TORONTO (Reuters): Young Canadians bear the brunt of the nation’s latest COVID-19 increase, creating a growing demand for artificial lungs and struggling to maintain the staff of critical care units as hospitals make efforts to save patients.
Treatment with artificial lungs, known as extracorporeal membrane oxygenation, or ECMO, is much more likely to be deployed in patients under 65, said Marcelo Cypel, surgical director of the University of Health’s extracorporeal life support program. of the Toronto Network (UHN).
Last week, 19 ECMO patients were registered at UHN, 17 of them with severe COVID-19. When the lungs of the sickest COVID-19 patients fill with fluid and the mechanical ventilators can no longer do the job, the artificial lungs can save lives.
On Monday, doctors had weaned off some of the machines and reached 14 ECMO patients, 12 of them with COVID-19.
The need for these artificial lungs reflects a change in Canada’s epidemic, which has worsened, with new cases coming out and outbreaks affecting jobs and schools.
With many older people vaccinated and new, much more contagious coronavirus variants circulating widely, younger patients are increasingly turning to intensive care.
“It’s very different now than the first wave, when we saw elderly people with comorbidities,” Cypel said. “We’re seeing more … young essential workers.”
The ECMO situation is under control for now, but things can change very quickly, Cypel warned.
When hospital systems in other countries were overwhelmed, they had to stop using ECMO because it requires a lot of staff: seven or more people to start treatment.
About 55 percent of people receiving therapy survive, Cypel said. However, they are often left with “severe physical limitations” from their prolonged hospital stay, he added.
Many Canadian provinces are in the throes of a worsening of the third wave COVID-19, as they struggle to accelerate the deployment of vaccines. The country reported more than 6,200 new cases on Monday, with a percentage of people who tested positive for the virus of up to 3.8%.
“SEE CREAM”
In British Columbia, where hospitals are preparing for an increase in demand for intensive care unit (ICU) beds caused by the very worrying variant of the P.1 virus first discovered in Brazil and now devastating , the critical care physician Del Dorscheid of St. Paul Hospital is more concerned with staffing than with the artificial use of lungs.
On a given shift, he said, a third of staff work overtime.
“They’re working hard to find bodies to fill those empty places,” he said. “I would not say we see more mistakes. Not yet, anyway. But we are certainly seeing an exhaustion. “
For ICUs, there is no end in sight. As of Tuesday, there were 497 COVID-19 patients in the Ontario ICU, a new high. Last week, experts who advised the provincial government said they could reach 800 by the end of April, even with a new home stay order, or that they would approach 1,000 without it. The province stopped in the face of a new order to stay at home.
The new restrictions implemented in Ontario last week change little in the hardest hit areas. In Toronto, courtyards for outdoor bars and restaurants were closed and a plan to reopen lounges was left behind. On Monday, the success of Peel, west of Toronto, moved on its own to suspend face-to-face classes in schools for two weeks.
Canada’s vaccination rate has risen after a slow start, with 15% of the population receiving at least one shot. But data from the Institute of Clinical Assessment Science show that Ontario communities at highest risk of COVID-19 transmission also have the lowest vaccination rates.
These communities typically have a high proportion of residents who cannot work from home, many of them non-white immigrants who maintain jobs with a high risk of exposure to the virus.
Some do not have cars to drive to vaccination sites or pay for free time to get the vaccine, said Brampton doctor Amanpreet Brar. Some of the most affected neighborhoods do not have pharmacies that dispense vaccines against COVID-19.
“It really reflects the systemic inequalities we see in our society,” Brar said. “They are considered non-essential, while their work is considered essential.”
Edited by Denny Thomas and Bill Berkrot