Plan to expand hospital capacity could triple ICU beds in case of COVID-19 patient surge

Manitoba health leaders have a plan to more than triple the number of critical care beds in the province should a surge of COVID-19 patients stretch hospital capacity.

The plan involves shuffling around staff and bringing in potentially thousands of students and other specialized health workers.

Health officials have mapped out space within hospitals that could be converted into intensive care units, expanding the number of intensive care unit beds from 72 currently to potentially 245. 

Those beds would be spread throughout hospitals in Winnipeg and at the Brandon Medical Centre.

Officials have also identified space where more than 1,000 medical beds for COVID-19 patients could be added.

The number of patients with COVID-19 has more than tripled in the last two weeks, pushing capacity to the brink. As of Friday, there were 161 people in hospital with the virus, 20 of those in intensive care.

Details of the plan were shared with members of the media in a technical briefing Friday morning.

Doctors raise concerns

Dr. Anand Kumar says he is concerned about a ‘bottleneck’ in staffing, and worries the surge capacity plan doesn’t address this well enough. (John Woods/The Canadian Press)

The Friday briefing came after two high-profile letters signed by Manitoba doctors called on the province to tighten restrictions and prevent the spread of COVID-19.

Dr. Anand Kumar, a Winnipeg intensive care doctor who wrote one of the letters and signed the other, said he still has concerns about the province’s response and plan for hospital staffing.

“The primary bottleneck will be manpower and health-care workers, nurses, respiratory technicians, maybe even physicians. And that, I don’t think has been adequately addressed,” he said.

Doctors, including Kumar, received a separate virtual briefing from officials about the health-care plan on Thursday evening. Neither Premier Brian Pallister nor Health Minister Cameron Friesen were on the call.

Three-phased plan

The plan would be rolled out in three phases, depending on how high the demand for space is. In the first phase, medical and critical care beds would be created by reducing surgical beds.

In the second phase, additional space would be created by relocating some services and repurposing more space, while staff would be redeployed based on their skills and work history. 

In the event of an extreme space crunch, non-COVID patients with lower health needs could be moved into spaces within the hospital not normally used for medical purposes, or to sites outside of the hospital, such as hotels.

There are up to 300 beds on hospital campuses that could be repurposed in such a situation, and 400 off-site beds have been identified, according to the plan. 

These beds would be staffed by drawing workers in from other areas, including surgery, medicine and ambulatory care. Around 600 trained critical care nurses working in other fields could be brought in, as well as former and retired staff and approximately 6,000 students. 

Since the spring, the province has purchased hundreds of ventilators, beds, monitors and other equipment, as well as increased its stockpile of personal protective equipment.

More staff needed, doctor says

Manitoba Shared Health Nursing Officer Lanette Siragusa said during the briefing with doctors Thursday night that much of the plan had been developed earlier this spring. 

After that briefing, Kumar said he was reassured by the province’s plan for equipment, but the largest concern for doctors — staffing — remains an issue.

He’s urging the province to consider calling on health-care workers from other provinces or support from the military.

He and other physicians are still pleading with the province to tighten restrictions and introduce further lockdowns. If that doesn’t happen and cases continue to increase, Kumar said the consequences could be dire for the health-care system.

“We have a significant problem. We don’t feel that it’s being adequately addressed, and … we think that if we don’t go more aggressively at this from a public health point of view, that we will overwhelm the system.”

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