The entrance to the Emergency Room of the Markham Stouffville Hospital.
The entrance to the Emergency Room of the Markham Stouffville Hospital. Credit: Raysonho

If you feel like yelling about the state of healthcare in Canada, say Aarrgghh.

In January 2022, the pandemic took an unforeseen turn in Canada with the arrival of the highly contagious Omicron variant. COVID seemed to be everywhere, infecting people regardless of vaccine or mask status. And with some one-fifth of the population resisting vaccination at the start of 2022, the number of admissions to hospitals was once again threatening to overwhelm acute care facilities.

We were between a rock and a hard place. Why? Because messaging about vaccinations lost impetus when even the vaccinated were affected by Omicron.

We were once again trying to flatten the curve. And the only thing that could help defeat Omicron – and the earlier Delta variant – was to increase the number of people vaccinated and to continue with masking, hand-washing, social distancing and isolation/quarantine when necessary. This was old news, but it did not make either the rock or the hard place any softer.

This old news repeated in February. Hospitals were still overwhelmed and the situation in congregate living situations was dire. Vaccines and masking became even more newsworthy, when the so-called Freedom Convoy descended on Ottawa, and several Canadian/U.S. border crossings, at least initially as a protest against these public health mandates.

Vaccines were already free. What if masks were, as well? Research was not yet and still is not available on the cost-savings to hospitals with reduced COVID admissions. In fact, these beds would not be empty even with reduced COVID admissions. People whose care has been delayed during the pandemic would occupy them. But from a public health perspective, free availability of proper masks could go a long way to ease the burden of remaining healthy.

March arrived with another shift in thinking. Omicron was losing steam. Infection rates, at least as reflected in hospitalizations and ICU admissions, were decreasing. Governments across the country reacted by reducing and/or eliminating health care cautions and restrictions. After dealing with COVID-19 for two years, Canadians could again enter restaurants, bars, gyms, theatres, and the like without proof of vaccination.

Not so for mask mandates. Most regions left the decision to wear a mask up to the individual. Canadians had to learn to live with COVID fear, but also to recognize that COVID fear did not have to be all-encompassing.

In the spring, Canadians began to look at COVID differently. The statistics did not accurately compare across regions, due to differences in definitions and in timing of reporting, among other things. The one certainty continued to be that those vaccinated fared better than those who had not had shots. Fewer vaccinated people became sick; those who did test positive were less sick and fewer were hospitalized. Of those vaccinated people who were hospitalized, fewer died. Still, a significant percentage of the population remained unconvinced.

With fewer restrictions and more personal responsibility, and encouragement from the travel industry, Canadians began to travel again. In addition to the almost daily changes announced by countries around the world, Canada began to receive lots of flak over the then mandatory ArriveCan app. Suffice to say, the app was neither user-friendly nor comprehensive.

Despite intense pressure to eliminate it, the Government of Canada persisted. It even threatened fines of several thousand dollars and potential incarceration for not following the app’s guidelines. Thousands of these threats were ultimately acknowledged as due to a glitch in the system, which did nothing to increase the app’s popularity. The requirement to complete the app was ultimately lifted in October 2022, after almost two-and-a half years.

There is only so much COVID news that is new. From the start of the pandemic in December 2019, many other aspects of the health of Canadians had been cancelled, put on indefinite hold or forgotten about. In the summer of 2022, the media and the public began to push back at the lack of availability for other healthcare issues.

Nightmare stories circulated about overflowing emergency rooms. Some ERs were so understaffed that they were closed entirely. The shortage of family doctors and nurse practitioners left some five million Canadians with no ongoing healthcare provider. People turned to emergency rooms when even virtual and walk-in healthcare clinics could not handle the traffic. Patients spent hours and some, days, in hospital waiting rooms and hallways.

Staff burnout contributed to the situation, as did demographics. Many baby boomer healthcare workers, burned out from two years of COVID on top of many years of shortages, either retired or resigned.

Provincial and territorial governments looked for band-aid solutions. They announced fixes to bring the healthcare system back to its pre-COVID stance. Defining that as a goal was and is part of the issue.

The provincial and territorial ministries of health insist that the problems result from a shortage of money from the federal government. The federal government wants the other levels to report on the healthcare outcomes for the additional funds demanded. More money won’t solve the myriad issues of a hospital-based and a fee-for-service insurance system.

We are at a healthcare stand-off of significant proportions. This year is ending with COVID-related cases rising yet again. Rates of vaccines and boosters are decreasing. At the same time, hospital emergency room visits and admissions for seasonal flu and for pediatric respiratory viruses are overcrowding facilities once again.

Shortages of over-the-counter medications for cold and flu symptoms leave parents with little choice when a child is very ill. This is particularly true in Ontario, where funding for virtual paediatric appointments was slashed and such services have essentially shut down. If the family has no doctor or nurse practitioner, and no virtual options, the emergency room is the only thing left. Waits seem endless, with children crying and coughing and gasping for breath.

In the past 12 months, very little has changed that encourages Canadians to be optimistic about our healthcare system in general and COVID in particular. Perhaps it is time for a time-out. Perhaps the provincial and territorial government premiers should be forced to sit in an emergency room for hours, to see for themselves how dire the situation is.

Would they then see things differently?

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Evelyn Lazare

Evelyn H Lazare is a healthcare planner, strategist and executive. Lazare has led nation-wide healthcare organizations in Canada and has consulted to an array of healthcare and related clients in both...