CHEO patient volumes reach 'unprecedented' levels as influenza B surges

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CHEO patient volumes have reached “unprecedented levels” as the hospital’s emergency department struggles to cope with a sustained influx of flu patients.

The Children’s Hospital of Eastern Ontario saw 7,200 patients in January — more than in any month of the H1N1 flu outbreak that badly stressed the health care system in the winter of 2009.

Patient volumes at CHEO continued at peak levels in February as preliminary estimates show the emergency department handled another 7,000 patients. Children with minor ailments have waited up to eight hours to be treated.

“We’re at peak season staffing, but despite that we’re overwhelmed,” CHEO’s chief of emergency medicine, Dr. Gina Neto, said in an interview Wednesday. “And I get the sense that we’re not the only hospital that’s overwhelmed.”

Last week, the Queensway Carleton Hospital declared a “Code Orange” — a rarely used protocol put in place when its 264 beds are filled and its surge capacity exhausted.

Communications director Ann Fuller said the hospital ended its Code Orange on Tuesday after cancelling eight surgeries to make beds available for emergency department patients. The hospital, she said, had 12 more emergency patients waiting for beds Wednesday.

A spokeswoman for The Ottawa Hospital said it has experienced a 10 per cent increase in emergency visits during the first two months of the year compared to the same period last year.

At Montfort Hospital, emergency visits have peaked during the past two weeks with record high numbers. Often, more than 200 patients a day have been treated in the emergency department — 30 per cent more than during an average day in February.

Communications director Geneviève Picard said patients who need hospitalization will have to wait for a bed since the Montfort is at full capacity.

The Montfort has also experienced a flu outbreak at one of its medical units, making it one of 18 ongoing outbreaks in the city’s long-term care homes, retirement residences and hospitals, according to Ottawa Public Health’s most recent surveillance report.

The city has reported 704 lab-confirmed cases of influenza this season. The agency said 25 deaths have been tied to the flu, the vast majority (22) of them among the city’s senior population. The others involved people with underlying health conditions.

The surveillance report also noted that the city is experiencing an unusually early and strong wave of influenza B as compared to previous years.

The Public Health Agency of Canada, in its latest flu watch report, said that flu activity remains at “peak levels” with influenza B now the dominant strain in circulation.

This year’s flu vaccine, although generally ineffective against influenza A, has proven to be 40 to 50 per cent effective against influenza B, said CHEO’s Neto. “But it appears to me there was a very low vaccination rate for influenza,” she said. “When I ask parents if their child has been vaccinated for influenza, overwhelmingly I hear, ‘No.’ We’re mostly seeing influenza B so there definitely would have been a protective effect with the vaccine.”

CHEO’s emergency department is now treating 250 to 300 patients a day. Patient volumes peak in the late morning (9-11 a.m.) and evening (5-9 p.m.) when the overflow sometimes has to be accommodated in one of the clinics.

“We have staffed to the maximum of our ability but we actually don’t have the physical space to see the number of patients that we’re seeing every day,” said Neto. “The goal is to see most patients within three hours, but we’ve had patients waiting for more than eight hours — that’s not at all normal for us.”

Almost half of the visits to CHEO’s emergency department, she said, involve medical conditions that could be safely treated by a family doctor or at a walk-in clinic. The hospital has published online guidelines to help parents decide whether a visit to the hospital emergency department is required.

CHEO’s single month record for most emergency visits came in December 2014 when 7,248 patients were treated during another dramatic flu outbreak. This January was the second busiest month in the hospital’s history.

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