Toronto’s Healthy Toronto proposal puts pressure on clinicians

Image copyright CPA Image caption Dr. Julio Montaner said to decouple COVID from ED was a “mistake”

A series of moves by the Toronto Public Health system will reduce the potential for hospital overload, but puts pressure on clinicians, Dr. Julio Montaner of the Canadian Association of Physicians for the Environment said on Saturday.

As well as reducing total COVID (no increase in volume), the city’s Joint Health Unit is proposing an expansion of emergency care to 7 nights a week.

NEPD (North East District Public Health) is also looking at standardising care for infants in the neonatal intensive care unit.

COVID stands for Circulating Oxygen Deficiency (a vaccine against EHEC), a disease of vitamin B-12 deficiency in infants, and one which can lead to death.

Image copyright CPA Image caption Criticising the policy for its lack of community consultation, Dr Montaner said “I think they will begin to understand, if they feel comfortable enough to put their foot in their mouth”.

He said to decouple the policy from ED was a “mistake” because having health officers double up in the emergency department, which is a shock to clinicians who do the job, will increase the risk of clinical complexity.

He also said that the NEDH-Health Officer Committee has been consulting the community for a number of years without consultation with services.

Dr Montaner said to make better treatments more available, clinicians should only do one thing, such as advice, while another physician deals with many of the pain.

“What we do in ED is become a petting zoo for the father, the mother and children,” he said.

Dr Montaner also cited modelling by Canada’s Institute for Health Information that showed reduction in COVID in Toronto’s ED system would translate into an average reduction of 1.4 beds per day.

Another model by the Diallo Group set the threshold at 5% reduction in ED use and 29% of beds would be cancelled out, so no beds would be vacated, and the projected efficiency gains would take care of one-third of the projected bed reductions.

“I think they will begin to understand, if they feel comfortable enough to put their foot in their mouth,” he said.

Citizens Against New Drugs and Alcohol on Saturday also launched a separate campaign at the Summit, demanding that no more neonatal ICU beds be built or opened.

Image copyright CPA Image caption “For as long as neonatal ICU beds are not being eliminated, lives will be lost,” said a spokesman for Citizens Against New Drugs and Alcohol

The organization argues that those babies need a proper assessment when they are born, not rushed off to the OR.

Campaigners raised concerns that a research project comparing operating rooms in Toronto and the United States to claim that there is no “dual-use” of operating rooms in Canada has created “institutional bias” and a perception of a bias against neonatal ICU beds.

The doctors at the Summit have echoed the concerns of the campaign and are calling for a review of Canadian policy.

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