Manitoba appears to be in the middle of the pack among Canadian provinces for ventilators, as health-care systems across the country scramble to get more of the machines used to treat the sickest patients from the novel coronavirus pandemic.
The province currently has 270 ventilators, according to a spokesperson for Shared Health. An additional 16 have been ordered, Health Minister Cameron Friesen said Wednesday.
Manitoba’s population was roughly 1.38 million in the first quarter of 2020, according to Statistics Canada. That works out to a capacity of roughly 20.8 ventilators per 100,000 people, once the additional machines arrive.
The total does not include ventilators in operating rooms, which are a different type of machine not preferred for critical care or cardiac patients, said Lanette Siraugsa, chief nursing officer for Shared Health, on Saturday. Those machines could be used to treat COVID-19 patients in “certain situations,” she said, but aren’t the preferred method.
Based on a CBC breakdown of reported ventilators and provincial populations across the country, Manitoba ranks roughly in the middle.
Ontario, with a capacity of roughly 12.3 ventilators to 100,000 people, is near the bottom, while Quebec leads the country, with an anticipated capacity of roughly 35.1 ventilators per 100,000 people.
Ventilators are mechanical breathing machines. They’re critical in the fight against COVID-19 in its sickest patients, whose lungs get so badly damaged by the disease they can’t get enough oxygen to breathe on their own.
But countries around the world are facing shortages of the machines as the explosion of cases overwhelms health-care systems. In the hardest-hit countries, like Italy, doctors have been forced to decide which patients get priority access, and which do not.
That’s the scenario Canada is bracing for — and scrambling to prevent — by finding more machines.
Prevention also includes flattening the curve through public health measures like social distancing, said Dr. Atul Kapur, an emergency physician in Ottawa and co-chair of the public affairs committee of the Canadian Association of Emergency Physicians.
“Right now, we don’t have anywhere close to the capacity or the number of ventilators for the demand that we’re anticipating, by looking at what other countries [experience],” Kapur said.
“This is unprecedented. The estimates that we have had so far are just not holding up to the demand that COVID is causing,” he continued.
“And even now, it’s a bit difficult, because we don’t know how bad it’s going to get.”
Manitoba preparing ‘for the worst case’: Top doctor
Most Canadian hospitals operate near 100 per cent capacity “at the best of times,” Kapur said. That means they don’t have the “buffer” to handle a sudden surge in demand — and neither did many other countries.
“That’s the problem,” Kapur said. “We’re fighting with every other country to increase our numbers.”
Canada’s readiness is a “mixed picture,” Kapur said. The country is orders of magnitude away from what it would need for its worst-case scenario.
“Even the best case scenario … Right now, we don’t have the capacity to deal with what that would be,” Kapur said. “But hopefully we have time, in a matter of weeks, to build that up.”
It’s difficult to pinpoint an ideal number of ventilators for Manitoba because the path of the virus in this province could change based on multiple variables, said Dr. Brent Roussin, Manitoba’s chief public health officer.
“There’s a large variability in the modelling numbers that we have. And so we’re looking to prepare not only for the expected case but we’re looking to prepare for the worst case,” Roussin said at a daily news briefing Thursday.
WATCH | Experts say Canada could come up against ventilator shortage in weeks
“I don’t have a specific number that I could tell you. But we are putting things in place to prepare for worst case scenarios, and so ventilators, critical care beds, those type of things, are part of that plan,” Roussin said.
The province has called on private businesses to donate ventilators and other supplies. On Friday, Friesen said public health officials have also had talks with manufacturers to see if they could make more of the machines, or other needed equipment.
There’s also nuance behind the numbers, said Dr. Kelly MacDonald, the head of the section of infectious disease in the department of internal medicine for the University of Manitoba and the WRHA.
Respiratory therapists are needed to run the machines. Unions have already raised concerns about staffing levels at Winnipeg hospitals.
Health-care experts are also working to find alternatives. Kapur noted some doctors are working on ways to rig ventilators to help two or three patients at a time, instead of just one, for example.
“I think that providing good health care and survival has a lot more to do with a variety of other things, other than just the machines,” MacDonald said.
Ability to ‘change our destiny’ in Manitoba: emerging virus expert
One of the traits of a COVID-19 outbreak that makes it so hard on health-care systems is a pattern of sickening patients all at once, said Dr. Jason Kindrachuk, an assistant professor of viral pathogenesis at the University of Manitoba and Canada Research Chair of emerging viruses.
Across the world, health-care systems have seen a sudden influx of very sick patients all at once, rather than staggered, like with influenza, he said.
He hopes that Manitoba has had enough warning to take action and flatten the curve, so that impact won’t be as overwhelming here. He praised Manitoba’s actions so far on implementing physical distancing measures, and said Manitobans have done a good job of responding to the call so far.
“It’s not necessarily just one variable where the virus hits and then you need all the ventilators,” Kindrachuk said.
“We still have the ability right now to kind of change our destiny a little bit with what’s going to happen in Winnipeg.”
It’s critical for Manitobans to act responsibly now to mitigate some of the pressure that will be placed on the health-care system, MacDonald said.
“Ultimately, how this goes is going to be as much an issue of how we do as a society, as it will be an issue of how people do at hospitals.”
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