Hospitals in northern B.C. whose intensive care units are full began sending their COVID-19 patients to Victoria this week.
Under the province’s pandemic response plan, which includes the transfer of patients between its five health authorities, two patients from Northern Health have been transferred to the intensive care unit at Royal Jubilee Hospital.
Northern Health, which saw another 15 cases on Tuesday, has 250 active cases, with 33 people in hospital, including 13 in critical care.
The Island, with 10 new cases of COVID-19 reported on Tuesday, has almost the same number of active cases — 246 — but only seven are in hospital, four of whom are in intensive care.
“We’re doing OK and these poor people, who are probably scared out of their minds, are getting good care, and they’re getting better care here, not because we’re better, but because we have the capacity to have them,” said Dr. Omar Ahmad, department head for emergency and critical care medicine for Island Health. “We can take more if we need to.”
Royal Jubilee Hospital and Nanaimo Regional General Hospital are the Island’s primary COVID-19 ICU referral sites, while North Island Hospital – Comox Valley Campus is a COVID-19 site for patients who don’t require critical care.
While some worry transferring patients from other health regions could spread the virus in our hospitals and leave less critical-care space for Islanders, Ahmad said much planning and “extreme precautions” go into the transfers, and discussions about bed capacity and patient numbers occur daily among those in charge of the Island’s ICUs, and between health authorities.
“We have to be cognizant of taking care of our patients, so we very carefully and judiciously look at the numbers and make these judgment calls,” he said, adding a strong contingency plan is in place in the event of a surge in Island patients.
“At the end of the day, we are in a global pandemic. So if we can help, I don’t see how ethically, you can say no.”
The bulk of the care falls to “incredible” nurses, and to respiratory therapists, because COVID-19 patients are labour-intensive, Ahmad said. Nurses were one of many groups included in the decision making to accept the COVID patients in Victoria, he said.
Dr. David Forrest, an infectious disease and critical-care physician at Nanaimo Regional General Hospital, said it’s not only the right thing to do, but a provincial obligation to transfer patients who need critical care if there are inadequate resources in one area.
“And I think that Northern Health would be in the same position of assisting us if we were overwhelmed.”
A Nanaimo physician who divides his time between Nanaimo and Terrace is admitting COVID-19 patients on a daily basis to the small rural hospital in Terrace, “and they are swamped,” said Forrest. Even the large hospital in Prince George is busy, he said.
It’s not ideal to move patients hundreds of kilometers between health authorities, and “taking them away from their families and so on is awful, but the reality is that they need for their care and I think it’s absolutely the right thing to do,” said Forrest.
Nanaimo, which currently has one COVID patient in its ICU, has not yet received COVID patients from other health authorities, but it does have the capacity, said Forrest.
One concern is that Royal Jubilee and Victoria General hospitals are the Island centres for specialties such as neurosurgery and thoracic surgery that can’t be done elsewhere on the Island, making Nanaimo a better fit for some of the COVID patients, Forrest said.
The Island Health region has 96 ICU beds and 140 ventilators, including 22 transport ventilators.
Ahmad said having extra COVID patients in Island Health facilities allows medical staff to gain experience working with such patients so they’re better prepared for Island patients.
Patients with other conditions and critical needs are regularly transferred to Victoria hospitals for a variety of reasons, including lack of capacity elsewhere or even weather issues that don’t permit landing in other centres.
The province reported 656 new cases of COVID-19 in B.C. on Tuesday, for 8,796 active cases. Of those, 336 people are hospitalized, including 76 in intensive-care units around the province.
The hot spot on the Island is the central region — of 246 active cases on the Island, 146 are in the central region — but “the guys in Northern Health are in a bit of a pickle,” said Forrest.