Alex Ballingall, Toronto Star
March 19, 2020

OTTAWA—The federal government is refusing to say how many ventilators Canada might need to weather the COVID-19 pandemic, as Ontario and other provinces look to acquire hundreds of additional breathing machines for people who get dangerously sick.

Experts say Canada’s supply of ventilators will be crucial to saving people’s lives, especially if measures to slow the rate of infections fail to prevent a surge of patients who need the intensive care that the machines — and the teams of specialists who run them — provide.

On Parliament Hill Thursday, federal Health Minister Patty Hajdu said it would be “misleading” to cite specific figures about the need for critical care beds and ventilators. But she and other top officials were adamant Canada will spare no expense and is considering a range of options to make sure the country has the medical equipment needed to confront the pandemic.

That includes plans to mobilize private manufacturers to make critical supplies, and for the Canadian military to possibly step in and help obtain essential provisions.

“This is an area that we are very urgently focused on, and we are looking at every single option, every single possibility,” said Deputy Prime Minister Chrystia Freeland.

“I hope people understand that from our government’s perspective, this is an all-hands-on-deck effort. Every single person in the government is involved. We are being creative and we are acting in real time to respond to this,” she said.

The question of medical equipment and supplies has come into sharp relief as other countries grapple with a shortage of essential items like hospital ventilators, which are used to help seriously ill patients breathe.

Reports from Italy — which surpassed China as the country with the most deaths from COVID-19 on Thursday — have described how a shortage of these machines has forced medical workers to make gut-wrenching decisions about which patients get to use them.

South of the border, the top doctor with the National Institute of Allergy and Infectious Diseases has warned the country is vulnerable to shortages of ventilators if the pandemic hits hard. On Thursday, New York Gov. Andrew Cuomo said his state has 5,000 to 6,000 ventilators, but will “need about 30,000” as the pandemic crests, according to a report from NPR.

In Canada, federal officials have been less forthcoming about the country’s supply. Hajdu, the health minister, dismissed a question at the government’s daily press conference Thursday about how many ventilators are needed in Canadian hospitals. She said Canada’s ultimate need will depend on how measures to contain the virus — from border restrictions on incoming tourism to appeals for “social distancing” — help slow the rate of infection.

If the virus is contained in certain areas, equipment like ventilators could be moved to regions that experience surges of the virus, she said, adding that provinces and territories are already working to clear space in hospitals by cancelling non-essential surgeries and making sure they have enough equipment and required specialists.

Theresa Tam, Canada’s chief public health officer, also said provinces and territories are better placed than Ottawa to determine how many ventilators they need. She said none has asked the federal government for help stocking up. Even so, Tam said the federal public health agency is “looking to acquire” more ventilators just in case.

Tam and Hajdu did not say how many.

“It’s somewhat disingenuous to say, ‘we’ve got X number of ventilators,’ to imply that that would be enough or not enough,” Hajdu said.

“The work is happening at the provincial and territorial level, and we’re very confident that the provinces are taking this with the utmost of seriousness and they’re having regular daily conversations with Dr. Tam.”

The federal health department did not respond to questions from the Star Thursday about Canada’s medical supplies, including the country’s overall supply of — and expected need for — ventilators.

Isaac Bogoch, an infectious diseases specialist with Toronto’s University Health Network, said it is up to provincial governments to make sure there is enough medical equipment to deal with the crisis — including testing material and equipment like ventilators.

But he also said Ottawa has the responsibility to be open and honest about current supplies across the country — even if there might not be enough for some scenarios.

“We need to know,” Bogoch said. “We’re going to see these (infection) case numbers go up pretty significantly, probably for the next week or so…There’s a lot of pillars to managing a pandemic appropriately, but one of the pillars is impeccable communication in real time. And part of that includes transparency and honesty.”

Sriniva Murthy, a clinical associate professor at the University of British Columbia, said it is not always easy to tally the number of ventilators in a country because of varying definitions for what counts as one.

In any case, he said it is too early to say whether Canada will have enough capacity since it is not clear yet whether the huge societal push to slow the virus will significantly slow the daily spread of the virus.

But Murthy was clear that “having enough ventilators for all of the sick people is absolutely crucial.

“Is it going to be a problem? Probably, possibly,” he said.

A 2015 study that surveyed 286 hospitals across Canada found there were 3,170 intensive care beds and 4,982 mechanical ventilators for critically ill patients. It concluded “resources vary widely” across the country, highlighting the need for co-operation across jurisdictions when there is “substantial increased demand.”

More than 772 people in Canada have contracted COVID-19 so far, Tam said Thursday. According to the government’s coronavirus information online, 11 per cent of people infected between Jan. 15 and March 15 were hospitalized.

Provinces are now moving to buy more ventilators amid warnings about shortages of other supplies, such as COVID-19 testing material and medical protective equipment.

On Wednesday, Ontario Health Minister Christine Elliott said the province has an “adequate supply” of ventilators for now but has ordered another 300 machines. Nova Scotia Premier Stephen McNeil said this week the province has 240 ventilators and has ordered another 140.

The Star asked every province and territory about their supplies on Thursday. Of those that responded, Quebec reported it has at least 3,000 ventilators of all types and has authorized hospitals to buy more. Ontario did not provide its current total but confirmed it is ordering an additional 300 to its current “surplus” of 210.

Saskatchewan said it has 91 adult ventilators for critical care and has ordered another 250. The province also has another 80 “subacute” ventilators and anaesthetic machines that also help patients breathe.

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