Omicron posing challenges for N.S. ambulance service, paramedics

The company that runs Nova Scotia's ambulance service says the Omicron variant is posing new challenges to the system. 

"I would say it's significant. This current variant is not just affecting the inpatients and tie-up of flow, but it's affecting the workforce itself," said Charbel Daniel, executive director of provincial operations for Emergency Health Services.

Daniel said a flood of COVID-19 patients is causing acute bed shortages, and the inability to offload patients is tying up ambulances for hours. 

He said offload times at hospitals in Halifax and Dartmouth are between three and six hours, taking between four and 12 ambulances off the road as they wait. Ambulances are waiting between one and three hours at hospitals in other parts of the province. 

With roughly 10 per cent of the active daily ambulance fleet idling at hospitals, he said, response times to emergencies are up. 

Unlike previous pandemic waves, such as in the spring when hospitalizations rose significantly, the Omicron variant is also affecting paramedic staffing levels. 

"Of our 1,200 staff members we currently have approximately 50 that are off," he said. 

Daniel said he's grateful for the work EHS staff are doing under difficult circumstances, including not just front-line paramedics but also support staff, nurses, 811 workers and the air ambulance teams.

"Truly every wave of COVID continues to be unprecedented, and the team continues to stand up to the challenge and work through it," he said. 

Emergency rooms tied up

Something similar is happening among staff in hospital emergency departments.

Dr. John Gillis, an ER doctor at Dartmouth General, said Omicron has been affecting staffing, which only adds to the wait time for patients and paramedics waiting to off load. He said patients can wait up to 10 hours to be seen.

"There is a level of strain and a level of stress that we are starting to see. It's affecting people. The staff are feeling it, and we must remember that they're human," Gillis told CBC Nova Scotia's News At Six on Tuesday.

"They're still doing a great job, but you do see the lines of strain starting to come through."

He reminded Nova Scotians to only come into an emergency department with COVID-19 if they're experiencing chest pain or trouble breathing. Otherwise, symptoms can be treated at home.

"Most of these cases will resolve on its own without a need to come in and add to the list, but also to risk bringing COVID into that hospital," he said.

Exhausting conditions

The union representing the province's paramedics said there's a risk of its members burning out in a marathon pandemic that keeps getting harder. 

"They're telling us it's horrendous in the field, because they're working 12-hour shifts, and sometimes they're not getting a meal break in that 12-hour period," said Kevin MacMullin, business manager for the International Union of Operating Engineers Local 727 for the Paramedics Union of Nova Scotia. 

MacMullin said it's hard for paramedics to recover, because staffing shortages mean more vacation requests are turned down. 

"It's difficult. It is very tedious and it's on the brink of collapse," he said. "I'm concerned with that ... I see it in the face of paramedics when I see them on the street, you know, it's tough."

As an illustration, MacMullin points to the frequency of internal "code critical" warnings that occur when a county has two or fewer ambulances available.

MacMullin said that since Dec.  20, there have been 158 code critical posts, five of which affected the entire province. Before that, he said, there had only been four other provincewide alerts since 2018.

Urgent need for solutions

MacMullin, who is a working paramedic, wants all levels of the ambulance system, union, management, Nova Scotia's health authority and the province to start talking about solutions. 

"They all have to sit in a room and they have to come up with ideas on how we're going to solve this problem," he said. 

"I'm worried that someone will be seeking an ambulance, and it'll be a long time before they get that ambulance, and that could be detrimental to their outcomes, and their health," he said. 

Daniel, the EHS executive director, said he's not aware of any cases where ambulance delays have harmed a patient's health. 

He said there are contingency plans in place if hospital congestion and paramedic illness stretch staffing levels even further. 

"I won't go into the specific details of it. It's our contingency plan, and our business continuity plan that we've been building over several years, and continue to build," Daniel said. "Hopefully, we don't reach them, and we don't have to deploy them."