Need for policy on life-and-death decisions pressing as COVID-19 strains Manitoba hospitals: doctors, advocate

Amid a crush of COVID-19 patients, staffing shortages and strained resources, what should happen if Manitoba hospital staff are forced to choose which patient receives life-saving care and which doesn't?

It's a question doctors and advocates for those with disabilities have been asking for months.

Now, they say the need for a formal framework guiding those impossible decisions is even more pressing, amid a rapidly spreading Omicron coronavirus variant that has put a record number of Manitobans in hospital and staff in isolation.

"It's something that administrators are not really keen to look at," said one doctor, who works in the Southern Health region. 

"We kind of hope and pray that things will just work out and it will all be fine, and I do, too. But it's just if we reach that critical situation, I would prefer to have a clear plan."

The physician, whom CBC News is not naming due to concerns speaking out could impact their job, echoed past calls for a triage protocol in the event there isn't enough capacity to manage all critically ill patients.

With many Canadian hospitals struggling amid record COVID-19 patient volumes, it's less likely Manitoba would be able to rely on out-of-province patient transfers again if hospitals here are overwhelmed.

That's what the province did when worst-case scenario projections for intensive care unit numbers were exceeded in the third wave. There were also calls at that time for a triage protocol. 

In May 2021, Shared Health said it didn't need those guidelines, even though its own ethical framework for making decisions during the pandemic called for such a plan.

A Shared Health spokesperson says patients with the most urgent needs continue to be prioritized, and clinical criteria have been used throughout the pandemic to identify and pull back on elective or less-urgent services when necessary. 

"The threat of exceeding ICU capacity remains directly related to the number of unvaccinated individuals, who are statistically far more likely to require critical care due to COVID than individuals with two or three doses," the spokesperson said in an email.

The Southern Health doctor says there is still no protocol, and if one is being developed, Shared Health isn't telling hospital physicians.

The doctor works at a rural hospital that hasn't yet been hit with the massive uptick in hospitalizations or staff shortages that Winnipeg has seen.

The hospital has limited capacity to care for intubated patients, who are often transferred to hospitals in Winnipeg or Brandon.