Kelly Prime has spent decades seeing people on their worst days, but the veteran paramedic says the fourth wave of COVID-19 in Saskatchewan is unlike anything he’s witnessed.
Ambulances are spending hours more on the road to get patients to a hospital that can treat them. When they arrive, paramedics sometimes wait hours in hallways before a nurse or doctor can see them. Call volumes are up across Saskatchewan; in Saskatoon, the local emergency medicine service said they are high as they have ever been.
The result is the sinew binding Saskatchewan’s health system together is under strain, and operators worry the very front of the front line staff are at risk of burning out.
“It’s kind of a whole, systemic crisis,” said Prime, who runs multiple ambulance services in southeastern Saskatchewan and is president of the Paramedic Services Chiefs of Saskatchewan.
He said it’s a confluence of both record-high COVID-19 hospitalizations and long-term underfunding, noting
EMS providers usually receive about 130,000 calls per year across Saskatchewan; in 2021, they are already close to 150,000.
Troy Davies, spokesman for Medavie Health Services West in Saskatoon, said the city’s call volume is at a record high, and not just because of COVID-19. Overdoses, for example, are much more frequent.
“Two years ago, we were doing roughly 600 calls a week, whereas now we’re roughly 800 calls a week,” Davies said. Nearby rural ambulance providers have been asked to help out, a step that is not unprecedented but is uncommon.
“It’s the worst that we’ve seen it, but at the end of the day we’ve found ways to work together,” Davies said.
Prime said paramedics in big cities are also spending up to eight or 10 hours waiting with their patients in hallways before they can be handed off to other staff, another symptom of record-high COVID-19 hospitalizations.
“It was very rare to see an offload delay of over 10 hours before. Very rare,” Prime said. “It was very rare to see an offload delay of anything over six hours. Now that is very common. It seems to be the norm.”
The StarPhoenix asked the SHA, which operates some EMS services and an air ambulance service, for data on how much offload times have increased. Spokeswoman Amanda Purcell said the SHA did not have the capacity to dig up that data because of the demands placed on the health care system by the fourth wave.
Davies cautioned that heightened offload times are not new and differ day-to-day, but acknowledged they have worsened.
Paramedics can mitigate delays by “stacking” — leaving one paramedic to treat multiple patients in a hospital hallway — but that still takes a paramedic off the road, Prime said.
That has been challenging for rural ambulance staff who sometimes travel hours to drop off patients in bigger cities with better-equipped hospitals.
Corey Ecarnot, the deputy chief of EMS and Air Medevac operations in La Ronge, said it has hampered their ability to respond to local calls.
“We’ve seen a huge increase in delays in our responses because of increased call volume and offload delays in urban settings, which has caused huge increase in our staff fatigue,” he said.
Some of those trips are about “load levelling” — distributing patients across the province to better manage the weight of the pandemic.
STARS air ambulance director of clinical operations Tracey Steel said STARS added a third helicopter crew last month at the request of Saskatchewan’s government and the Saskatchewan Health Authority to help transport sick COVID-19 patients from rural areas to big hospitals, or between intensive care units.
Between Oct. 1 and Oct. 6, 2020, six per cent of patients STARS moved had the virus or were symptomatic; in the same time period in 2021, the proportion grew to 21 per cent.
“The type of COVID patient we are transporting are critically unwell. They are on a ventilator, multiple infusions. They are very complex missions,” Steel said.
All those hours on the road tighten how many staff are available, Ecarnot said, noting that in La Ronge, paramedics might be on call for days on end.
He, Prime and Steel expressed fears about how all the extra work is affecting staff.
“We’re seeing, frankly, some really tragic things happening with folks around their own health and well-being,” said Saskatchewan College of Paramedics registrar and executive director Jacque Messer-Lepage.
The concern is shared across the health-care system. Jocelyn Argue, an SHA spokeswoman, said a survey of all SHA staff and doctors between October and December 2020 found 66 per cent agreed their colleagues were burned out. The response rate of the survey was 38 per cent.
“Comparing 2020 to 2021 (January to September), we have seen a 10.5 per cent increase in the number of staff leaving the organization,” Argue wrote.