Ontario pediatric ICUs operating above capacity, provincial data shows

Ontario's pediatric intensive care units are operating over capacity, while general hospitals are now receiving children who are healthy enough to leave ICUs, The Canadian Press has learned.

There are 122 children in pediatric ICUs as of Wednesday, up from 111 the day before, Critical Care Services Ontario's daily census shows. Only five children in ICUs have COVID-19. The province has a total of 112 intensive care beds for children.

Children's hospitals across Ontario have been overwhelmed over the past month, largely due to influenza and respiratory syncytial virus, both of which have hit a month earlier than usual.

The agency overseeing the province's health system has instructed general and community hospitals to take children who are healthy enough to leave intensive care, but still need hospitalization while they recover, said Ontario Health's chief medical director Dr. Chris Simpson.

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“As soon as they're ready to move to the next step, they move to the next step,” Simpson said.

“From a capacity point of view, that patient flow is really, really key.”

The Children's Hospital of Eastern Ontario in Ottawa has opened a second ICU to deal with an “unprecedented major surge.” It has cancelled non-urgent surgeries and redeployed staff to meet the demand. Similar situations are hitting children's hospitals in Toronto and Hamilton.

Simpson said hospitals will be using a “dimmer switch” on surgeries, rather than cancelling surgeries outright as they did during some of the worst waves of the COVID-19 pandemic.

“We want to stay away from that blunt instrument and just encourage hospitals to dial them down and dial them up as needed to accommodate these surge forces,” Simpson said.

There are some 250,000 surgeries backlogged, Simpson said. He said that's roughly the same number before the pandemic, but that people are now waiting longer to get those surgeries - about 45 per cent are waiting longer than the clinically determined benchmark.

He said they were making progress on the backlog.

“This surge is likely to slow down our progress on that front a little bit,” Simpson said. “There's just no, no avoiding that.”

Last week, Ontario Health directed general hospitals to accept patients 14 and older who need intensive care.

But CHEO has said the vast majority of its patients are five years old and younger.

Children and teens are also hitting emergency departments at a rate two-to-three times higher than usual this time of year, statistics from Acute Care Enhanced Surveillance, a real-time Ontario-wide system that monitors hospital registration records, show.

There have been an average of 1,414 children aged four and under visiting emergency departments over the last week in the province, compared to the historical seven-day average of 560 children. For those aged five to 17, there has been on average 1,210 visits to the emergency department over the last week compared with a historical average of 325 visits.

Simpson said because staffing is so tight in hospitals, the only way to deal with the surge is by redeploying staff.

“We just have to adjust those to meet the demands of the moment and that means we have to slow down some other stuff,” he said.

Ontario Health teams are meeting daily, he said.

“I think I feel much less worried than I did a couple of weeks ago because I think we have a good plan,” Simpson said. “The surge is coming, there's very little we can do about that now, it's kind of baked in and I think it's really just about preparedness.”

A spokeswoman for Minister of Health Sylvia Jones said the government is in “constant contact with our pediatric hospitals, Ontario Health, and other health system partners to alleviate critical care pressures and ensure all patients receive the care they need.”

“The Minister has spoken to the pediatric hospital CEOs in recent days and has offered the government's full support to get through this challenging time,” Hannah Jensen said.

This report by The Canadian Press was first published Nov. 10, 2022.