As third-wave COVID-19 hospitalizations steadily rise, keeping intensive-care units properly staffed is becoming a major challenge.
As of midnight Tuesday, there were 108 patients in Manitoba ICUs, 47 of them infected with the virus. Most are in their 40s and 50s and from the Winnipeg health region.
Shared Health provided the ICU figures in response to a Free Press request the same day 16 doctors — all of them medical leads in the province — released an open letter on Shared Health letterhead, pleading with Manitobans to follow public-health rules for a while longer "on behalf of your exhausted health system."
Before the pandemic began in spring 2020, there were 72 ICU beds in Manitoba. The province has increased the number, which it has not made public, but Shared Health said there is space to open 173 beds.
It is clear that ICUs are approaching maximum capacity, and more medical staff are needed to look after the growing patient load.
Nurses are tired and morale is fragile as they patient volumes get closer to what they were at the height of the second wave last fall, one Winnipeg ICU nurse who has been working throughout the pandemic said Tuesday, requesting anonymity for fear of repercussions on the job.
When asked for the province's contingency plans to increase staffing and deal with full ICUs in this third wave, a Shared Health spokesperson said an update is expected to be announced next week on plans released in November.
Manitoba doctors write open letter, warn of overloaded health-care systemClick to Expand
Posted: 10:04 AM May. 5, 2021
WINNIPEG - Some of Manitoba's top doctors have written an open letter that pleads with the public to obey COVID-19 public health orders to prevent hospitals from being overwhelmed.
"Our health system cannot manage the potential volume of what is coming our way if we do not do everything possible to limit the spread of this virus," reads the letter signed by the provincial medical leads of 16 specialties, including primary care, surgery and cardiac sciences.
Those plans relied on team-based care, rounding up all critical-care trained staff in Manitoba, issue a callout to bring back retired nurses and enlist the help of thousands of health-care students, if needed.
Not long after, ICU nurses were being forced to carry double or triple their usual patient loads. The November plans noted "the limiting factor in any pandemic plan will be human resources."
The Manitoba Nurses' Union has been raising the alarm about higher vacancy rates in front-line critical-care positions as more ICU and emergency nurses retire, quit or look for less-stressful work in the field. In critical-care units at Health Sciences Centre, Grace Hospital and St. Boniface Hospital, nursing vacancy rates are between 11 to 16 per cent — higher at HSC, where more positions were added at the end of March.
Staffing is more of a concern than space, Winnipeg Regional Health Authority attending ICU physician Dr. Anand Kumar said.
"I doubt we can staff up to the number that we staffed up to before. I'm confident that we can't, at least not with the same level of care. We've had too much attrition in the nursing corps," Kumar said.
ICU hospitalizations are considered a lagging indicator — by the time they're noticeably rising, it's too late to be proactive, he said.
"We've already missed the window to substantially blunt this wave," he said. "It's going to get bad. Whether it breaks the ICU or not is the question, and I don't know what the answer to that is."
Manitoba's Official Opposition is calling on the province to publicly release its pandemic planning and forecasting as hospital admissions increase.
NDP health critic Uzoma Asagwara said members of the party had a "helpful" briefing from chief provincial public health officer Dr. Brent Roussin six months ago, but haven't seen any third-wave contingency plans.
If all Manitobans could see the plans, it would help them trust the need for public-health restrictions, Asagwara said Tuesday.
"What we're asking for here in Manitoba is for the government to catch up to other jurisdictions and to be transparent with that information."
During the peak of Manitoba's second-wave hospitalizations in early December, more than 350 COVID-19 patients were in hospital and more than 50 were in ICUs. The number of total ICU patients peaked at 129 Dec. 10.
There are no ICUs outside of Winnipeg or Brandon. Health Sciences Centre in Winnipeg has the largest share of the province's ICU beds, with space for about 30.
On Tuesday, 291 new cases of COVID-19 were announced and five-day test-positivity rates were 9.2 per cent in Winnipeg and 8.5 per cent provincewide.
— With files from Carol Sanders
Katie May reports on courts, crime and justice for the Free Press.