TORONTO -- There are now more COVID-19 patients in Ontario’s intensive care units than at any other point during the pandemic as concerns continue to mount around the health-care system’s ability to withstand the strain.

The latest Critical Care Services Ontario report obtained by CP24 suggests that there were 285 COVID-19 patients in intensive care as of Dec. 21, exceeding the first wave peak of 283 for the first time.

Nearly 40 per cent of all COVID-19 patients being treated in intensive care as of Dec. 21 were located in the Central health region, which covers a wide swath of territory that includes hospitals in Peel, Halton and York regions. Another 64 of the COVID patients in the ICU were in Toronto hospitals, including 21 at Toronto General Hospital and 11 at Sunnybrook Health Sciences Centre.

Meanwhile, some of the hardest-hit hospitals continue to be in Peel Region, where there have been reports of elective surgeries and procedures being cancelled for weeks now.

At the Brampton Civic Hospital, nearly half of all patients being cared for in the ICU on Dec. 21 – 17 out of 37 - had been diagnosed with COVID-19. A similar situation was also reported at Mississauga’s Credit Valley Hospital where 16 out of 35 ICU patients had COVID-19.

There does appear to be some additional capacity in terms of ICU beds with the report suggesting that more than 400 remain available province-wide but medical professionals have argued that there are simply not enough doctors and nurses to staff those beds.

“Only 15 per cent of the work that we do is elective and 85 per cent of the stuff that comes to our door we can’t alter. That is traumas, cardiac surgery, cancer surgery, transplants and we can’t cancel those,” Dr. Michael Warner, the medical director of critical care at Michael Garron Hospital, told CP24 on Tuesday morning. “So our ability to flex up is limited primarily by the number of highly trained nurses we have and those nurses are in critically short supply right now. We have to get this thing under control.”

The latest numbers suggest that an additional 32 COVID-19 patients were admitted to intensive care over the last 24 hours, which is among the biggest single-day jumps to take place during the second wave.

Warner, whose hospital is currently treating eight COVID patients in its ICU, said that he is very concerned that the “upward trajectory will continue” and that we will soon find ourselves in a situation in which we have to “ration care.”

He said that burnout among doctors and nurses is also a concern after months of working under incredibly difficult circumstances.

“Many nurses and other frontline staff have been told that their Christmas or holiday vacation will have to be deferred, the patients in hospital will generally be alone and most of the patients with COVID-19 who die will die alone because their families are case contacts, which means they have to quarantine themselves. That means dying on Zoom, which is horrifying, and definitely takes a lot out of the health-care workers who are holding the patient’s hand at the end as well,” he said.

Some hospitals have more critical care patients than beds

About 80 per cent of all critical care beds were filled by patients on Dec. 21 but the situation in hospitals in hard-hit areas of the province was more dire.

At Credit Valley Hospital there were 35 people in intensive care despite there being only 29 beds, suggesting that some patients were being treated in alternative locations.

The same was also true at Mackenzie Health in Richmond Hill, which listed 41 patients in intensive care and 38 beds.

Meanwhile, every single one of the 23 critical care beds at North York General Hospital was filled.

“The hospital system is being overwhelmed,” infectious disease specialist Dr. Issac Bogoch said during an interview with CP24 on Tuesday morning. “It is a very, very difficult setting and the longer you carry on with the status quo, the more challenging it is going to be and the harder it is going to be to turn the ship around.”

The total number of COVID-19 patients in Ontario hospitals as of Dec. 21 was 1,005.

The first wave peak was 1,043 on May 4.