As the sixth wave of COVID-19 in Canada continues, hospitals caring for the youngest patients in the country face both large numbers of patients and high levels of hospital staff.
At this time of year, the Eastern Ontario Children’s Hospital (CHEO) in Ottawa typically accepts up to 150 patients each day in its emergency department, but recently there may be twice as many, with hours of waiting.
Tammy DeGiovanni, senior vice president of clinical services and CHEO’s chief nurse, said about two-thirds of these children come with COVID symptoms.
The hospital has also been forced to cancel some operations.
“The double blow for us is that we also have a lot of staff, medical staff and volunteers who have also left because of symptoms of COVID or COVID in the household,” DeGiovanni said.
She said that every day lately, approximately 10 to 15 percent of the hospital’s workforce has been out of work – with each staff member taking 10 days to recover.
“This is putting extra pressure on the system right now, unlike previous waves,” she said.
According to hospital records, CHEO’s one-day record for the number of staff, medical staff, students and volunteers barred from entering for COVID-related reasons was 199 in early January – just as the initial Omicron wave intensified after the holiday season.
The next highest day was April 11, at 191, with the facility still experiencing a large daily shortage of staff.
Children with COVID, other diseases
In Saskatchewan, health facilities are also coping with an increase in sick children, along with record-breaking general hospitalizations, provincial data on Wednesday showed a new all-time record of 417 people in hospital with COVID-19.
“There’s just a huge increase in the number of children coming in with upper respiratory illnesses and related complications. Many of them, you guessed it, have COVID,” said Dr. Alexander Wong of the Saskatchewan Health Authority.
Esther Shea Berman, 10, receives a dose of COVID-19 vaccine at a clinic in Toronto on November 25, 2021 (Evan Mitsui / CBC)
“This creates a lot of pressure from the emergency care, in terms of hospitalizations, as well as admission to the intensive care unit, as well as the emergency department.
Data from BC Children’s Hospital in Vancouver show a combination of COVID-19 and other respiratory illnesses that have occurred in young patients in recent months.
In February, 76 children tested positive for COVID-19 in the hospital’s emergency department, while another 29 tested positive for other respiratory illnesses. The following month, this ratio changed, with 37 children having COVID-19 and 72 having other respiratory illnesses, including one case of influenza. (The hospital did not provide data for April.)
Healthcare workers in children’s hospitals, as well as their adult counterparts, are “similarly affected by the spread of disease in their communities,” said Dr. Srinivas Murty, a pediatric critical care physician and infectious disease specialist at BC Children’s Hospital.
At McMaster Children’s Hospital in Hamilton, Ont., The number of pediatric patients admitted to COVID remained low and relatively stable in the fifth and sixth waves, a hospital spokesman told CBC News.
However, the number of children coming to the hospital’s emergency department with respiratory symptoms – some of which are COVID-related – is very high. The spokesman said that combined with the pressure on staff, the system was “very challenging”.
Visits back to pre-pandemic levels
The situation is similar in one of the largest youth health centers in Canada, the Hospital for Sick Children in Toronto (also known as SickKids).
The entire hospital is under pressure, in part because approximately 10 to 30 percent of staff are not ill each day during the two waves of Omicron, said Dr. Jason Fisher, head of SickKids’ emergency medicine department.
Hospitalizations and admissions to the intensive care unit remain high in Ontariojust as the number of patients coming to the SickKids emergency department is expected to return to pre-pandemic levels, hospital data show.
In April 2019, there were more than 7,000 emergency visits to the hospital, but this number decreased in April 2020, in the first days of the pandemic, when many health facilities experienced a significant decline in visits.
Dr. Jason Fisher, head of SickKids’ emergency department, says the entire hospital is “under pressure,” in part because approximately 10 to 30 percent of staff are not sick each day during the two waves of Omicron. (SickKids / Delivered)
The total number reached about 4,400 in April 2021, and nearly 4,000 young patients appeared in the first half of April this year – an average of 222 visits per day, about the same as before the pandemic.
Despite these volumes, Fischer said it was crucial for COVID-19 employees to stay home for 10 days.
“We see a lot of children between the ages of 0 and 5 who are not immunized, so we are particularly conservative in ensuring that no one comes to work sick,” he said.
Low vaccination rate among children
Vaccination rates remain low among young people across Canada. Recent country-wide data show that only 40% of children aged 5 to 11 are fully vaccinated, while younger children do not yet have access to an approved vaccine.
Because millions of children are still vulnerable to infections – while hospitals are under pressure – some parents are wondering what is the best approach if their child does catch COVID-19.
Nicole Rajakovic, a mother of two from Toronto, has faced this dilemma in the past month. Her whole family fell ill, and her five-year-old son first showed symptoms in late March. At the time, she said, he had only had one dose of the vaccine, while the rest of the family had been fully vaccinated.
“He had a really serious bout of coughing, which included not being able to breathe, and that was the worst time for us,” she recalls. “Shall we call 911?”
Nicole Rajakovic, right, and her family all caught COVID-19 this year, one by one, starting with her five-year-old son. (Courtesy of Nicole Rajakovic)
Rajakovic took care of her son at home, and he has since recovered from his illness. But she said it was a difficult decision.
“Where we usually go to the doctor or the emergency room, we no longer make these decisions because we know they are understaffed and we know they are exhausted.”
Fisher of SickKids agreed that health workers are often blocked from working long hours while families face long waits for care.
However, he stressed that if parents are worried about their child’s symptoms, they should still take him to the emergency department, emergency care center or use virtual care options.
According to the Canadian Pediatric Society, mild symptoms do not require hospital travel, but parents should seek medical attention if their child is not drinking well, has a fever, has trouble breathing, or if their symptoms persist or worsen.
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