Most Saskatchewan residents who are in hospital with COVID-19 were not formally diagnosed until they were admitted. A top doctor worries this could be a symptom of people not seeking testing.
Dr. Susan Shaw, the Saskatchewan Health Authority’s medical health officer, said 55 per cent of people admitted to hospital with the virus in September had not been diagnosed before admission.
“I’ve never seen people show up so sick, so late,” Shaw said.
Saskatchewan is seeing a record number of people admitted to hospital with the virus, many critically sick. On Wednesday, the Ministry of Health reported 76 patients were in intensive care.
There were only 79 ICU beds in Saskatchewan prior to COVID-19, but the Saskatchewan Health Authority has boosted capacity at the cost of cancelling thousands of other surgeries and services.
Shaw said there’s no clear reason why so many COVID-19 patients are presenting so late, but she worries patients fear what a positive diagnosis may mean.
“I think people are scared. There’s also a stigma. I’ve heard anecdotally … that in some towns and some communities, you’re not supposed to get tested, and I don’t understand that at all,” she said.
Shaw, an ICU doctor, has warned in recent weeks that the health-care system may be approaching a point where critical care staff have to decide which patients get life-saving measures.
The SHA was bracing for as many as 125 COVID-19 patients in intensive care by the end of September. That did not come to pass, in part because of good luck — but also because a significant number of patients have been successfully managed in less-intensive care settings, Shaw said.
“The acute care COVID wards are doing an amazing job faithfully looking after people who in usual times would be in the ICU,” she said. About 40 patients provincewide are on non-invasive ventilation in such wards, and some would likely have been in ICU otherwise, she added.
She warned the number of patients who are undiagnosed on arrival in hospital means interventions that could prevent them from getting sicker are no longer usable.
In recent days, Premier Scott Moe has said he wants to “ambitiously look” at the use of monoclonal antibodies for COVID-19 in Saskatchewan. Shaw cautioned that the therapy is only recommended for a subset of people in the early stages of illness, not those in hospital. She estimated they might prevent just one or two admissions a week.
She said every admission counts, but noted vaccination is the safest and best way to prevent severe outcomes.
“I do think our system is in crisis. So if we’re at risk, it is important to explore any and all ways to make sure all therapies that are effective are available as much as possible.”
Shaw said the province is likely close to the point of having to request aid from other jurisdictions like Manitoba. She was audibly emotional when asked if Saskatchewan may be heading for a situation where doctors are forced to make impossible choices.
“I’m very worried that the answer is yes,” Shaw said. “I want it to be no, so bad.”