Canada’s flu season is in full swing with cases of respiratory illnesses surging across the country, putting additional pressure on already strained emergency departments and children’s hospitals.
The spike is being driven by influenza, according to the Public Health Agency of Canada’s latest FluWatch report, which shows the proportion of tests that came back positive for this virus was 11.3 per cent during the first week of January, up from 10.1 the week prior.
Respiratory syncytial virus, or RSV, seemed to peak in December but still has a positivity rate of 10.7, according to the update released last Friday. Meanwhile, COVID-19 is stable nationally at 9.2 per cent.
Trends, however, vary by region. Ontario is dealing with the highest rate of COVID-19 but the lowest rate for RSV, while the territories are nearly double the national average for flu. Meanwhile, the Prairie provinces are seeing a decline of flu cases after coming to a head last month, as the virus picks up speed in Atlantic Canada, British Columbia and Quebec.
While additional health care staff and beds have been added to hospitals across the country to deal with the surge, it is still difficult to keep up. Hospitals are still dealing with the impact of the COVID-19 pandemic that began five years ago, exacerbating wait times and challenging health care staffing.
In Manitoba, Philippe Lagacé-Wiens, a medical microbiologist at St. Boniface Hospital in Winnipeg, said emergency departments have been particularly strained over the last three weeks with a “dramatic rise” in both flu and RSV cases, which he explained don’t always hit at the same time. Minimal space in other wards has amplified the backlog, as patients in emergency have nowhere to go.
“You’ve got a lot of people who need to be admitted, who are waiting in the emergency rooms for, probably, longer than they should because there are no beds on the wards,” Dr. Lagacé-Wiens said. “Which means that people with ostensibly less severe illnesses end up waiting longer and longer and longer because those rooms are taken up.”
Last week, a middle-aged man who spent eight hours waiting for care died at the Health Science Centre, a different Winnipeg hospital. The patient was triaged as not urgent, but his condition continued to deteriorate overnight, and he could not be revived.
Dr. Lagacé-Wiens said he has no direct knowledge of the incident but believes the flu season overload “absolutely could have played a role into this tragedy.” A review of the death, ordered by the Manitoba government, is continuing.
In Nova Scotia, Kirstin Weerdenburg, a pediatric emergency physician at the IWK Health Centre in Halifax, said there has been a shift over the past month from children presenting with walking pneumonia to presentations of flu and RSV. She said they appear to be at the start of their flu season and she expects cases to rise quickly.
She said it was abnormal to treat so many cases of walking pneumonia – more than 160 in the first 10 months of 2024 – but that the increase in respiratory viruses is standard for this time of year. Physician staffing levels have been increased, and the hospital has allocated more staff hours to when patient volumes are the highest, Dr. Weerdenburg said.
Part of the preparation involves looking to Western Canada. She said, typically, whatever happens on the respiratory virus front in places such as Alberta eventually replicates in the east. Dr. Weerdenburg said children’s hospitals in the Prairie province being overburdened with patients in December has caused some anxiety: “It’s like, oh gosh, what’s going to happen here?”
Sidd Thakore, a pediatrician at the Alberta Children’s Hospital in Calgary, said flu activity reached a peak in mid-December when the hospital was pushed to 150-per-cent capacity and had to add dozens of beds to care for an influx of patients. He described the hospital as a “zoo” with children double bunked in rooms, cared for by staff that picked up extra shifts.
“That’s the way we needed it to maintain patient safety. But, when I say that, we had sick kids on the unit that would normally be in the ICU, but were on units because there was no capacity,” he said.
The situation has calmed down since then, but the hospital was still operating at 100-per-cent capacity last week, Dr. Thakore said, and staff are feeling the strain.
“Is it slowing down now? Possibly. Are we going to see another surge? We don’t know yet,” he said, adding that “we’re still preparing for it.”