Flu siege, RSV force drastic action at Children’s Hospital

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This article was published 13/12/2022 (645 days ago), so information in it may no longer be current.

Children’s elective surgeries are being postponed, nurses with pediatric experience are being called in and city health-care agencies are being told to staff up as an unprecedented surge of influenza continues to strain resources.

Starting Thursday, the children’s hospital is cutting back on procedures that are not time-sensitive so surgical and recovery nurses can instead help out in critical-care units.

The hospital’s five pediatric surgery slates will be reduced to two, and postponements of non-urgent surgeries — such as ear, nose and throat procedures — are expected to continue into the new year, said Health Sciences Centre chief operating officer Dr. Shawn Young.

“We’ve asked all sites in Winnipeg to consider their plans to go over-capacity, and to staff up where possible. These are difficult decisions, but they are necessary right now,” Young told reporters during a virtual news conference Wednesday.

The reduction in surgeries means the hospital can reassign the equivalent of 4.7 full-time nurse positions to work in the pediatric intensive-care unit. He said there’s no target number of nurses who are needed to fill in, but the hospital put out a call across the provincial health system Wednesday morning asking nurses and casual staff who previously worked in pediatrics to step in.

The demands are changing daily, if not by the hour, Young said. Postponing adult surgeries is a possibility, but for now, that’s not happening.

“There are a number of other, less-acute services that could see some disruptions if this escalates,” he said.

An influx of influenza and complications of respiratory syncytial virus have resulted in double the pre-pandemic rate of children needing intensive care. HSC’s pediatric unit usually has capacity for nine beds. There were 21 young patients there as of Wednesday morning, in addition to 48 infants in the neonatal intensive-care unit, which typically has 50 beds.

Young patients who can safely stay at home rather than in hospital are more likely to have their surgeries rescheduled. Doctors’ offices are contacting postponed patients directly, Young said. He noted some surgeries that would usually be followed by admission to the pediatric intensive-care unit for recovery will also have to be delayed because the ICU is full.

The unit has been over capacity since last spring, and for the past few months, 10 to 15 nurses per weekly shift were reassigned to help out. But a sudden surge in severely ill infants and children forced more extreme action, Young explained.

There were 10 babies and children admitted to intensive care over 48 hours, ending Monday night. Last month, following a record-high number of patient visits to the children’s ER, health officials said cutting back surgery slates was not on the table.

On Nov. 14, Dr. Karen Gripp, Health Sciences Centre Children’s Hospital emergency department medical director, told the Free Press postponing pediatric surgeries wasn’t part of the plan to increase capacity, and would occur only under extraordinary circumstances.

The hospital hasn’t surpassed that record-high number of patients (201 patients on Nov. 12), but the children who are arriving now are sicker, and are being hospitalized at a higher rate. There were 128 ER visits Tuesday and 18 of those patients were admitted, said Dr. Elisabete Doyle, section head of emergency medicine at Children’s Hospital. She described the current number of pediatric ICU patients as unprecedented.

Postponing children’s surgeries has occurred in the past during particularly difficult respiratory virus seasons, Young said.

Urgent and life-saving surgeries will proceed, but Young said he realizes delaying elective surgeries for children puts stress on families.

“I’m a dad, I get it. No one is happy that this is occurring in Manitoba, just as no one is happy this is occurring in other provinces, but it’s necessary to ensure our hospital maintains its capacity to provide care to all infants and children who need it, both now and in days and weeks ahead.”

No parent wants to hear their child’s surgery is cancelled, NDP Leader Wab Kinew said in response to the announcement.

“The Children’s Hospital has been in crisis mode for weeks, yet we haven’t heard a word from the premier. We need a plan to ease the pressure on Health Sciences Centre now. Sick kids deserve better from this government,” Kinew said.

— with files from Danielle Da Silva

katie.may@winnipegfreepress.com