With each new wave of COVID-19, the health system around us is collapsing | Coronavirus

This is no surprise: The health system in Quebec, Ontario and elsewhere in the country was vulnerable long before the pandemic. But seven waves of contamination in two years have exacerbated the situation.

dr. Judy Morris thinks the public doesn’t know how difficult the situation is in health care, especially in the emergency room. : \”Les urgences débordent depuis toujours\”. Mais c’est une situation critique. C’est pire qu’avant”,”text”:”Je pense qu’il y a une désensibilisation; les gens se disent: \”Les urgences débordent depuis toujours\”. Mais c’est une situation critique. C’est pire qu’avant”}}”>I think there is a desensitization; people say to themselves, “Emergencies have always been overcrowded”. But it is a critical situation. It’s worse than beforeshe says, complaining that the public seems to be more concerned about queues at passport offices than queues at emergency rooms.

ans. Mais la pandémie a accéléré la détérioration du système de santé”,”text”:”Oui, le système est en difficulté depuis 20-30ans. Mais la pandémie a accéléré la détérioration du système de santé”}}”>Yes, the system has been in trouble for 20-30 years. But the pandemic has accelerated the deterioration of the health systemadds Dr. Katherine Smart, president of the Canadian Medical Association (CMA).

The situation is becoming increasingly untenable and the more waves there are, the faster Canada’s healthcare system will crumble, she says.

The health system is at an end, if it isn’t already [sous] artificial respiration machine. If we are not serious and we do not take the necessary measures to: [aborder] the challenges, we will end up with a code blue situation in the coming yearsadded Paul-Émile Cloutier, President and CEO of HealthCareCAN, an organization that represents research hospitals, health centers and health organizations across the country.

At the rate at which the system is falling apart, the reality is very different from previous crises, said Damien Contandriopoulos, a professor at the University of Victoria School of Nursing and an expert on public health policy.

And no, he stresses, the strain on the health care system caused by the pandemic cannot be the same as during a flu season.

The flu was a pretty long wave every winter. But there it is the same, but a bionic version, all year round. »

A quote from Damien Contandriopoulos, professor at the University of Victoria School of Nursing

Controlling Covid-19 to help the system

While the pandemic has exposed flaws in the system, Dr. Morris:we no longer have the capacity to live with other overflows.

The system is not designed to handle such continuous pressure, adds Paul-Émile Cloutier.

The more the virus circulates, the more health workers become infected and have to self-isolate, exacerbating the staffing problem, Dr. Be smart. Every more stress, every more wave pushes the system even more toward failure. The healthcare system can no longer handle the waves.

For example, on July 15 in Quebec, more than 7,000 health care workers are absent due to COVID-19. If this is less than the 20,000 absentees in January 2022, it should be remembered that Quebec’s health minister, Christian Dubé, confirmed in December 2021, when there were 7,000 absentees, that the province has a social problem. We have more and more patients, but fewer and fewer people to treat them.

Even during the breaks between waves, there were always more than 3,000 absent Quebec workers.

The question haunting these experts: Which wave will be the death knell for the health system?

Therefore, they believe that in order to help health care survive, it must first and foremost reduce the transmission of SARS-CoV-2.

We need a credible COVID-19 exit scenario. We were told the “epidemiological” crazy scenario that it’s the last wave and it’s overcriticizes Mr Contandriopoulos, who is not very optimistic about the coming months, especially if governments do not intervene.

We decided we didn’t want to wear masks anymore, even though it’s a very effective measure. But can we afford not to if the hospitals burst? »

A quote from Damien Contandriopoulos, professor at the University of Victoria School of Nursing

Judy Morris, president of the Quebec Association of Emergency Physicians

Photo: University of Montreal

According to Dr. Judy Morris, president of the Association of Emergency Physicians of Quebec, if we choose not to introduce certain sanitation measures, we will en masse health workers.

A labor shortage that grows from wave to wave

It is still necessary to be able to find these employees, in a context of scarcity and professional exhaustion.

There is an extremely large number of employees who have worked tirelessly for two years and have cared for a large number of patients. They are burntsays Dr. Smart, adding that more and more people are leaving healthcare. These workers are tired of being in a broken system, she says.

