TORONTO (Reuters) – Young Canadians bear the brunt of the nation’s latest wave of COVID-19, creating a growing demand for artificial lungs and a struggle to keep staff in critical care units as hospitals work to save patients.
Treatment with artificial lungs, known as extracorporeal membrane oxygenation or ECMO, is more likely to be performed in patients under the age of 65, explained Marcelo Cypel, surgical director for the extracorporeal life support program at the Health Network. of the University of Toronto (UHN).
Last week, 19 ECMO patients were registered at UHN, of which 17 with severe COVID-19. When the lungs of the sickest COVID-19 patients fill with fluids and mechanical ventilators can no longer do the job, artificial lungs can save lives.
By Monday, doctors weaned some cars and reached 14 ECMO patients, 12 of them with COVID-19.
The need for these artificial lungs reflects a shift in Canada’s epidemic, which has taken a turn for the worse, with new cases growing and outbreaks hitting jobs and schools.
With many vaccinated seniors and new, much more contagious coronavirus variants circulating on a large scale, 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 see more … young essential workers.”
The ECMO situation is under control for the time being, but things can change very quickly, Cypel warned.
When hospital systems in other countries were overwhelmed, they had to stop using ECMO because it required a lot of staff – seven or more people to start treatment.
About 55 percent of people receiving therapy survive, Cypel said. However, they often remain with “severe physical limitations” from the extended hospital stay, he added.
Many provinces in Canada are in control of a third wave of COVID-19, which is getting worse as they struggle to speed up the vaccine. The country reported more than 6,200 new cases on Monday, the percentage of people who tested positive for the virus up to 3.8%.
“SEE BURNOUT”
In British Columbia, where hospitals are preparing for an increase in demand for beds for intensive care units (ICUs) caused by the extremely worrying version of the P.1 virus first discovered in Brazil, and now devastating, critical care doctor Del Dorscheid of the St. Paul Hospital is more concerned about staff than the artificial use of the lungs.
At one change, he said, a third of staff work overtime.
“They work so hard to find bodies to fill those empty places,” he said. “I would not say that we see more mistakes. Not yet, anyway. But we certainly see exhaustion. “
For ICUs, there is no visible purpose. As of Tuesday, there were 497 patients with COVID-19 in Ontario’s ICUs, a new high. Last week, experts advising the provincial government said it could rise to 800 by the end of April, even with a new home order – or approach 1,000 without it. The province stopped again for a new home order.
The new restrictions implemented in Ontario last week change little for the hardest hit areas. In Toronto, the terraces for outdoor bars and restaurants have closed, and a plan to reopen lounges has been filed. On Monday, Peel, hit hard west of Toronto, moved on his own to suspend in-person classes at schools for two weeks.
Canada’s vaccination rate has risen after a slow start, with 15% of the population receiving at least one stroke. But data from the Institute for Evaluative Clinical Sciences show that communities in Ontario with the highest risk of COVID-19 transmission also have the lowest vaccination rates.
These communities tend to have a high proportion of residents unable to work from home, many of whom are non-white immigrants in high-risk jobs.
Some do not have cars to get to the vaccination sites or have paid free time to receive the vaccine, said Brampton doctor Amanpreet Brar. Some of the worst affected neighborhoods do not have pharmacies that distribute COVID-19 vaccines.
“It really reflects the systemic inequities 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