased admissions in acute care and critical care services due to respiratory symptoms.”

What is causing more severe infections this year continues to be debated, but Public Health Ontario has noted that there is growing evidence COVID-19 contributes to dysregulation of the immune system.

1. 'All hands on deck' as CHEO brings in Red Cross amid respiratory viral crisis

2. Ottawa paramedics were at 'Level Zero' when call came in about 11-year-old with no vital signs