Overcrowded Montreal ERs working at over 100 per cent capacity, some in Quebec reaching 300 per cent

ERs are bursting at the seams in the Greater Montreal Area and in most regions of Quebec. We spoke to Dr. Christopher Labos about how this can happen, what to expect, and possible solutions.

If we look at the numbers, the majority of Quebec ERs are overcrowded, working at over 100 per cent capacity. If we look in Lanaudière and the Laurentians, there are some hospital ERs running at 200 and 300 per cent capacity. In Montreal, the Royal Victoria is operating at 185 per cent, and the Children’s Hospital at 167 per cent. How can this happen?

It happens when there are too many patients and not enough hospital beds to accommodate them. I think there’s multiple factors playing into it. You have a lack of personnel. You have a population that’s getting older. You have the lack of access to family doctors and a lack of access to long term care so there’s too many people in the hospital system and just not enough beds to accommodate the people who are getting sick on a daily basis.

A Quebec man over 70-years-old reportedly fell through the cracks of the triage system and died after waiting 16 hours in the ER of an unnamed hospital. Do you feel that patients are at risk right now when you see these numbers?

Whenever you have emergency rooms working at overcapacity, there is a point where you start providing suboptimal care. I think that is a real danger and if we allow these numbers to continue, if cases get worse and if we see more people getting sick with things like the flu or COVID, and emergency rooms becoming overwhelmed, we just won’t have the capacity to treat all the other stuff that are making people sick.

What’s your message to government officials? How can we fix this problem?

Well, we sort of have to fix multiple things in parallel. We have to have more long term care beds so people can move out of the hospital when the acute phase of their illness is done. We need more staff in hospital to be able to staff all the beds that are available. We need more resources and we need more family doctors and a greater capacity for walk-in clinics so we can redirect low risk patients away from the emergency room. So, there’s a lot of different things we have to do. But if we can do all of them, it’s really going to help in decreasing the burden that’s being placed on ERs in the hospital system overall.

We’re hearing about RSV (Respiratory syncytial virus) in children spiking. Colds and flus are likely to increase as we see our temperatures drop. Do you worry that the situation could get worse before it gets better?

It’s certainly possible. There’s a lot of respiratory viruses circulating. It’s not just COVID. So if people are not careful, if we allow viruses to spread out of control. Yeah, we could see an upsurge in cases. And, when you have emergency rooms already overwhelmed, well, a spike in RSV or the flu or COVID is just going to make the situation worse.