Right in the centre - Will we do better in the future?

Details

Published on Friday, August 5, 2022

By Ken Waddell

Neepawa Banner & Press

In the past, I have written about the U.S. medical system. I have had to delay getting back to Canada because I ended up in three different U.S. hospitals last week, one in Kentucky and two in Missouri. Treatment was excellent and as of Tuesday, Aug. 1, my wife Christine was driving me 15 hours home. God bless health care staff and my wife.

A couple of years ago, I posed this question to Manitoba Health: “If Manitoba had the same ratio of population to ICUs as North Dakota, there would be over 400 ICUs in Manitoba instead of 72. Do you know why Manitoba numbers of available ICUs varies so much from North Dakota?” The stats are a couple years old now.

I actually got an answer but, as usual, the words can’t be attributed to an actual person, but here’s the answer which was “attributed to a Shared Health spokesperson”:

“Manitoba’s ICU capacity pre-COVID was 72 beds. In addition, up to 22 beds are maintained to meet the needs of cardiac sciences patients.

This bed base has regularly expanded to meet patient demands during surges and busy periods, such as the annual flu season, but has been considered by system experts and leaders as appropriate capacity for a population the size of Manitoba and in line with historical needs during normal, non-surge times.

COVID has placed unprecedented pressures on critical care services not just in Manitoba, but around the globe. In response to these demands, Manitoba has increased critical care capacity to 152 beds locally and has arranged for access to additional capacity out of province through a number of agreements with other Canadian jurisdictions. As of Thursday, 122 patients (60 COVID and 62 non-COVID) were being cared for in Manitoba ICUs.

The sustained pressures of COVID-19 are expected to subside over the coming months with the expanded availability and adoption of vaccines.

System and critical care leadership continue to review evidence and data related to the ongoing and anticipated demands on critical care capacity both for potential future waves of COVID and for the future health demands of Manitoba’s population. Comparison of bed base between vastly different jurisdictions, particularly between Canada and the United States which have extremely different health systems, does not provide an accurate picture of capacity or demand in Manitoba ICUs.”

In a newspaper article in the Grand Forks Herald ,Minot Trinity Hospital Dr. Jeffrey Sather explained that at the height of the C-19 pandemic, North Dakota was running low on ICUs. If that was the case, then it’s no wonder Manitoba’s ICUs were overloaded. North Dakota has had 111,000 cases and 1,554 deaths. The ND population was stated as 762,000 in 2019. By the numbers, they haven’t done as well as Manitoba on cases and deaths.

C-19 has always been about numbers. Manitoba has done better than North Dakota. In Manitoba, there have been 1,125 deaths attributed to C-19 as of June 21. Out of a population of 1.4 million, that is a small percentage, but every death is sad and many were tragic. It has been stated many times that a high percentage of the deaths were among the elderly and in care homes. The situation will be studied much more I am sure, but it is widely felt that many of the care home deaths could have been avoided. We will never know for sure.

There have been 55,405 cases, which means about four per cent of Manitobans tested positive for C-19. How many more actually had C-19?  We will also never know. Earlier this month, Manitoba Health, when I asked how many people died in ICU, stated that one in four people in ICU didn’t survive.

Now, go back and re-read Manitoba Health’s statement above about ICUs. They defend Manitoba numbers by saying, “Comparison of bed base between vastly different jurisdictions, particularly between Canada and the United States, which have extremely different health systems, does not provide an accurate picture of capacity or demand in Manitoba ICUs.”

That’s a very telling statement. In Manitoba, the government decides how many ICUs or most other services we have. In the U.S., demand determines how many services they have. While we can be very thankful for the quality of health care in Manitoba, the availability is often lacking. In  the U.S., there are very short waiting lists. In Canada, a person can wait for months or years to get a treatment or surgery.

Canada, and especially Manitoba, has been adamant that private health care is a bad thing. Maybe it’s time to re-examine that premise. Had we re-visited that premise a few years ago, maybe we wouldn’t have run out of ICUs.

Sixteen months ago, the whole C-19 process was geared to two numbers. One was reducing deaths and the other was not overloading the ICUs. It appears we fell short on both counts and in the process ran into a pile of social and economic issues as a consequence. I feel that overall, Manitoba did OK, but we could have done a lot better. We fell short, we didn’t measure up and that should be a wake-up call. There will be another pandemic, there will be more and more demand on health care, even without a pandemic. Manitoba Health admits we only had enough ICU beds for “non-surge” times. Will we do better in the future? Only if we decide to do so.