Flu cases across Canada are on the rise and may push hospitals to their limits over the holidays and into the new year, leading health officials in regions across the country to warn people not to visit emergency rooms unless it’s absolutely necessary.
The situation is serious enough that some hospitals are taking extra precautions to prevent strain on the system and to curb flu transmission within their facilities.
The Public Health Agency of Canada (PHAC), in its most recent reporting released Dec. 19, indicated a significant week-over-week jump in hospitalizations, with people over the age of 65 and children under four accounting for the most influenza-related admissions.
While it’s not entirely unusual to see influenza cases increase this time of year, health officials have said an early start to flu season and some provinces seeing just 20 per cent of eligible people getting vaccinated have likely contributed to a quicker uptick and, subsequently, greater pressure on hospitals.
“It’s too soon to know how this season is going to shake out,” said Dr. Isaac Bogoch, an infectious disease specialist at Toronto General Hospital. “But I think when we’re looking at the data in hindsight, there probably will be more hospitalizations related to the flu this year compared to a regular flu season.”
Flu cases are rising across Canada, including in Alberta where 650 people are currently in hospital and as Dr. Louis Francescutti explains, a few factors are making this season especially bad.
Hospitals plan for surging cases
Doctors, epidemiologists and other health officials have all warned that the strain of flu hitting Canada is more severe.
Emeline Edgett, a musical theatre student at Sheridan College in Oakville, Ont., said she felt “pretty awful” when she came down with the flu around two weeks ago.
She told CBC News that her symptoms started with nausea, then escalated quickly to a fever and chills as well as head and body aches.
“It was painful just to be, like, standing,” she said.
This particular season is being dominated by H3N2, a subtype of influenza A, which accounts for nearly all of the positive cases of influenza in Canada at the moment — 99.4 per cent — according PHAC.
Otherwise healthy adults are winding up in the ER, with some even needing intensive care, says Dr. Raghu Venugopal, an emergency physician in Toronto, who noted that every ER across the country “is working gangbusters.”
“I think most Canadians know we don’t have strong bed capacity in provinces like Ontario, but really across the country,” he said.
Venugopal says people should do what he has done since he got the flu just over a week ago: stay home and rest until you recover.
He says people should only visit the ER if they truly need primary care, not just to confirm if they have the flu or not.
Health authorities across the country are urging people to do.
“We need the public’s help by choosing the right care option for their needs,” Margaret Melanson, CEO of New Brunswick’s English-language health authority Horizon Health, said last week.
Melanson says there are always “unexpected circumstances” that warrant an ER visit, but she suggested turning to walk-in clinics, pharmacies or using eVisitNB, where a nurse practitioner can can assess non-urgent needs online.
Horizon Health New Brunswick, as well as Newfoundland and Labrador’s health authority, had already revived a mask mandate for people working and visiting hospitals and other care facilities earlier this fall in order to limit the spread of the flu and other respiratory illnesses.
Data from the Public Health Agency of Canada released Friday shows the number of flu outbreaks across the country is still rising, and hospitalizations due to the virus are set to surge in the coming weeks. Dr. Jennifer Vines from the B.C. Centre for Disease Control tells Hanomansing Tonight why it’s never too late to get the influenza vaccine, despite concerns that this year’s available vaccine isn’t a good match for the current predominant strain.
Extra beds, longer hours for doctors
In Alberta, where hospitalizations have spiked, doctors haver reported having to treat patients in waiting rooms and hallways.
The latest provincial data shows there are 360 people in hospital, with 30 in the ICU — a significant jump over the previous week, when Alberta hospitals were treating 216 flu patients, with 18 in intensive care.
The province has opened additional temporary beds to maximize space and patient flow, Minister of Hospital and Surgical Health Services Matt Jones said in a news conference on Friday.
He also said the province is expanding its capacity to provide virtual health services to help ease the burden.
But in other parts of Canada, the need goes further than hospital space.
Ottawa’s Children’s Hospital of Eastern Ontario (CHEO) has already had to put out a call to family doctors and pediatricians to consider working longer days and responding to urgent calls.
“If there are further opportunities to prioritize after hours and urgent appointments at your clinics for children with respiratory symptoms, this will continue to help with the demand,” president and CEO Dr. Vera Etches wrote in a Dec. 12 letter to physicians.
Public health officials in Quebec also note that the flu is spreading particularly among children aged five to 17, and that, quite often, parents go to emergency rooms, many of which are overflowing, instead of consulting a doctor or letting the child rest at home.
Dr. Antonio D’Angelo, the medical director of the Emergency Pediatrics Department at Montreal’s University of Sainte-Justine Hospital, told Radio-Canada he recommends going to the emergency room only if a child under three months old has a fever, or in cases of dehydration or respiratory distress.
But D’Angelo worries it could be a particularly tricky situation over Christmas and Boxing Day “when fewer people are available in the network to take care of all these patients.”
Flu season hit the province early and it’s expected to peak around the holidays. Both the CHU Sainte-Justine and the Montreal Children’s hospitals are asking parents to avoid the emergency room if their children don’t require urgent care.
Other illnesses a concern
Influenza is not the only illness people could be exposed to if visiting an overcrowded ER.
Doctors across the country are also dealing with COVID-19 and RSV, although each is affecting different populations.
Positive lab results for COVID-19 are highest among people over 65, but the spread is low or moderate in much of the country — the exception being New Brunswick, according to the most recent data from PHAC.
RSV is also affecting a higher number of seniors, but the most confirmed cases are in children one and under.
But there are also concerns about the spread of infections like measles. In Quebec, for example, there were eight reported cases in the province as of Sunday.
D’Angelo says that number is expected to rise, reiterating the need to have fewer people waiting to be treated.
“If there is a case of measles in the waiting room waiting to be triaged, they could infect other people,” he explained. “So, it’s important that we can triage safely and quickly.”
Health officials in Ottawa say three children have died this month from flu-related illness as cases surge in the region earlier than is typical. Doctors are encouraging people to get vaccinated ahead of the holidays.
