Tag Archives: staffing

Canada’s hospitals deploy artificial lungs, scramble for staff as COVID-19 hits younger patients

By Anna Mehler Paperny and Allison Martell

TORONTO (Reuters) – Younger Canadians are bearing the brunt of the nation’s latest COVID-19 surge, creating growing demand for artificial lungs and a struggle to maintain staffing in critical care units as hospitals make last-ditch efforts to save patients.

Treatment with artificial lungs, known as extracorporeal membrane oxygenation, or ECMO, is much more likely to be deployed for patients under age 65, explained Marcelo Cypel, surgical director for the extracorporeal life support program at Toronto’s University Health Network (UHN).

Last week, there were a record 19 ECMO patients at UHN, 17 of them with severe COVID-19. When the sickest COVID-19 patients’ lungs fill with fluid and mechanical ventilators can no longer do the job, artificial lungs can save lives.

By Monday, doctors had weaned some off the machines and were down to 14 ECMO patients, 12 of them with COVID-19.

The need for these artificial lungs reflects a change in Canada’s epidemic, which has taken a turn for the worse, with new cases surging and outbreaks hitting workplaces and schools.

With many seniors vaccinated and new, far more contagious coronavirus variants circulating widely, younger patients are increasingly arriving in intensive care.

“It’s very different now than the first wave, when we saw older 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 cautioned.

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 the treatment.

About 55% of people who receive the therapy survive, Cypel said. However, they are often left with “severe physical limitations” from their extended hospital stay, he added.

Many of Canada’s provinces are in the grip of a worsening third COVID-19 wave, as they struggle to hasten vaccine rollouts. The country reported more than 6,200 new cases on Monday, with the percentage of people testing positive for the virus up to 3.8%.

‘SEEING BURNOUT’

In British Columbia, where hospitals are bracing for a surge in demand for intensive care unit (ICU) beds caused by the highly concerning P.1 virus variant first discovered in, and now ravaging, Brazil, critical care doctor Del Dorscheid from Vancouver’s St. Paul’s Hospital is more worried about staffing than artificial lung use.

On a given shift, he said, a third of the staff are working overtime.

“They’re working so hard to find bodies to fill those empty spots,” he said. “I wouldn’t say we’re seeing more mistakes. Not yet, anyways. But we are certainly seeing burnout.”

For ICUs, there is no end in sight. As of Tuesday, there were 497 COVID-19 patients in Ontario’s ICUs, a new high. Last week, experts advising the provincial government said that could rise to 800 by the end of April even with a new stay-at-home order – or approach 1,000 without it. The province stopped short of a new stay-at-home order.

New restrictions implemented in Ontario last week change little for hardest-hit areas. In Toronto, patios for outdoor bars and restaurants closed, and a plan to reopen salons was shelved. On Monday, hard-hit Peel, west of Toronto, moved on its own to suspend in-person classes at schools for two weeks.

Canada’s vaccination rate has picked up after a slow start, with 15% of the population getting at least one shot. But data from the Institute for Clinical Evaluative Sciences shows that the Ontario communities at highest risk of COVID-19 transmission also have the lowest rates of vaccination.

These communities tend to have a high proportion of residents unable to work from home, many of them non-white immigrants holding down jobs at high risk of virus exposure.

Some lack cars to drive to vaccination sites or paid time off to get the vaccine, said Brampton doctor Amanpreet Brar. Some of the hardest-hit neighborhoods lack pharmacies that dispense COVID-19 vaccines.

“It really reflects systemic inequities we see in our society,” said Brar. “They’re considered non-essential, while their work is considered essential.”

(Editing by Denny Thomas and Bill Berkrot)

No school for Chicago students; teachers strike enters second week

No school for Chicago students; teachers strike enters second week
By Brendan O’Brien

CHICAGO (Reuters) – Classes for more than 300,000 students in Chicago were canceled for a third straight school day on Monday, although striking teachers reported progress over the weekend over issues such as class size and staffing in the Chicago Public Schools (CPS), the third-largest U.S. system.

Some 25,000 teachers went on strike last Thursday after their union was unable to reach an agreement with Chicago Public Schools over pay, overcrowding in schools and a lack of support staff, such as nurses and social workers.

At a news conference on Monday morning, Chicago Teachers Union President Jesse Sharkey said that over the weekend, the board of education gave the union written proposals about reduced class sizes and increased staffing.

But he said the board still had not met certain union demands, such as improved clinical services for students and staffing a school nurse in every school every day.

“We’re optimistic that this does not have to be long, but there does need to be a commitment of new resources,” Sharkey said.

Mayor Lori Lightfoot wrote a column for the Chicago Sun-Times newspaper on Sunday in which she noted her own background growing up in a disadvantaged school district, saying she understands how important educational equity is.

“I am disappointed that the Chicago Teachers Union has decided to strike,” she wrote. “I believe our contract offer is fair and respectful of the union’s leaders and their members. But my disappointment will absolutely not soften my resolve to reach an agreement.”

The strike is the latest in a recent wave of work stoppages in school districts across the United States in which demands for school resources have superseded calls for higher salaries and benefits.

In Chicago and elsewhere, teachers have emphasized the need to help underfunded schools, framing their demands as a call for social justice.

Although the latest work stoppage has forced officials to cancel classes, school buildings are staying open for children in need of a place to go.

The strike comes seven years after Chicago teachers walked out for seven days over teacher evaluations and hiring practices. In 2016, teachers staged a one-day walkout to protest the lack of a contract and failure to stabilize the school system’s finances.

The district has offered a raise for teachers of 16% over five years, enforceable targets for reducing class sizes and the addition of support staff across the district, according to Lightfoot, who was elected in April.

Lightfoot has previously said the union’s initial full list of demands would cost the district an additional $2.5 billion annually.

(Reporting by Brendan O’Brien in Chicago; additional reporting by Joseph Ax in New York; editing by Richard Pullin and David Gregorio)