Currently there are 16 adult critical care ventilators in the Northern Health area, according to figures released by provincial Medical Health Officer Bonnie Henry last week.
Of those, nine are in large hospitals and seven are in smaller hospitals and could be, at any given time, be used by patients who are battling something other than COVID-19.
There are, however, 32 beds in the region that are ventilator capable and another 25 that could also be ventilator capable by using operating room ventilators and employing other strategies such as doubling up.
While that may not sound like a lot, whether it is enough depends on how hard and how fast COVID-19 hits the area.
The best case scenario is that containment measures taken in B.C. and the Northern Health result in a virus spread like that of South Korea. According to the modelling conducted the province, that would result in, at the peak time of the epidemic, 12 people requiring an intensive care unit bed. Northern Health has 10 ICU beds, meaning there would be a shortage of two beds. Additionally, 10 people, at the peak of the epidemic, would require ventilation. The adult critical care ventilator capacity is only nine. This, however, represents existing
ventilator capacity at Primary COVID sites only and does not include ventilators that could be
moved from smaller sites or the addition of new purchased ventilators.
The worst-case scenario is a northern Italy rate of infection and containment.
This would result, according to the modelling, 47 ICU patients, with the capacity of 10 beds and 38 requiring ventilation by one of the nine ventilators available. Once again, however, this represents existing ventilator capacity at Primary COVID sites only and does not include ventilators that could be moved from smaller sites or the addition of new purchased ventilators.
A range of scenarios are presented based on evidence from other jurisdictions and a set of grounded clinically oriented assumptions.
As the days of the epidemic pass here in B.C., it will become more clear what curve will occur for acute care and ICU needs. The impact of public health measures in B.C. and Canada should influence B.C. following a lower curve. Planning is going ahead based on a higher curve.
These scenarios are being used by health authorities for planning a cascading response. It will require them and their clinical leadership to try to find a balance between meeting the needs of potential COVID-19 patients AND reducing the risk of unintended consequences on other non-Covid-19 patients needing access to acute and critical care.
Health authorities now focused on putting in place, with their clinical and support staff, a
four to six week staffing schedule based on their planning:
Redeployment and any required refresh training of key clinical staff to support critical care;
Redeployment of staff to support non-acute inpatient Covid-19 care;
Accessing additional staff to support both non-acute surgical and medical care (including re-registrants, trainee health-care professionals);
Enhancing primary and community care capacity to support and monitor Covid-19 patients in self-isolation;
Maintaining primary and community care to meet health needs of non-Covid-19 patients; and
Providing support to clinical care professionals throughout the surge.
- Health authorities are also focused on implementing measures to best use personal
protective equipment based on existing at-hand and warehouse supplies.
- The province and federal government are also focused on securing additional needed PPE
in the coming week and throughout the months of April and May.