Protective equipment shortage slowing return of health-care services

Top health officials saythe rescheduling of surgeriespostponed because of the pandemic has been limited by anongoing struggle to acquire personal protective equipment.

Dr. Larry Alteen, Eastern Health's vice-president of medical services, says the short supply of equipment like masks and gloves is a worldwide problem.

"This isa worldwide problem," said Dr. Larry Alteen, Eastern Health's vice-president of medical services.

"Access to PPE does limit what we can do across the board. I don't think we would be able to do things the way we did them pre-COVID. We would not have all the resources available to do them presently."

For planing for this week we talked about going up an additional five surgeries a day.'- Larry Alteen

Newfoundland and Labrador'shealth minister said the province's deliveries of equipment are "late and light."

"That has been a consistent feature since we put in our orders in January," said John Haggie at Friday's COVID-19 briefing.

Haggie said that has done more to prevent surgeriesthan concerns about the availability of beds in health-care facilities. The health ministersaid 62 per cent of hospital beds were occupied as of Friday morning, and regional health authoritieswould be comfortable if that was as high as 75 per cent.

"Our challenge around doing more in terms of elective surgeries at the moment is not beds. The challenge is that we are going through PPEfor non-COVID-related cases because of new regulations around infection prevention and control way faster than we would this time last year," he said.

Haggie said until a large, reliable supply of equipmentis found, health authorities will have to continue to assess their surgical capabilitiesweek by week.

In mid-March, health authorities across the province postponed all elective surgeries and procedures to free up hospital beds and resources fora possible surge in COVID-19 cases.

On May 11 the province moved from Level 5, the highest level, to Level 4 of its five-stage reopening plane.

• Stand by, patients: Health authorities start resuming some medical procedures

Since then health authorities have been working to rebook thousands of postponed procedures, but Alteen says it's happening slowly because of a number of considerations, not just protective equipment.

"PPE is one of them but it's also the number of hospital beds, available intensive-care beds, available blood products.Are we able to maintain social distancing?" he said."But PPE is definitely one and every week we are looking at: what is the supply?And do we have enough to do the types of procedures we want?"

Alteen says the number of daily procedures beyond emergency surgeriesthat were notpostponed has grown steadily.

"We started off last week with, 'Let's try a number of surgeries per day.' This week we are doing more and next week we are doing even more," he said.

"For planning for this week we talked about going up an additional five surgeries a day, and planning for next week we are looking at even more. We just have to make sure we have the capacity."

Health officials say they are aware of the effect on patients of waiting for procedures like heart and cancer surgeries.

"That impact on patients is absolutely something that is taken very seriously and we understand the angst that that causes for patients," he said.

"Our providers, our physicians and other health-care providers are extremely worried and they are trying to prioritize their patient to determine who are the most urgent ones and get those people looked after first. They worry about their patients and their care and access to it."

Balancing act

Health officials say it's been impossible to predict how much capacity is needed for COVID-19.

"It a really tough balancing act that requires treading between being overly cautious or overly aggressive," said Alteen

"If you look at the overall number of patients who were hospitalized for COVID in these past 10 weeks it's not a huge number but If public health didn't do all the great work it did tracing,contacting and isolating people who may have been exposed to COVID, then this number could have exploded, and you have to be prepared for that."

Over the May 24 weekend did people engage more? Will we see more cases? We'll see over the next week to 10 days what the impact of that has been.- Larry Alteen

Alteen saidthe health-care system must continue to be prepared for the possibility of a surge ofCOVID-19 cases.

"It's anticipated that there will be a surge of COVID activity at some time in the future. We just don't know when, and prior to having the vaccine it's anticipated that will happen," he said.

"As you loosen up the restrictions it's expected we will see more cases. Over the May 24 weekend did people engage more? Will we see more cases? We'll see over the next week to 10 days what the impact of that has been."

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