Hamilton officials warn social distancing may need to last months to make a difference
'We're in uncharted waters,' says Dr. Bart Harvey
Hamilton hospitals have already suspended elective surgeries and are screening everyone at their doors, but warn more "difficult measures" may be necessary, as health officials hint social distancing might need to stretch into September to stop the spread of COVID-19.
Staff with public health joined administrators from both Hamilton Health Sciences (HHS) and St. Joseph's Healthcare Hamilton Thursday for a video update on what they're doing to contain the new coronavirus.
"We need to act now to give ourselves the best chance to avoid a healthcare disaster," said Dr. Michael Stacy, executive vice president at HHS, adding taking pressure of the city's two hospitals is critical.
"We're asking for everyone's help as in the coming days and weeks we anticipate additional and even more difficult measures will be needed."
What exactly those further measures might entail isn't exactly clear as the situation continues to evolve at a rapid pace.
There were 23 confirmed cases of COVID-19 in Hamilton as of noon Thursday. A provincial update provided details on two of the newest cases — a woman and man in their 60s whose sources of transmission were described as travel to the U.S. and U.S. travel/close contact respectively.
Brant County has also declared a state of emergency "in order to demonstrate how serious we are about the evolving health emergency COVID-19," stated Mayor David Bailey in a media release.
Two more Halton cases were also included in the provincial list, on top of the 10 the region provided details on Wednesday.
During the update, Hamilton health officials said some areas where tough choices might have to be made to help hospitals keep their heads above water are staff allocation and finding ways to open up beds in unconventional spaces.
Stacey said he wasn't immediately sure how many ICU beds HHS might be able to free up, they're looking at options to expansion and transforming other units.
Dr. David Russell, interim chief of staff at St. Joe's, said the hospital currently has 43 ICU beds, including 20 that could be expanded to use ventilators. That means they have some stock in case there's a surge, but there are still many unknowns when it comes to how the virus will play out.
Isolation might need to last weeks or months
"The challenge is we're in uncharted waters," explained Dr. Bart Harvey, Hamilton's associate medical officer of health.
"We're trying to plan to be prepared for all eventualities and hope we're disappointed and it's lighter and shorter than it is. But we need to be prepared to go the long route."
Just how long that route might be could be the biggest unknown of all.
The situation continues to escalate every day, said Dr. Zain Chagla, co-director of infection control at St. Joe's.
Our <a href="https://twitter.com/hashtag/COVID?src=hash&ref_src=twsrc%5Etfw">#COVID</a> Screening Team is in action <a href="https://twitter.com/mch_childrens?ref_src=twsrc%5Etfw">@mch_childrens</a> - all about <a href="https://twitter.com/hashtag/bendingthecurve?src=hash&ref_src=twsrc%5Etfw">#bendingthecurve</a> and ensuring the safety of our patients, families, staff, physicians and volunteers. <a href="https://t.co/y7bHTNvikO">pic.twitter.com/y7bHTNvikO</a>—@BrucePSquires
And, because of how long it takes for symptoms of COVID-19 to show, the number of cases we're seeing today could be a reflection of the situation before schools were shut down and people were told to work from home.
It could be weeks yet before the impact of social distancing can be seen and even then, the response needs to be measured.
"If things do improve, or we do get some flattening of the curve we have to be very careful about de-escalating these measures in order to not see a resurgence."
Harvey said he appreciated Chagla's optimism, but pointed to modelling from the U.K. and researchers at the University of Toronto that show we could be talking about months, not weeks.
"It appears that the song see you in September is starting to trend," he quipped.
"The kind of social distancing we're currently implementing is anticipated to have modest effects if it's in place for four weeks and … noticeable and significant effects if they're in place for six months."
Staff returning from travel could be called in
In the meantime, the city's hospitals continue juggling staff, particularly those who have come back from international travel.
Officials say they were grappling with the question of whether or not staff returning from abroad should come in to work or isolate for 14 days.
In keeping with a request from the Ontario Ministry of Health, St. Joe’s has suspended elective surgeries & other non-urgent clinical activity. Your physician will contact you if your surgery is postponed. We understand how difficult this is & will reassess on a regular basis.—@STJOESHAMILTON
Melissa Farrell, president at St. Joe's, said they finally got clarification from the province yesterday and Stacey said HHS has told staff they should, indeed, go into isolation after coming back from a trip.
However, Harvey said staff remain the "key resource" for taking on COVID-19, so it is possible exceptions could be made.
"We do have unique ... situations, where there is a distinct shortage of a particular skill set," said Stacey. "And if we have a staff member who is asymptomatic and whose skill set is critical to treating a patient, there is a possibility of them being asked to come back, but wearing a mask the entire time they're in the organization."