SHA concerned that COVID-19 will overwhelm the health-care system

A Saskatchewan Health Authority internal document warns COVID-19 could overwhelm the health-care system.

But the authority’s CEO, Scott Livingstone, stressed during a media conference Tuesday at the Saskatchewan legislative building that the document was the first model created by the SHA — and therefore represented the worst possible situation.

“It’s critical that people understand that we’ve got to consider worst-case scenarios when we are doing our planning,” he said. “Any planning requires planning assumptions and we needed to give our team something to start that work so that we didn’t get behind with respect to executing on how we were going to handle the cases coming to us within the pandemic.

“It’s important to understand that the worst-case modelling does not take into consideration the number of initiatives that have already been put in place to limit and lower the curve for us with respect to COVID-19.”

The province has taken a number of steps already, including ordering travellers from outside Canada to self-isolate for 14 days, closing restaurants, bars and recreation facilities, and requiring self-distancing. Individuals have been reminded constantly to keep their distance from each other and to wash their hands regularly to potentially stop the spread of the virus.

But the document obtained by The Canadian Press on Tuesday paints a bleak picture.

It says demand for acute services will exceed existing capacity for hospital beds, ICU beds and ventilators, and will create a major burden on other acute services.

It predicts that with a 30 per cent infection rate, about 300,000 people in the province would get sick. Of that number, 240,000 people could be expected to recover at home, with about 15,000 requiring hospitalization in intensive care units.

A death rate of between three and five per cent — or between 9,000 and 15,000 people — could be expected, reads the document.

It also states that Saskatchewan has 109 ICU beds right now, but that there are plans to expand bed capacity.

The COVID-19 Planning Strategy says that more accurate modelling is anticipated in the coming days, but added that time is of the essence and preparations must start immediately.

Dr. Saqib Shahab, the province’s chief medical health officer, said the first model is similar to those done in other provinces and other countries.

“They project what will happen if the worst-case scenario, where there’s rapid transmission with no action being taken at the public-health level,” Shahab said.

“But then they also project that if you do everything you need to do, both at the government level but also at an individual and community level, how we can flatten the curve. So far we have seen good evidence that we are keeping the curve flat.”

The document predicts that at the peak of the pandemic, Saskatoon would need to provide for 2,000 patients. But Livingstone stressed that Saskatoon was used only as an example in the model.

Livingstone added the model is constantly changing and being fed to regional departments, both urban and rural. He added that the models “are not a secret,” so he doesn’t have any concerns about releasing them to the public in the future.

“What I want to make sure that people understand is the models are just a planning tool,” Livingstone said. “They’re not going to be a ‘What does that mean for my local community with respect to the services that we’ll be accessing?’ ”

Livingstone said the SHA’s focus is on expanding its capacity to meet the demand for acute care it expects to see in the future.

The SHA already has taken some steps in that direction, reducing non-essential services to increase bed availability, saving supplies and reallocating health-care providers.

To create additional capacity, the SHA is:

• Creating dedicated spaces to keep COVID-19 patients together within facilities;
• Designating hospitals in Regina, Saskatoon and other areas as COVID-19 specific facilities; and,
• Creating additional community-based acute care capacity (such as field hospitals in school gyms, community centres, rinks and so on).

Livingstone said the field hospitals currently don’t exist. Instead, the focus is on increasing capacity in existing facilities and planning for what’s coming to come.

“With the model at hand, we will over-respond if we only use the model as it exists without inputting any other components or successes with respect to some of the public-based initiatives that we’ve done,” Livingstone said. “The modelling is one component of the planning.”

Six new cases

Saskatchewan reported six new cases Tuesday for a total of 72, without any deaths.

Two of the 72 cases are under the age of 19, 11 are 65 or older and 59 are between the ages of 20 and 64.

The government said 5,757 COVID-19 tests have been performed by the Roy Romanow Provincial Laboratory in Regina.

The 72 cases comprise 34 in Saskatoon, 22 in Regina, eight in the central area of the province (excluding Saskatoon), five in the south (excluding Regina) and three in the north.

Shahab confirmed there are four cases where there isn’t any clear exposure history or link to travel. One is in the Regina area, two are in the Saskatoon area and one is in central Saskatchewan.

“This is an important infection point in terms of these are the cases we were expecting,” Shahab said. “Based on that, we will be making some recommendations for further increasing testing for people who have not travelled.

“We already test a large number of people in the ER in the in-patient setting and the long-term care setting. We will be expanding that to people in the out-patient setting who have not travelled. There is lab capacity to maintain that.

“And obviously we will be looking at other measures beyond what are already in place to try to further limit or break the chains of transmission.”

— With files from The Canadian Press