Infected patients being treated for another disease | Real weight in hospitals

30% to 40% of patients currently hospitalized with a diagnosis of COVID-19 in Quebec are primarily untreated for the disease. But should we be wondering how much weight the Omicron variant puts on the health system? Not at all, according to experts.


Ariane LaCourcier

Ariane LaCourcier
Journalism

Over the past week, the number of hospitalizations linked to the COVID-19 virus has risen in the county. As of Wednesday, 1,750 infected patients occupied hospital beds. The Department of Health and Social Services notes that “the situation in hospitals is critical, and is made worse by the number of workers who are infected or isolated.”

In a press briefing Thursday, Quebec’s National Director of Public Health Drs Horacio Arruda, noted that 30% to 40% of these hospitalizations will be “really unrelated” to COVID-19. ” [Le virus] est tellement en circulation que si vous avez un problème d’estomac et devez être hospitalisé, ils vont vous tester et trouver la COVID-19, mais ce n’est pas la raison pour laquelle vous êtes à l’hôpital », at – says . More accurate data is collected on this topic.

At the University Hospital Center of Montreal, for example, spokeswoman André-Anne Toussaint says, “A large proportion of our patients do not have respiratory symptoms associated with COVID, they are hospitalized more often because of their illness.”

At CIUSSS du Center-Sud-de-l’Île-de-Montréal, it is indicated that of the 62 patients hospitalized with COVID-19, 19 were admitted for this reason and 32 for another. For 11 patients, the admission prognosis remains unknown. At CISSS de Laval, 26 of the 50 hospitalized patients have been admitted to the hot units due to COVID-19. In CIUSSS de l’Ouest-de-l’Île-de-Montréal, it is 49 out of 76 patients.

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data vigilance

Geriatrician and Epidemiologist Drs Quoc Dinh Nguyen says this data should be analyzed with caution, not least because it is difficult to determine beyond reasonable doubt that COVID-19 is not partly responsible for a person’s illness. Especially in elderly patients.

He gives the example of an elderly patient, weakened by the COVID-19 virus, who fell and fractured his hip. Or someone else with a cognitive impairment who sees their disorder getting worse with COVID-19, to the point of having to be hospitalized. What is the main reason for hospitalization? Dr. says.s Nguyen.

An opinion shared by emergency physician Alain Fadeboncourt, who explained that COVID-19 “can cause a lot of complications, in many systems” of the human body. Under these circumstances, it may be difficult to conclude that COVID-19 is not at all involved in the symptoms of a person with the disease in hospital.

The phenomenon of patients being hospitalized with COVID-19, but without any symptoms, certainly exists. But it is very difficult to define it.

considered ds Alain Fadeboncourt, emergency physician

for ds Nguyen, it is “right” to question what kind of patients are currently in the hospital. “By the first wave, it was clear that hospital patients were treated for COVID first. There, it’s more mysterious.

Many necessary precautions

However, the specialist explains that the effect of the Omicron variant on hospitals is real. Once a patient is infected with COVID-19, their treatment is necessarily heavier. Because of the protective measures, more personnel are needed. Fewer employees because many are infected with the virus.

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Because the severity of the Omicron variant remains uncertain, extreme caution should be exercised with all patients with COVID-19.

We can’t cure [les patients atteints de la COVID-19] As if they had a simple flu. A patient with COVID-19 is very distressing, whether or not he is being treated in the first place.

considered ds Quoc Dinh Nguyen, Gerontologist and Epidemiologist

for ds Vadeboncourt, if the hospitalization questioning is correct, we still have to be very careful about the way we present the results. “Because we can lead people to believe that the situation is not that serious, while we still have to take care of these 1,700 patients who have problems with the system.”

President of the Association of Specialists in Emergency Medicine Quebec Drs Gilbert Boucher notes that the picture of hospitalized patients who have tested positive for COVID varies from region to region. But whether it’s treated “for” or “with” COVID, they are all “heavier in difference,” he says. “The pressure on the system is there,” says Dr.s Boucher, who noted that some institutions are considering different solutions if the situation continues to deteriorate, such as closing outpatient rooms in the emergency room.

according to ds Nguyen, knowing that a certain percentage of hospitalized patients with COVID-19 are not being treated for the disease, could predict that the impact on intensive care will be less strong than expected. “Having reliable data on this topic could be very interesting for planning acute care needs,” he says.

How do you document the rest?

These questions about in-hospital patients are being raised at a time when Quebec is announcing that it will not be following the daily evolution of the number of new COVID-19 cases in the province, as its testing capacity has been exceeded. What should we trust now to follow the evolution of the epidemic?

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“One thing is for sure, it’s going to take a tool. You can’t sail by sight,” says Roxanne Borges da Silva, a professor at the University of Montreal’s School of Public Health.

considered ds Nguyen points out that in England, a random sample of the population is regularly tested, which makes it possible to assess the rate of spread of the virus. He said Quebec could do the same. considered ds Nguyen also believes that the number of health care workers can be tracked on a daily basis. Because these are still being tested. While they are more susceptible to the virus than the average population, health care workers “live in the community.” “That should give us an idea,” said the doctor.

MI Borges da Silva and Drs Vadeboncourt believes that the return of wastewater analyzes could also provide an overview of the situation. “It is important to know how many hospitalizations we have. But increases in cases always precede an increase in hospitalizations. So you need to know how many cases are so we see them coming,” says Dr.s Vadeboncourt.

“From the moment we impose measures on the population, such as a curfew, we have a duty to follow the situation as closely as possible,” notes Dr.s Nguyen.

In collaboration with Marie-Yves Moras, Journalism

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