Acute care operating at highest capacity levels ever: Sask. Health Authority

The province’s acute care system is operating at its “highest capacity levels ever,” according to Saskatchewan Health Authority (SHA) slides presented at Thursday’s physicians’ town hall.

People 70 and older have the highest COVID-19 hospitalization rate followed by those aged 30 to 39.

“We surged and are beginning to see some slows, but we are particularly busy at the non-ICU part of our acute care, particularly in our tertiary centres,” said SHA medical health officer Dr. Johnmark Opondo during the town hall.

“Some of them are at the highest capacity they’ve seen this pandemic.”

As of Mar. 2, 353 people were in hospital with COVID-19. Of those, 183 were considered incidental infections, which means the patients were hospitalized for reasons other than COVID-19.

According to the SHA slides, 71 people were receiving intensive care as of Mar. 3. Thirty of them had COVID-19.

This puts the ICU system in the yellow zone, which means it is challenged and care is impacted.

While the Saskatchewan government removed all remaining public health measures on Monday, doctors are reminding the public COVID-19 still exists.

The virus will continue to circulate for the foreseeable future as new variants emerge, according to a presentation by Dr. Denise Werker during the town hall.

Werker says it is a misconception that “viruses mutate to cause less severe disease.” She says new variants may or may not be less severe than previous ones.

According to Dr. Werker, a “relatively stable, repeating transmission pattern” could be reached in the next two to 10 years, but the transition to stability will be unpredictable.

The slides suggest there are four possible medium-term scenarios that could take place over the next 12 to 18 months, according to U.K. research.

In the best-case scenario, Omicron’s transmissibility will remain the same, while severity and immune escape will decrease. This scenario has a relatively small resurgence with low levels of disease in the fall and winter of 2022.

The worst-case scenario shows transmissibility, severity and immune escape all increase. In this scenario, a new variant emerges, resulting in a large wave with severe disease and mortality.

IMPACTS OF LONG COVID-19

According to a presentation by Dr. Johnmark Opondo, healthcare professionals needs to prepare for the additional burden that long-COVID-19 patients will have on the acute care and primary systems.

Long COVID-19 is a post-acute condition that affects 10 to 30 per cent of people have been infected with the virus.

There have been more than 100 reported symptoms linked to long COVID-19 that affect 10 different organ systems, according to a presentation from Dr. Denise Werker.

Limited data suggests a number of factors can increase the risk of long COVID-19, including: hospitalization during infection, experiencing more than five COVID-19 symptoms, pre-existing respiratory disease and other co-morbidities.

Evidence also shows long COVID-19 disproportionately affects women and young adults.

Fully vaccinated people are half as likely to experience long COVID-19 compared to those who are partially vaccinated or unvaccinated, according to data from the U.K. Vaccine effectiveness in preventing post-COVID-19 symptoms was highest in those 60 and older, and lowest in people aged 19 to 35.

It is unknown how Omicron will impact the prevalence of long COVID-19.

COVID-19-RELATED ER VISITS HIGHER FOR PRESCHOOLERS

Children under five years old are taking more trips to the emergency room from COVID-19-like illnesses than any other age group, according to data from the SHA.

The most recent data, dated Feb. 26, shows a weekly average of roughly 48 per 1,000 preschoolers visiting the ER with COVID-19-like illnesses. The rate is down from 110 per 1,000 in the previous week, but still higher than the provincial rate of 39.5 per 1,000

“It’s tough to interpret one week at a time,” said Dr. Ayisha Kurji, a pediatrician in Saskatoon.

“Unless we see consistent trends over time in terms of what’s happening in ERs or what’s happening in hospitalizations, we can’t really interpret it.”

Kids of all ages are visiting the hospital and emergency room with COVID-19 symptoms, Kurji says.

Omicron can affect children differently. Some kids experience mild upper-respiratory symptoms like sniffles, a cough and runny nose. Some may require oxygen if the virus settles in their chest and makes it difficult to breathe. Others experience gastrointestinal issues such as vomiting and diarrhea.

For the most part, Kurji says preschoolers who experience COVID-19 or COVID-19-like illnesses are doing just fine, but some do need to make the trip to the ER.

“Occasionally, they need to be admitted to the hospital just for a couple of days either because they need help, they are dehydrated or they need a bit of oxygen,” she said.

Kurji says parents should not think of their child’s symptoms as COVID-19 or not COVID-19, but rather “how they are doing overall.”

“If your child is acting differently in any way and you’re worried, the safest thing is to go get care,” she said.

Children under five years old are still ineligible to receive a COVID-19 vaccine. Kurji says it is important that everyone gets their booster dose and continues wearing masks to help protect preschoolers.

Long COVID-19 can impact kids, Kurji says, but to what extent is still unknown. She says answers will come with time.