Children feel the effects of the health system crisis

“This is the state of health care in Ottawa. Literal parking lot medicine.”

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Earlier this month, Sean McTavish’s three-year-old son woke up sick with inflamed red and white tonsils. McTavish and his wife were worried it was a bacterial infection that required antibiotics, so they called their family doctor.

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That’s when the family’s challenges began. After three days of trying to get his son assessed, McTavish was finally asked to remove his son’s throat himself, in the parking lot of a walk-in clinic.

“Throughout this process, after three days of active effort, no medical professional was able to see my child’s tonsils in person. This is the state of health care in Ottawa. Literal parking lot medicine.

Ontario’s health care system is on the verge of a summer of crisis, with overcapacity emergency departments – patients are now waiting an average of 20 hours in the emergency room before being admitted, according to the provincial NDP – and worsening staffing shortages across the province.

Children are among those feeling the effects – from difficulty finding primary care, to long waits in hospital, to lack of access to crisis-level mental health treatment.

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McTavish said the lack of timely in-person care for children, like her son, who have symptoms consistent with COVID, is one more sign of how children have been an afterthought throughout the pandemic.

When McTavish phoned his family doctor’s clinic, they told him they couldn’t see the boy for at least 13 days and only then if his sore throat was gone, as it could be a symptom of COVID. -19. They suggested the family go to the emergency room or a walk-in clinic.

McTavish said he knew his son’s situation wasn’t an emergency and CHEO was over capacity, so they didn’t want to go.

CHEO is currently under unprecedented pressure. Children’s Hospital canceled and postponed some surgeries and procedures this week after record numbers of patients waited in emergency beds over the weekend, causing a “lockdown effect” across the hospital.

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On Wednesday, the hospital’s inpatient units were down slightly from a peak capacity of 122% over the weekend to 112%, hospital spokesman Patrick Moore said, but they stayed “super busy”. Hospitalization is where the majority of patients admitted to the hospital urgently have to go and when there is no room, they wait to be admitted, resulting in longer waiting times. long and traffic jams. The number of patients waiting for beds in the emergency room had also fallen since the weekend, but waiting times remain long – around seven hours as of Thursday afternoon.

McTavish was directed to a walk-in clinic where he and his son stood outside for three hours waiting to see someone. When they got to the front of the queue, they were told they couldn’t get in because of his son’s symptoms and McTavish was asked to dab his son’s throat in the parking lot. McTavish, who is a researcher in the federal government, said he was worried he wouldn’t be able to perform the swab properly.

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“I did the best I could,” he said. “I am not a nurse. That’s asking a lot of a parent without information or training.

In the end, the boy did not have a bacterial infection, according to the swab, and the sore throat ran its course.

McTavish said he later learned that children who have symptoms consistent with COVID-19 — including fevers and sore throats that are common with childhood illnesses — can be seen at one of the clinics in COVID care still operated by Ottawa Public Health, but this, he says, is not widely known or advertised.

After more than two years of a pandemic in which children have suffered disproportionately, McTavish believes the health care system continues to fail them. His family’s experience is an example.

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“Parents and their children have borne the brunt of lockdowns, PCR tests, isolations and employment-related impacts for two years. Now we have been let down by clinics that deny in-person care to sick children.

“We’re really letting our kids down right now.”

He said clinics are choosing not to see sick children in person despite Public Health Ontario providing guidance to clinics on how to adapt care to care for patients who show symptoms associated with COVID-19. .

He said he does not blame hard-working doctors or nurses, but criticizes health care bureaucracy, political and public health leaders “who willfully ignore the key challenges of our health system ; and the continued downgrading of children’s needs.

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Ottawa family physician Dr. Nili Kaplan-Myrth noted that family practice clinics are also facing severe staffing shortages and staff are at risk when they see symptomatic patients, which could make the situation worse.

She said most of what happens around Ottawa causing sore throats is viral and doesn’t last long, so waiting a few days is probably best. If the symptoms lasted longer, she said she would take a swab from the porch and treat it with antibiotics if the result was positive.

Primary and hospital care aren’t the only areas where there are growing concerns that children won’t be able to get the help they need in a timely manner.

Ottawa pediatricians say they have been overwhelmed with patients in need of mental health treatment who cannot get timely care. Children wait five to six times longer for mental health services in Ontario than adults, said Dr. Andrzej Rochowski, chief of pediatrics at Queensway Carleton Hospital and member of the Ottawa Community Paediatricians Network.

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Mental health issues in children and young people, including eating disorders, have skyrocketed during the pandemic.

Rochowski said he and his colleagues have to act as psychiatrists and prescribe drugs that they would not have prescribed in the past because their patients are unable to get timely mental health care.

Only the sickest patients are eligible for publicly funded care – if available – but now even private mental health care is “overwhelmed”, he said. Even the wait to have a patient evaluated can be up to a year.

“We all have our list of resources, but those kind of dried up,” he said. Pediatricians treat patients medically – with drugs some have never used before – because the wait for therapy is so long.

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“I have to give six-year-olds antidepressants because they can’t function,” he said.

Dr. Kelly Zwicker, who founded the Ottawa Community Paediatricians Network to enable paediatricians to work together to meet the challenges of the pandemic, said 80% of her referrals are related to mental health. While patients wait, pediatricians continue to treat them.

“I’m not a psychotherapist, but I’m the person who checks them every week,” she said.

She said she referred some of her anxious patients to online resources because they couldn’t get timely treatment. She says there is no end in sight to the current situation.

“We all knew this was coming and we know it’s not going away any time soon.”

The lack of timely access to family medicine is likely to make the situation worse for children, she said.

Rochowski also says children and youth continue to be viewed as an afterthought in the province, even as their health needs increase. Mental health care was barely touched on during the recent provincial election campaign, he noted.

“Children and young people seem like an afterthought and the election was just a demonstration of that.”

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