Toronto hospitals report surge in sick kids as some pediatricians still won't see them in person

When her 11-month-oldson'sfever neared the 40 C mark, Sonu Maanfollowed their pediatrician's advice and took him to Toronto's SickKids emergency department.

Maansaid althoughKiesh'scough, runny nose and fever were getting worse, itlikely didn't warrant hospital attention.She'd much rather walk the half block to his doctor'sclinicto put her mind at ease that he wasn't suffering from something serious.

But even after Kiesh tested negative for COVID-19 and continued going to daycare Maan said his pediatrician refused to examine him in person and, over the phone,recommended she take him to SickKids.

"It was really shocking to me his doctor wouldn't see him," Mann said.

"At least for the younger kids who can't really talk or communicate what they're going through, it's really important to get a doctor's examination."

She andKiesh waited five hours inthe busy emergency departmentone eveningin July, and then were told they'd need to wait at least five hours more before a doctor would be available, Maan said. At 1 a.m. she called it quits and headed home.

"I probably would not take him back to emergency," she said. "I felt like it made him more uncomfortable."

But months later, she and her son stillface the same barriers, Maan said.

Kiesh hasimproved slowlybut still haslingeringsymptoms andhasn't yet been examined by a doctor, his mother said. She'sbeen told by hispediatrician thatuntil her son'scompletely symptom-free, he can't come tothe clinic even for a routinewellness check andvaccinations.

Her experience is one shared by parents across the Toronto area.

Last month,CBC News reported thatMichelle Sadowski couldn't get her son Averyexamined by his pediatrician. She took him to St. Joseph'sJust for Kids Clinic where he was diagnosed with a severe ear infection.

Roxana Bakhshian took her 18-month-old daughter Elodie to SickKidslast month. She'd been told by Elodie's pediatrician the emergency department was the best option if her childhad any symptoms that could indicate she hasCOVID-19. After a seven-hour wait in the lobby, Elodie was diagnosed with an ear infection and given antibiotics.

"I shouldn't have to take my daughter to the hospital to get a simple check. Something has to give somewhere,"Bakhshian said.

SickKids records busiest August in years

The Ministry of Health said since July, it has encouraged all doctors to resume seeing both kids and adults in person.

While August is usually SickKids emergency department's quietest month, so far thisyear it's thebusiestwith close to 6,000 patients 40 per cent more than the same month last year, and 15 per cent more than in2019, said division head Dr. Jason Fischer.

The hospital hasalso noticed an increase in patients with less serious or "low acuity" illnesses.

Fischer said it's because patients haveless access to community medical care, or think they havelimited options.

When asked what he'd say to doctors hesitant to see patients in their offices, Fischer said: "We know there are lots of family physicians and pediatricians that have made the adjustment to see these patients in person. I think there's a lot we can learn from those individuals."

St. Joseph's Health Centre is also reporting its kids clinic is as busy or busier than before the pandemic, reaching capacity daily, and will soon be expanding its hours to meet the demand, said spokesperson Jennifer Stranges.

"If a child has a dedicated primary-care provider, we encourage parents to call the provider first to discuss the health issue and navigate next steps," she said.

The clinic is supposed to be a back-up for when family doctors aren't available or a child's symptoms are urgent but not an emergency, Strangessaid.

Nikki Bergen took her sick toddler Gabrielle to St. Joseph'sa few weeks ago as instructed byher pediatrician, who wouldn't examineher in person even after a negative COVID-19 test. Bergensaid the hospital was busy with other worried parents who had "nowhere else to go"and tired staff who appeared to be working non-stop.

"I am really grateful for our health-care system," Bergen said. "But having a baby in 2018 and then again in the pandemic, the care is different straight up. It has to be different, I understand that, but I think we need to work on improving it so there are fewer people falling through the cracks."

The Ontario Medical Association's pediatrician section said it encourages pediatricians to see patients in person and has provided suggestions on how it can be done safely. Ultimately, its up to individual clinics to determine if it's feasible.

"As vaccine rates increase among children, doctors will gradually shift back to in-person care while continuing to provide virtual care when appropriate," the pediatricians said.

Pediatricians protecting vulnerable kids

Oakville pediatrician Sadhana Balakrishnan, who also works at Scarborough General Hospital, said she and her colleagues are balancing the safetyof vulnerablepatientswith the needs of those experiencing what could be COVID-19 symptoms.

Pediatricians are experiencing increased demand as the cold and flu season seems to have begun earlier than usual and parents are on high alert for respiratory illnesses, she said.

However,Balakrishnansaid she manages to seekids with fevers, coughsor gastrointestinal symptoms whohave tested negative forCOVID-19, by scheduling their appointments at the end of the day, so they don'tspendtime in the waiting room.

She saidif a child isn't seriously unwellbutneedsa doctor, parents should first consider going to an urgent-care centre or walk-in clinic first. But even with these alternatives,Balakrishnansaid she'sstill concerned about the impacts of patients not routinely seeing their family physician.

"We're going to potentially see the fallout from delayed access to care over the pandemic in the coming years for both adults and children," Balakrishnan said.

"I think we're going to have to take stock of what's being missed."