Reduced contact tracing, patients warehoused in ER as Interior Health struggles

Vancouver -

Officials are blaming the twin pressures of COVID-19 and wildfire evacuations for a strained health-care system that’s seeing exhausted workers asked to dive into the region’s worst coronavirus outbreaks. 

CTV News has learned that health authorities across B.C. are asking doctors and nurses to volunteer for secondment to Interior Health, where frontline workers and civic officials are painting a troubling portrait of short-staffed facilities closing early with patients stalled in the emergency department.

“We are asking for any health-care provider able and willing to be deployed to provide temporary assistance to Interior Health to sign up on the province’s Emergency Health Provider Registry,” read a memo sent to Vancouver Island health-care workers. “We recognize that all regions across the province are experiencing staffing challenges.” 

While Health Minister Adrian Dix emphasized the memos cited wildfire evacuations as the driver behind the plea for help, the province’s top doctor acknowledged that was, in fact, a secondary reason.

"There are many different issues affecting communities across Interior Health – not the least of which is COVID 19 – but also the displacement of communities and the volatility of the wildfire season," acknowledged provincial health officer Dr. Bonnie Henry, though she downplayed the significance of the request.

“I'm not sure I would call the situation dire. People are exhausted and this is a pre-emptive measure."

CTV News asked Emergency Health Services, Fraser Health and Vancouver Coastal Health how many patients, COVID-19-related or otherwise, had been transferred out of the Interior to hospitals in the Lower Mainland. None of the three agencies would say, despite initially indicating they would provide a response.

Interior Health would not provide hospital capacity statistics, despite multiple requests from CTV News, and Health Minister Adrian Dix has been vague about how many surgeries have been cancelled due to the fourth wave of the pandemic.

When asked how it was possible that the provincial hot spot for the spread of the virus has no public exposure notices, nor workplaces shut down, Henry insisted that there were no unknown sources of transmission. But, she also revealed that contact tracing in Interior Health has been scaled back to only high-risk environments due to staffing shortages; she did not explain how the paradoxical statements lined up.

THE SITUATION BEHIND CLOSED DOORS

Henry said most of the people who are hospitalized with COVID-19 in B.C. are unvaccinated. Their cases are putting added pressure on hospitals in Nelson, Vernon, Kamloops, Keremeos and other communities in the Thompson-Cariboo and Shuswap areas.

An emergency physician in Kelowna says doctors are still able to accept patients of all needs without excessive waits at that city’s hospital, but the coronavirus is taking up valuable resources and exhausting beleaguered staff, who are continuing to follow safety protocols to prevent any potential spread of the virus in the hospital. 

"Patients are being warehoused in emergency because they can't go up to the wards because the wards are being occupied by such a large number of COVID patients," said Dr. Jeffrey Eppler, estimating that half of the ICU beds at Kelowna General Hospital are taken up by COVID-19 patients.

“The reason we're seeing this right now is because we have unvaccinated people – younger people anywhere from 20 to 50 – and some of them getting very sick,” Eppler added. “I mean people in their 40s being intubated and on a ventilator."

He says nearly all the COVID-19 patients the hospital is seeing are unvaccinated.

On one occasion, a patient in their 50s came into the emergency department via ambulance, admitting that they’d tested positive for COVID-19 but hadn’t told their family.

“They were on the verge of intubation and when I told them they were very sick they said, 'With what?’” said Eppler. “Even though they knew they had COVID, even though they couldn't breathe, they still in their mind were denying they were sick from the COVID itself."

There are 129 people with COVID-19 in B.C. hospitals right now, the highest number since June 17. There are 59 in ICU, requiring special care and safety precautions.

SMALLER COMMUNITIES STRUGGLING WITH VACCINATION RATES BELOW PROVINCIAL AVERAGE

Several of B.C.’s smaller communities are grappling with reduced service hours as a long-term staffing shortage is exacerbated by COVID-19 and wildfires, through civic leaders are often kept in the dark about details.

“Getting hard data from Interior Health is almost impossible,” said Merlin Blackwell, mayor of Clearwater, B.C.

“The lack of information is one of the biggest anxieties in a community like ours, so putting out fires on social media is my main job right now other than being mayor."

Blackwell said he can’t get statistics on how many COVID-19 cases are in his community, nor when the next bi-monthly vaccination clinic will take place.

Clearwater’s Dr. Helmcken Memorial Hospital is currently only open 7 a.m. to 7 p.m. because it’s short several nurses and doctors required to run it 24-7. That means any medical emergencies require a paramedic callout and a 90-minute drive to Kamloops, bypassing the community of Barriere, where the local clinic is also closing early due to staff shortages.

"A lot of people aren't happy doing this job anymore and they're deciding to opt out," said Blackwell. “We've put people through the wringer and some of it's our own behaviour around not vaccinating and masks."

EMPHASIS ON VACCINES IN REGION BELOW THE PROVINCIAL AVERAGE

While 83 per cent of eligible British Columbians 12 and older have been vaccinated with at least one dose, several areas of Interior Health have vaccination rates in the high 60s and 70s. 

"Most health-care workers view (the fourth wave) as something that's preventable with what I sincerely believe is a very safe intervention – that is the COVID vaccine," said Eppler. “The vaccine is safe – a lot more safe than getting COVID."

Experts estimate up to a third of people with symptomatic COVID-19 infections will become long-haulers. While the vaccines are universally believed to lessen the symptoms in the event of infection, it’s not clear whether they can prevent someone who’s infected from having those symptoms for many months, and doctors still advise following precautions to avoid infection.