Rural hospitals see changes as COVID-19 plans continue

Some hospitals in rural Saskatchewan are already making changes as the province prepares for more COVID-19 infections.

The Saskatchewan Health Authority released its modeling data today, including how its facilities will handle an increasing number of positive cases.

The models are what-if scenarios, not predictions, officials cautioned, and continued compliance with physical distancing and isolation measures are key to preventing the worst case from happening.

The models suggest between 153,000 and 408,000 people could be affected by COVID-19, with deaths ranging from 3,075 to 8,370.

The models use three different scenarios based on different rates of spread.

In one scenario, using early Canadian high estimates, the model shows 4,256 COVID-19 patients in acute care simultaneously. Of those hospitalized, 1,280 would be in ICU and between 90 and 95 percent of them would require ventilation.

A second scenario, dubbed the low Italy range, would see 1,265 patients in acute cure at the same time, with 380 in ICU and the same percentage requiring ventilation.

The third scenario, called the Wuhan, Imperial Model, estimates a peak of 390 COVID-19 patients in acute care at one time. Of those, 120 would be in ICU and 90 to 95 percent of them needing ventilation.

The SHA has increased access to testing by creating 38 sites around the province and tripling staff available for contact tracing efforts.

The plan calls for up to 57 percent more acute care capacity to be phased in as needed as hospitalization rates increase. This would include field hospitals in Saskatoon and Regina and other places if required.

As of April 5, 43 percent of the province’s acute care beds were available for use due to the previous slow-down of non-essential procedures and services.

The SHA said 20 out of its 65 hospitals would designated for COVID-19 if required.

“We wanted to be transparent with the plan going forward so the public is aware of the escalated measures we will put into place if needed, but it is critical to remember that many of the changes proposed in this plan will be implemented only in response to anticipated surges in patient demand that start to exceed our capacity,” said Scott Livingstone, chief executive officer of the SHA. “Changes like conversion to COVID-19 dedicated hospitals will only occur where it is absolutely required to ensure safety and maintain access for patients who need our care.”

In the Integrated Rural Health region, which includes the area south of Saskatoon, a dozen hospitals will be temporarily converted to “alternate level of care” patients. They will accept patients from tertiary and regional hospitals to create capacity in the former.

As well, these facilities will lose their emergency department services while staff are deployed to other places.

The SHA said this will occur over the next four to six weeks in Biggar, Kerrobert, Leader, Herbert, Davidson, Lanigan, Preeceville, Broadview, Wolseley, Arcola, Oxbow and Radville.

Changes at other hospitals and health-care centres will be phased in as needed. Some will be designated for COVID-19 patients only, while others will have only non-COVID patients. Primary care services would also be reduced in some communities.

Rural areas north of Saskatoon fall into the Integrated Northern Region, where facilities will be designated either for all patients or only non-COVID patients.

As of April 8, Saskatchewan reported a total of 271 cases. Of those, 165 are considered active as others have recovered and three have died.

There are eight people in hospitals: six are in acute care and two are in intensive care.

The Saskatoon area has 135 cases, while 56 are in Regina area, 51 are in the north, 15 in the south, 10 from the central region and four in the far north.

Twenty-six of the cases are health-care workers but the health ministry said the source of infection is not necessarily related to health care in all 26.

The source of 199 cases is travel, followed by 90 from community contact including mass gatherings, 16 with no known exposure and 46 still under investigation by public health officials.

Fifteen of the cases are in people 19 years old and under.


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