‘Underwater,’ ‘overwhelmed’: Doctors presentation paints dire picture of Sask. health care

On Thursday, the Saskatchewan government announced a loosening of the isolation rules around COVID-19 while talking about learning to live with the virus.

Just a few hours later, doctors in the province listened to a presentation that painted a much more grim picture.

Every other week, leaders in the Saskatchewan Health Authority (SHA) put together a presentation with information for doctors about where the authority is at and what it’s doing in the pandemic, and often with technical or workplace information doctors might need.

Much of the presentation on Thursday centred around the current load within Saskatchewan health care, and the anticipated increase.

“We are thinking we are on the upward slope and we’re getting ready for an overwhelming surge in acute care,” medical health officer Dr. Johnmark Opondo said during the town hall.

Opondo explained case counts are very high and Omicron is circulating widely through the province. He said there currently is an “unprecedented” number of COVID outbreaks in acute care, long-term-care and personal care homes — all of which comes with staffing challenges.

“This is really straining our system. This particular week has been very, very challenging,” said Opondo.

When the presentation was put together, Saskatchewan had the second-highest case rate among Canadian provinces.

“But even with fewer people testing, this is most likely just the tip of the iceberg. We’re probably higher than that,” explained Opondo.

According to the doctor, with the current level of mixing in the province and lower vaccine coverage, the authority is expecting high volumes of sick people, some of whom will end up filtering through to hospitals and critical care.

“Our public health teams, which is sort of the leading edge of our response, are currently underwater. We are overwhelmed but we are trying to modify and retool and really focus our efforts to protecting the most vulnerable,” said Opondo.

Dr. John Froh, deputy medical health officer for the pandemic, gave an update on what’s happening in the hospitals and ICUs specifically. He said the SHA is seeing an increase in COVID demands in ICU and a significant increase in COVID case demands outside of the ICU.

“Our non-ICU cases are exceeding prior peaks throughout the pandemic and our ICU cases are now rapidly rising,” Froh explained.

The current slope on a graph for people admitted to hospital, according to Froh’s presentation, is showing exponential growth, which he said makes a lot of sense seeing as the province is seeing more cases than ever in the community and a portion of those will end up in hospital.

Froh noted Saskatchewan has some of the most liberal policies in the country around people mixing with one another.

“The idea (is) that if public health orders were relaxed we would see increased mixing (and) we would see increased cases, and I believe it’s inevitable we would see an increase in hospital burden,” said Froh.

And Froh believes if it’s continued to be left unchecked, Omicron will strain the acute care system to a dangerous level.

“If we leave it further unchecked, I think that Omicron will overwhelm our system,” said Froh.

Both Opondo and Froh pointed to higher rates of sick health-care workers as a growing problem, Froh saying it’s the highest it has been during the pandemic and it’s affecting their ability to provide care.

“We are seeing an increase across the board in illness and unexpected absenteeism, and within certain areas that are in outbreak and have a really high level, it’s very high — it’s up to 20 per cent in some areas,” said Froh.

Contradictions

At the end of every physician town hall is a question-and-answer session, with some that are done through the chat which isn’t visible on the recording. A few questions are asked and answered verbally.

The questions and comments Thursday all revolved around, in some cases, the stark difference between what was in the presentation and the tone of government announcements during the week.

One doctor asked for advice on what to tell their patients, saying it’s getting increasingly difficult to reconcile the difference between the two.

The authority’s chief medical health officer responded briefly, then there was a long silence when she asked for any of the other panelists to respond as well.

Dr. Kevin Wasko, the physician executive for Integrated Rural Health, eventually spoke up calling it a conundrum.

“The message out there in the public would lead people to believe that the system isn’t facing what we all know it is and we know that people are at risk to get severe COVID from Omicron even though they likely won’t, but it can happen,” said Wasko.

Wasko said there is a segment of the population that still can’t be vaccinated — people under five years of age — and there are those for whom vaccination doesn’t provide much protection, like those with compromised immune systems.

He advised the doctor to be honest and transparent with patients and tell them what they know.

Another doctor asked a question, and prefaced it with his own concerns about government messaging.

“I think the messaging the government has their policies, and their contradictions between what we hear and what we see out in the public is honestly actively undermining trust in physicians in the province. They’re hearing one thing from us (and) they’re hearing something completely (different) from the government,” said the doctor.

One doctor commented he’s a medical health officer in the north and, in a recent weekly meeting with local leaders, advised they might want to cancel a couple of upcoming events. He said he was told off for the first time since working here.

He said the leaders told him their people weren’t willing to stay restricted to their communities, and repeated the argument that he might be saying one thing but the provincial government isn’t taking COVID that seriously.