New Brunswick

65 seniors to be moved out of hospitals to make way for COVID-19 patients

Sixty-five seniors who are in hospitals across New Brunswick awaiting nursing home placements will soon be moved out to make way for an anticipated influx of COVID-19 patients, Premier Blaine Higgs announced Tuesday.

Government seeks to free up acute care beds by finding new placements for seniors awaiting nursing home beds

Premier Blaine Higgs said the new measure will free up dozens of hospital beds, while enhancing the well-being of seniors who require 24-hour nursing care. (Evan Mitsui/CBC)

Sixty-five seniors who are in hospitals across New Brunswick awaiting nursing home placements will soon be moved out to make way for an anticipated influx of COVID-19 patients, Premier Blaine Higgs announced Tuesday.

The Department of Social Development has introduced an "urgent nursing home placement process" to free up hospital beds occupied by the so-called alternate level of care (ALC) patients, he said.

The 65 people will temporarily be moved into a nursing home that provides services in the language of their choice within 100 kilometres of their permanent address.

"In some cases these individuals may not be placed in their preferred nursing home locations," Higgs told reporters during the daily briefing in Fredericton.

But it will "allow for more capacity in our health-care system to address the needs of people facing serious illness," he said.

The new measure comes as the number of COVID-19 cases in New Brunswick increased to eight.

The latest case is a boy under the age of 10 in the central part of the province who is a presumptive case linked to a previous travel-related case, chief medical officer of health Dr. Jennifer Russell announced.

The other cases include two confirmed and five presumptive. The affected individuals are in their 20s to 60s.

Russell anticipates more cases will be diagnosed.

She reiterated the importance of staying home if people can and maintaining a social distance of six feet to prevent the spread of the virus and to prevent the health-care system from becoming overwhelmed.

Dr. Jennifer Russell, the province chief medical officer of health, says it's imperative everyone keep a distance of two metres (six feet) between themselves and others at all times. (Ed Hunter/CBC)

About 80 per cent of people who contract the novel coronavirus are expected to develop a "mild to moderate" respiratory illness and will be able to self-isolate at home.

But the other 20 per cent will likely need hospitalization and even intensive care unit-care, according to Russell.

People aged 65 and older are considered among the most vulnerable, along with those who have compromised immune systems, or underlying medical conditions.

Provincial officials are hoping to "flatten the curve," or slow the spread of the pandemic to protect health-care resources and staff from "an overflow" of COVID-19 patients.

"I am confident this virus will not overwhelm us," Russell has said.

WATCH: Premier Blaine Higgs describes urgent plan to free up beds for COVID-19 patients. 

Premier Blaine Higgs said the Department of Social Development is working on an urgent plan that will move 65 individuals from hospital beds into nursing homes to free up beds for COVID-19 patients. 1:19

The Department of Social Development is "in the process of working through the logistics" of relocating the ALC patients, said spokesperson Jean Bertin.

No other details were provided.

The affected residents and their families will be contacted directly, he said.

Cecile Cassista, executive director of the Coalition for Seniors and Nursing Home Residents' Rights, said she welcomes the opportunity for the ALC seniors to be accommodated in nursing homes or special care homes across the province.

But she questioned the sudden availability of nursing home beds — and staff.

Cecile Cassista, executive director of the Coalition for Seniors and Nursing Home Residents' Rights, called putting seniors in a home provides services in their language of choice within 100 kilometres of their permanent address 'a great move.' (CBC)

"Why did these seniors languish in the hospital for so long?" she asked in an emailed statement.

"It should not take a crisis to accommodate these seniors."

Cassista said she hopes the seniors being moved to a home that wasn't their first choice will be given the opportunity to transfer later. "That has not always been the case," she said.

Either way, it will be an adjustment for them, noted Cassista. "It is difficult at the best of times to move seniors."

Higgs said more patient transfers will be necessary to ensure the hospitals will be able to manage the pandemic.

We are acutely aware that we need the hospitals as empty as possible, as soon as possible.- Chris Goodyear, New Brunswick Medical Society president

Many hospitals across the province have struggled with being overcapacity and understaffed long before COVID-19 hit last week.

The number of ALC patients occupying hospital beds has been a contributing factor, but government and health officials have been scrambling to come up with solutions, according to the president of the province's medical society.

"We are acutely aware that we need the hospitals as empty as possible, as soon as possible," Dr. Chris Goodyear told CBC News on Monday, before the nursing home placement program was announced.

420 ALC patients

As of January, the most recent figures available, about 420 hospital beds in the Horizon and Vitalité health networks were occupied by ALC patients — roughly 20 per cent of all acute care beds.

According to Horizon, its percentage of ALC patients in acute care beds is even higher, at approximately one in four.

Dr. Chris Goodyear, president of the New Brunswick Medical Society, said he's confident government and health officials are doing their best in a 'tough' and evolving situation, and making decisions based on the best available information at the time. (New Brunswick Medical Society)

Hospital overcrowding typically worsens during the winter months, with flu season, said Goodyear, who is a general surgeon at the Dr. Everett Chalmers Regional Hospital in Fredericton.

But efforts have been underway to "get the number of empty beds in the hospitals as high as it can be, as well as to curtail patients coming to the hospitals for non-urgent needs," he said.

That includes finding somewhere to move the ALC patients to as quickly and as safely as possible to make way for the anticipated "very sick" COVID-19 patients who may need to be admitted, said Goodyear.

'We recognize that the situation we're in now is certainly a unique situation."

It's too soon to offer any details about possible locations, Goodyear said.

"Certainly anything is on the table right now and we have to be ready to react at a moment's notice for what potentially, who may be coming," he said.

"We can't say for sure what things are going to look like here in two or three or four weeks' time. What we're doing right now is everything that we can do to make sure we're as ready as possible."

