Chaos in the emergency rooms: hospitals are collapsing even without the Covid emergency

TORONTO – We were told it was “Covid’s fault”, but now that the pandemic is just a memory (new variants permitting…), what is the cause of paralysis in hospital emergency rooms? The question arises when reading the story – reported by CTV – of a Toronto woman who waited 48 hours in a city emergency room despite needing urgent surgery. 

Siobhan Mitchell, that’s the name of the woman, was admitted in mid-August to undergo an urgent operation on the gallbladder, but there were no beds and so she had to wait for two days in a bed in the corridor of the ward. And she was not the only one. “There are so many people looking for care, immediate care, critical care, urgent care, but there aren’t enough beds, not enough space, and waiting times because of the volume of patients seeking care,” Mitchell said. Critical care is off the charts.” Siobhan praised the nurses and personal support workers for keeping their cool amidst the chaos. She was ultimately successful in surgery, but she says people need to understand that what emergency crews are saying about overcrowding is real. “We need to support our doctors and nurses…and make sure we raise the alarm about what’s happening in our communities, in our community institutions,” Mitchell said.

“We have normalized this dysfunction in our hospitals,” says Dr. James Worrall, an emergency specialist at the Hospital of Ottawa and a professor at the University of Ottawa. “It is now ‘okay’ for inpatients to wait in the emergency room for hours or even days before moving to the appropriate hospitalization area. We have to say that this is not acceptable,” adds the professor.

A new study based on data from British Columbia shows that emergency rooms have seen “a sustained increase” in emergency visits three years after the start of the pandemic: data show that emergency visits, which had declined sharply at the beginning of 2020 due to restrictions imposed by the pandemic, they returned to largely traditional levels within a year and then increased.

The study also found that utilization of emergency departments grew at faster rates than the country’s population growth, while more patients were admitted to hospital for more serious illnesses. “This confirms what many of us have seen on the front lines over the past two years,” said Dr. Catherine Varner, an emergency room physician and deputy editor of the Canadian Medical Association Journal who reviewed the study and wrote an accompanying editorial. “Across Canada, we’ve seen unprecedented crowding over the summer. We feel like we’re in a constant state of peak capacity and crisis management.”

The same data also shows that the historically observed surges of patients seeking emergency room care during flu season — which traditionally lasted from a few days to a few weeks — are now weeks if not months. “This means that emergency departments have to operate in this state of high capacity for much longer periods of time, which is exhausting on staff,” she adds.

It’s also true that emergency rooms have become what Nova Scotia’s Dr. Tania Sullivan calls “the one default care space for all things. Don’t have a primary care provider? Go to the emergency room. Can’t see your specialist for a month? Go to the ER. So it’s no wonder,” says Sullivan, who heads the ER at St. Martha’s Regional Hospital in Antigonish.

Another question, however, arises spontaneously: why, after the pandemic was over, did no one get involved in the reorganization of hospitals and healthcare in general to make everything work again?

Pic by Mat Napo from Unsplash