CEO Statement: Update on Horizon’s ongoing response to the COVID-19 pandemic

Today, Horizon’s President and CEO Karen McGrath provided an update to staff and media on Horizon’s ongoing response to the COVID-19 pandemic in New Brunswick:

Hello/bonjour. Good afternoon, and thank you for being here.

I will provide a brief update on Horizon’s ongoing response to the COVID-19 pandemic in New Brunswick, then take your questions.

As I’ve said before, our health care system is in a vulnerable state. This has never been truer than it is now, as we continue to see a rise in new cases of COVID-19 in the province.

With the Fredericton area returning to Orange Phase protocols, joining the Saint John and Moncton areas, all but one of our 12 hospitals are now at the Orange level.

All of our hospitals are continually reviewing their contingency plans to prepare for the possibility of reducing health care services, such as clinics and certain surgeries so that we can deploy our staffing resources to the greatest areas of need.

We remain committed to maintaining as many services as we possibly can during these challenging times, however things can change quickly and we will not hesitate to adapt our response accordingly, should the need arise.

In fact, we’ve already had to cancel some surgeries – due to many factors, such as high inpatient occupancy rates or not having enough time to complete pre-op testing.

The same issues that threatened our health care system before the pandemic – a lack of staff, a lack of beds, and limited resources in general – have become even more magnified during the pandemic.

With the recent rise in new cases in our province and the increased risk for potential exposure to COVID-19, as of this past Friday there weremore than 100 of our staff who were unable to come to work because they were self-isolating at home, doing their part to control the spread of this virus.

There is no magic solution when you take 100 people out of a workforce that is already stretched to its limit.

COVID-19 fatigue is real and in New Brunswick we have been fortunate to have low case numbers and hospitalizations, but the impact is still here. Even just a few hospitalized cases will wreak havoc on our entire health system -everything is connected.

And hospitalizations arenot the only indicator-when the number of cases grow, the impact on our human resources is significant.There is a domino effect happening within the health care system that is being highlighted by COVID-19.

For example: Even one public exposure can quickly increase the need for COVID-19 testing at our assessment centres, as identifying positive cases is not something that can be delayed.

When there’s a public exposure, we see an increase in testing requests that need to be dealt withimmediately.

This causes delays and service closures in other areas because, as you know, we’re already working with a finite number of staff.

At all of our assessment sites, for example, staff were redeployed from other areas to quickly meet the growing demand. This means staff who usually work at our community health centres, or in administrative roles are pulled from their regular duties to fulfill important roles at our assessment centres.

By shifting staff from these areas, we have no choice but to reduce services elsewhere in the health care system. For example, patients who visit our ambulatory care clinics, such as diabetic and COPD patients may miss a follow-up appointment or a child’s immunization may be delayed.

We see the effects in our hospitals, too, and our messaging around our Emergency Departments has been clear:  we have been asking New Brunswickers to seek alternate options for non-urgent medical needs. I want to stress why now – more than ever – this is so important.

The Emergency Department is not for mild symptoms or COVID testing.

It’s no secret that before COVID-19 Horizon emergency departments were experiencing lengthy wait times, high capacity levels and staffing challenges. As we continue the fight against COVID, our teams have added a great deal of extra precautions to protect their patients and themselves.

This means emergency department staff must treat anyone with COVID symptoms as COVID suspect, triaging time has increased, additional PPE is required, and staff are stretched thinner than ever before.

The time they are spending ensuring safety precautions and COVID protocols are in place is time that may be taken away from other ED patients. But this must occur to prevent the spread within a health care facility.

We want the community to understand we are doing this for them, and we need them to be our allies and work with us. Please consider all your options in the community so when you need urgent care, we can be here for you.

Here’s another scenario: Ignoring Public Health guidelines and exposing health care staff to COVID-19 can have a devasting effect on the entire system.

If just one person failed to comply with self-isolation guidelines set in place by Public Health and visited a Nurse Practitioner or family physician at a Community Health Centre, the NP or physician would have to self-isolate quarantine for 14 days.  On average these primary care providers would see 12-15 patients a day.

This could result in 120 patients NOT being seen and cared for in a two-week period.

To go one step further, if the eight other health care providers working at the community health centre are exposed to COVID the result could be 1,280 patients without proper care in a 2-week time period. 

To go even another step further, this means these patients often have nowhere to turn but to our Emergency Departments for primary health care.

Because their needs – though important -aren’t urgent, they’ll have to wait a long time to be seen. This is frustrating, no doubt, for our patients and also for our health care staff who want to provide safe and quality care to every person, every day, but only have so many beds in each unit and so many hours in a shift.

So, you can see here how one failure to self-isolate or comply with Public Health guidelines can quickly snowball.

Some of these same NPs are also redeployed to assessment centres where they perform 200+ swabs per day.

These are just some examples of how our system is tested each day.

And, despite this all, our staff and system continue to persevere, working as a team to find ways of overcoming these challenges as best we can.

Thanks, everyone, for your questions today. I want to end this briefing with a note to all Horizon staff and physicians:

The work I’ve spoken to today is no small feat, and it’s a credit to the hard work and dedication of countless Horizon employees who have come together from across our organization to find effective, creative solutions to these challenges.

Every discipline and department within Horizon have adjusted their focus and we are using every available resource to meet the challenges of this second wave head-on.

The level of commitment and innovation our team has shown during these unprecedented times is simply amazing, and as CEO, I could not be prouder.