Horizon has 35 isolation rooms

Horizon has 35 isolation rooms set up across its network of hospitals, according to Margaret Melanson, vice-president of quality and patient-centred care.

All of its emergency departments utilize severe acute respiratory infection (SARI) screening protocols on any patients who may present with these symptoms.

In early February, Horizon established a multidisciplinary task force to help ensure its facilities would be ready to respond effectively when the virus reached the province, Melanson said in a emailed statement. 

The task force has also carried out "supply, resource and infection prevention and control measures in collaboration with our provincial health care partners," she said without elaborating.

Vitalité officials did not respond to requests for information.

Ventilator numbers 'fluid'

A registered nurse raised concerns about the province's supply of ventilators during a CBC Information Morning Fredericton call-in show with the chief medical health officer on Monday morning.

Ventilators are machines that help patients with damaged lungs get enough oxygen to live.

The nurse said she was "relatively disappointed" after Sunday's briefing by officials because she felt there were still "many unanswered questions." She wanted to know how many ventilators the province has and how many more it can get.

Russell said she didn't know those figures off the top of her head, but that they were available and she would get them.

Dr. John Dornan, Horizon Health Network's chief of staff, said If people try to go to the community COVID-19 testing centres directly as a 'shortcut,' without going through 811 or their family doctor first, they will have 'undone our whole purpose.' (Ed Hunter/CBC)

During an afternoon news conference led by Russell, Horizon's chief of staff Dr. John Dornan said the number of ventilators is "fluid." Officials are trying to figure out the exact number, he said.

Ventilator companies have offered additional products, should that become necessarily, he added.

Neighbouring Nova Scotia, which has five presumptive cases of COVID-19 and no confirmed cases, has ordered 140 ventilators — a nearly 60 per cent increase to its existing supply of about 240 ventilators, Premier Stephen McNeil has said.

Medical students may serve as backups

Although members of the New Brunswick Nurses Union have raised the alarm about people stealing other medical supplies, such as masks, gloves and hand sanitizer from New Brunswick healthcare facilities, Goodyear said he was unaware of any thefts or shortages.

"To the best of my knowledge I have access to whatever I need to provide the care I need in the hospital and to best protect myself."

Physicians are taking other protective measures, such as limiting contact with patients and following Russell's advice of social distancing, he said.

Asked whether medical students might be called upon to help if many doctors fall ill or the situation becomes a crisis, Goodyear said that's all hypothetical.

"Right now we are dealing with what we can deal with, what's in front of us. And again, we aren't leaving any options off the table right now."

Dornan didn't rule out the possibility of medical, nursing and respiratory therapy students doing more than just their education and training. It will depend how many staff members get sick or need to be in self-isolation, he said.

8 cases within 6 days

COVID-19 was first announced in New Brunswick as a presumptive case last Wednesday and confirmed the following day. The woman in her 50s from the southeastern part of the province had recently travelled to France.

The other travel-related case, announced Monday, is a woman in her 20s from the southern part of the province who recently returned from Greece. She is considered presumptive, has been treated and is in self-isolation at home, awaiting further test results.

Elective surgeries, services reduced

On Monday, Horizon and Vitalité officials both announced they are cutting back on elective surgeries in a bid to curb the spread of COVID-19.

"We are concentrating on doing surgery on people that need it today," urgent surgeries, such as limb-saving and cancer surgeries, said Dornan.

People scheduled for elective surgeries will be contacted about their appointments, he said.

"This is a significant undertaking, and we believe it will reduce the transmission of coronavirus in our facilities."

Similarly, many of the ambulatory clinics, which provide follow-up care for conditions such as diabetes, asthma and thyroid disease, will be reduced "significantly," said Dornan.

'We need to be creative'

That doesn't mean patients won't be cared for, however, he stressed. "We need to be creative."

He cited the busy clinic he was scheduled to run in St. Stephen on Monday as an example. Instead, he conducted a "virtual clinic" from Saint John.

He called people, gave them their results, told them what they needed to do and arranged for appropriate follow-up, he said. "I didn't see a single person, but ran a full clinic."

At Vitalité hospitals, officials are in the active phase of their pandemic plan and prioritizing "life and death" cases that must be seen, pediatrician Dr. Nicole LeBlanc told reporters.

That means some patients will receive a call in the coming days informing them that their surgery or diagnostic imaging appointment or outpatient clinic appointment have been cancelled, said LeBlanc.

Only essential and urgent tests will be performed, until further notice.

Elective appointments will be rescheduled according to how the COVID-19 situation unfolds in the coming months, she said.

"We will ask you to be patient. We know this is not an optimal situation and it will be uncomfortable. Please know that this is temporary. And again, the objective is to minimize contact and transmission. This will help our personnel to focus on priority needs."

Testing centres by referral only

Vitalité opened its first COVID-19 screening centre in Moncton last Friday, said LeBlanc.

"This will allow us to see one patient at a time and to be able to clean the facility between each patient," she said.

It was created based on the experiences elsewhere in Canada and around the world.

The testing is available only to those exhibiting mild to moderate symptoms. They must be referred by Tele-Care 811 or a family doctor and receive an appointment.

Other Vitalité clinics are expected to open today in Edmundston, Grand Falls Campbellton, Bathurst and Tracadie-Sheila, LeBlanc said.

As needs increase, additional screening centres will be opened, she said.

Horizon Health has also set up community assessments centres in Moncton, Saint John, Miramichi and Fredericton with plans to open another in Upper River Valley soon.

All patient visits are restricted within Horizon facilities. 

There is a complete ban on patient visits across all Vitalité facilities, except for palliative care, obstetric and pediatric units. One designated immediate family member or care partner will be allowed to visit these units.

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