Surge in flu cases has some overwhelmed Canadian ERs telling would-be patients to stay away

Patients with flu-like symptoms are flooding many Canadian emergency departments, adding to chronic backlogs and prompting some hospitals to suggest people should go elsewhere for help.

Flu cases are peaking somewhat earlier in parts of the country, while the flu vaccine appears a less-than-optimal match to this year’s viruses.

It is unclear whether this influenza season is worse than usual, but Lakeridge Health, just east of Toronto, has been overwhelmed with patients in its three emergency departments – 30-40% of them with respiratory symptoms.

“It’s been huge, because it’s the time of year when our staff want to be off work,” said Lisa Shiozaki, Lakeridge’s chief nursing executive. On Monday, it admitted 60 more patients than usual.

Flu seems at least partly to blame, with the number of cases in Durham Region, where the hospitals are located, up 41% in December from last year, she said.

Montreal’s two children’s hospitals have also reported unusual influxes of patients in recent days, despite a call by officials before Christmas for people not to bring their children to the emergency department unless they are sure it is an emergency problem.

“There is a high volume of patients — there are a lot of colds, flu and gastro,” said Mélanie Dallaire, a public relations spokesperson at Sainte-Justine children’s hospital.

The Saskatoon Health Region issued a similar plea for people to keep away from its backlogged ERs unless it was completely necessary.

The Winnipeg Regional Health Authority has seen wait times in its hospitals’ emergency departments double in recent days as patient visits soared, officials told the Winnipeg Free Press.

“We are seeing not only more people, but sicker people,” Lori Lamont, the authority’s chief nurse, told the Free Press.

Yet the problems are by no means universal.

Admissions to Toronto hospitals have not been particularly high in recent days, said Allison McGeer, infectious disease specialist at Mount Sinai Hospital and one of the country’s leading flu authorities.

“This is a busy season, though not an awful season,” she said Tuesday. “It’s busier than the year before, but not as busy as the year before that … It’s not an exceptional season.”

Ontario’s statistics – updated to Dec. 20 — show the number of flu cases confirmed by lab tests to be similar or lower than in recent years. However, reports from hospitals and others suggest the numbers have been spiking over the last week or so, said Doug Sider, Public Health Ontario’s head of communicable disease prevention.

Public Health Agency of Canada statistics, which typically lag behind provincial numbers, show close to 2,000 confirmed cases nationally by Dec. 13, compared to less than 400 last year. The year before that, however, the agency had recorded about 1,400 cases by that date.

The predominant strain this season is H3N2, which is relatively virulent. Yet it seems the vaccine — developed about six months ahead of time — is not a great match for what’s circulating. It won’t be known until the end of the season how useful it was, but its effectiveness against H3N2 could be as low as about 40%, some experts say.

Meanwhile, the flu may be a distraction from the chief reasons that Canadians continue to face long waits in the emergency department.

‘This is a busy season, though not an awful season’

In Edmonton, departments have been experiencing some of their worst backlogs in years, but the flu has not had any more impact on that long-standing problem than usual, said Brian Rowe, an emergency medicine professor at the University of Alberta.

The key problem remains the bottlenecks “upstream” in the hospital — especially ward beds that are occupied by people who should be in nursing homes or other facilities, not an acute-care hospital, he said. That in turn delays patients being admitted to the wards from emergency, causing logjams there.

If Edmonton hospitals were somehow able to clear the 20% of beds now holding patients waiting for a spot in another institution, emergency could likely handle surges caused by the flu with ease, said Dr. Rowe.

In Ontario, about 160 of the 650 beds at the Lakeridge Health hospitals are also filled by patients who would be best served somewhere else, noted Ms. Shiozaki. Lakeridge has actually had to open 50 more beds than normal this time of year, and bring in health workers before the end of their Christmas-New Year’s holidays, said Ms. Shiozaki.

In the meantime, Dr. Rowe said he believes it’s a mistake to tell people to stay away from the emergency department, given the risks of “self triage.”

National Post, with files from Postmedia News