She said there were nearly 137,000 health care job openings across Canada in the first quarter of 2022, a record high. If the trend continues, it is clear that a break is coming.

But this rift is already being felt. According to Dr. Smart, emergency wait times across the country are at the highest level in 14 years; one in seven Canadians does not have a GP. And then we haven’t even mentioned the waiting lists for surgeries that are getting longer and longer.

At the beginning of June, Quebec’s medical heads sounded the alarm: in a letter they expressed concern about not being able to provide safe services for the summer period. Six emergency services have been partially closed in Quebec this summer due to staff shortages.

In Ontario, several regional ERs will also be closed. The same scenario in New Brunswick, Alberta, Manitoba, Newfoundland and Labrador and British Columbia.

This is a very worrying situation for these communitiessays Mr Cloutier, who fears these closures will become more frequent or permanent.

Sign for closure of Newfoundland and Labrador Hospital emergency room.

Emergency departments at hospitals in Newfoundland and Labrador regularly experience service interruptions.

Photo: Jeremy Eaton/CBC

dr. Smart is concerned when she hears more and more heartbreaking stories from Canadians who lack access to good healthcare. She cites the death of a patient in the waiting room of a New Brunswick emergency room or that of a 91-year-old Montrealer who died on her balcony after waiting 7 hours for an ambulance.

They are no longer separate stories. It’s reality. That means primary care as we know and expect it is slowly dying. »

A quote from dr. Katherine Smart, President of the Canadian Medical Association
A female doctor poses in front of a white wall

Katherine Smart, President of the Canadian Medical Association

Photo: Courtesy: Canadian Medical Association

Money is not the silver bullet

This week, provincial and territorial prime ministers, meeting in the Federation Council, demanded that Ottawa significantly increase its share of health care costs.

But according to Mr. Cloutier, Dr. Morris, Dr. Smart, Mr. Cloutier and Mr. Contandriopoulos is the solution to the problem not necessarily more money.

It’s a little sad to see this spectacle of prime ministers blaming federal funding for health problems and the federal government promising money, but only under certain conditions., laments Mr Contandriopoulos. Having more money without a concrete plan will not solve the situation, he says.

Portrait of Damien Contandriopoulos.

Damien Contandriopoulos, professor at the School of Nursing at the University of Victoria and holder of the research chair in Canadian Policy, Knowledge and Health.

Photo: Radio Canada/Claude Brunet

dr. Smart agrees. Nobody dares to tackle a change in the system and we dare not adopt innovative solutions. This is the fundamental problem and that’s why we don’t see any changes.

If a complete overhaul of Canada’s health care systems is needed, the first priority is to address workforce retention.

Contandriopoulos. Sinon, l’hémorragie de la main-d’œuvre ne cessera pas. Les gens ne veulent pas attendre toute leur carrière pour voir des changements.”,”text”:”Il faut que les politiciens arrivent avec un plan dans lequel les travailleurs voient une lumière au bout du tunnel, dit M.Contandriopoulos. Sinon, l’hémorragie de la main-d’œuvre ne cessera pas. Les gens ne veulent pas attendre toute leur carrière pour voir des changements.”}}”>Politicians must come up with a plan in which workers see light at the end of the tunnel, Contandriopoulos says. Otherwise the contraction bleeding will not stop. People don’t want to wait their entire career to see changes.

Different organizations and associations representing health professionals are proposing different measures to begin this overhaul of the health care system, such as the following:

  • harmonization of licensing to practice across the country, to enable better labor mobility;

  • simplify the requalification of foreign workers;

  • encourage universities to graduate more people in labor shortage areas;

  • have better national workforce data;

  • reorganize the structure of primary care;

  • reduce administrative burdens for doctors.

While the task may seem daunting and insurmountable, Dr. Smart believes the pandemic has shown it is possible for the healthcare system to transform quickly. For example, before the pandemic, there was almost no telemedicine in Canada. And almost overnight, we switched to online dating. So it is possible to make things happen when we work together.

Even though it is one before midnight, Dr. Smart remains hopeful that governments will act on time. The alternative is the complete collapse of the health care system.

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