COVID-19 pandemic: the impact on Canada’s intensive care units

Abstract

The COVID-19 pandemic has exposed the precarious demand-capacity balance in Canadian hospitals, including critical care where there is an urgent need for trained health care professionals to dramatically increase ICU capacity. The impact of the pandemic on ICUs varied significantly across the country with provinces that implemented public health measures later and relaxed them sooner being impacted more severely. Pediatric ICUs routinely admitted adult patients. Non-ICU areas were converted to ICUs and staff were redeployed from other essential service areas. Faced with a lack of critical care capacity, triage plans for ICU admission were developed and nearly implemented in some provinces. Twenty eight percent of patients in Canadian ICUs who required mechanical ventilation died. Surviving patients have required prolonged ICU admission, hospitalization and extensive ongoing rehabilitation. Family members of patients were not permitted to visit, resulting in additional psychological stresses to patients, families, and healthcare teams. ICU professionals also experienced extreme psychological stresses from caring for such large numbers of critically ill patients, often in sub-standard conditions. This resulted in large numbers of health workers leaving their professions. This pandemic is not yet over, and it is likely that new pandemics will follow. A review and recommendations for the future are provided.

The impact of nursing workforce skill-mix on patient outcomes in intensive care units in Victoria, Australia

“…13 The COVID-19 pandemic impacted health and healthcare delivery, with workforce shortages, especially in critical care environments continuing to be a global challenge for healthcare systems. [25] , [26] , [27] Pandemic models of care may have influenced healthcare systems and patient outcomes. 28 Our study covered the COVID-19 peak which affected Victoria between the end of 2021 and early 2022, when many hospitals relied on nursing staff without critical care experience redeployed into ICU.…”

Delivery and Prioritization of Surgical Care in Canada During COVID-19: An Environmental Scan

“…Postponing non-urgent surgery was a strategic measure to ensure that healthcare systems were not overwhelmed during the pandemic. 33 , 34 Consequently, surgical patients became collateral damage in mitigating the impact of the COVID-19 pandemic. Globally it is estimated that 28 million surgeries were cancelled in the first three months of the pandemic alone.…”

Long COVID as a functional somatic symptom disorder caused by abnormally precise prior expectations during Bayesian perceptual processing: A new hypothesis and implications for pandemic response

“…. .” 2 A multinational Delphi consensus recommended that “REC2.9 Public health policy should take better account of the potential long-term impact of the unchecked spread of COVID-19, given ongoing uncertainties about the prevalence, severity, and duration of post-COVID-19 morbidity (long COVID),” and to “REC5.6 Prioritize research funding for long COVID . .…”