Quebec ER overcrowding will ‘continue to be difficult’: health minister

Quebec Health Minister Christian Dubé had mostly bad news in his first update of the year on the province’s emergency room network.

With emergency departments across the province today at 137 per cent capacity on average, Dubé told reporters the situation would continue to be difficult for some time.

“It was difficult, but it’s going to continue to be difficult in the next few weeks, few months,” Dubé said. “So let’s make sure that we protect ourselves.”

About 10,000 a day are visiting ERs in the last two weeks, with almost 2,000 daily for respiratory viruses, a rate roughly double what was seen at the same time last year.

“Maybe COVID is not as bad, but influenza is still going up,” he said “If there is a clear message on influenza: vaccination is still a possibility because we have only 50 per cent of the population that is more vulnerable above 65, 70 years old, that could be vaccinated. A difference of 10, 15 per cent could make a huge difference at the ER.”

As well, Dubé says more people over the age of 65 are going to ERs, which results in more complex cases.

The Index Santé site, which monitors and reports occupancy rates and waiting times in ERs, says shortly after 8 a.m. that the average rate for Montreal was 139 per cent with the Lakeshore General Hospital at 216 per cent and the Montreal General at 187 per cent.

The most critical situation: in the Lanaudière region, where the occupancy of the emergency rooms of Pierre-Le Gardeur Hospital and the Lanaudière Hospital averaged 201 per cent.

In the neighbouring region of the Laurentians, the emergency occupancy rate at 161 per cent.

The rates at 169 per cent in Laval and 146 per cent in the Montérégie.

“Emergency rooms are occupied by patients that are waiting for hospital beds or don’t have anywhere else to go and they’re on the stretchers,” said Dr. Judy Morris, president of the Association of Emergency Physicians of Quebec. “A big chunk of those patients on the stretchers in emergency room are actually patients that should be up on the ward in the hospital but they’re stuck in the emergency room for a lack of space on the floor to take them in.”

She says that the situation has been difficult in many of Quebec’s regions.

“It makes working conditions and patient care very difficult for all emergency room teams,” she said.

Dr. Morris says there are solutions to solve the congestion in ERs, some even put forward by Quebec’s crisis cell.

“The big one is the overcapacity protocol of the ER meaning if is at 160 per cent, you have to share a little bit that burden, you distribute a little bit of pressure on the wards and have each department on the ward take an extra patient or an extra two patients to relieve a little bit of pressure on the emergency room,” she said. “It’s not a perfect solution. It’s only a temporary solution, but this is one of the things that needs to happen if we want to give a little bit of breathing room to the emergency room to be able to to achieve our mission, which is to take care of the acute patients coming in.”

#WATCH: “Emergency rooms are occupied by patients that are waiting for hospital beds,” said Dr. @MHJudyMorris of the Association of Emergency Physicians of Quebec. Health Minister Christian Dubé will hold a press conference at 1:30 p.m.

READ: https://t.co/t9xV5t3dUC pic.twitter.com/4cIv3NoP05

— CityNews Montreal (@CityNewsMTL) January 10, 2024

“What we noticed is that on the ground it’s not being applied,” said Dr. Morris. “So, hopefully there’s going to be more of a strict follow up with all establishments.”

The health minister says almost half of the daily ER visits are for ailments that aren’t urgent and can be treated at walk-in clinics or with family doctors.

Just before New Year’s Eve, the Quebec government called on the population to exercise caution in order to limit the transmission of these viruses and avoid applying additional pressure to the health network. The Health ministry stated that a large proportion of patients who consult the emergency room do not need to go there.

Erica Feininger was one of those people who avoided the ER.

“I actually felt really unwell over the holidays and I would have gone to the hospital if we hadn’t been being told not to go to the hospital,” she said.

The Montrealer was dealing with a pinched nerve. “I was close to a 10 in pain and I chose not to go to the hospital because I thought they’re not going to be able to help me,” she said.

Among the examples observed on a daily basis, the ministry reported sore throats, mild coughs, gastroenteritis without signs of significant dehydration and symptoms of urinary tract infection. These health problems can often be neutralized by a consultation on the 811 telephone line or at the digital first line access desk (GAP).

“Every time we asked people not to come to the emergency, we also mentioned that if you’d feel sick, if you’re not well, we are there for you,” said Dr. Gilbert Boucher, president of the Association of medical specialists and emergency medicine of Quebec. “We’re sorry if that wasn’t clear, but people have to understand we are there for the sickest patients all the time 24/7.”

Dubé says workers who took time off for the holidays are returning to the health system this week and easing pressure on overworked staff and influenza cases are expected to peak mid-January.

“I think that’s the thing that makes us sad as Quebecers is that if you don’t feel like your hospital system or your doctor can be there for you and there’s such a huge burnout rate with the nurses, it makes us feel more vulnerable,” said Feininger.”

-With files from The Canadian Press