Ontario Supporting Health System Response During Third Wave of COVID-19

Published on April 09, 2021

Action being taken to maximize capacity and preserve resources needed to care for patients

In response to the recent and rapid rise in hospitalizations, ICU admissions and the threat to the province's critical care capacity, the Ontario government is issuing two emergency orders under the Emergency Management and Civil Protection Act (EMCPA). These orders will maximize system capacity, ensuring that hospitals have the resources required to provide care for patients and save lives.

These temporary emergency orders will support the redeployment of health care professionals and other workers currently working in Ontario Health and Home and Community Care Support Services organizations to hospitals. They will also provide hospitals with the flexibility to transfer patients to alternate hospital sites in situations where a hospital's resources are at significant and immediate risk of becoming overwhelmed. These orders, along with additional measures being taken, are expected to increase ICU capacity in the province by up to 1,000 patient beds.   

Over the last year, the government has made significant investments and efforts to build capacity and maintain the integrity of Ontario's health care system, including investing $5.1 billion to support hospitals, creating over 3,100 more hospital beds. However, as Ontario, like other provinces and jurisdictions around the world, combats the third wave of the COVID-19 pandemic and deadly variants, further action is needed to allow hospitals to maximize capacity and ensure patients are receiving the most appropriate care. 

Effective immediately, similar to orders previously introduced, Home and Community Care Support Services organizations (formerly LHINs) and Ontario Health will be provided the authority and flexibility to voluntarily deploy staff, such as care coordinators, nurses, and others, to work in team-based models in hospitals that are experiencing significant capacity pressures due to COVID-19. In addition, Home and Community Care Support Services organizations will now be authorized to deploy staff to backfill redeployed staff within and to another Home and Community Care Support Service organization.

In addition, the government is taking action to better leverage Ontario's hospital system as one connected resource, improving the ability of hospitals to respond to the most emergent and acute needs so that all patients can receive the most appropriate care in the right setting. During major surge events where the demand for critical care threatens to overwhelm a hospital, the province will allow hospitals the flexibility to transfer patients to alternate hospital sites without obtaining the consent of the patient or, where the patient is incapable, their substitute decision maker. Hospitals may rely upon this order to facilitate the transfer of a patient to an alternate hospital site only when necessary to respond to a major surge event, when the attending physician is satisfied that the patient will receive the care they require at that other site and that the transfer can be effected without compromising the patient's medical condition, and where all of the other conditions specified within the order have been met.

As soon as possible following the conclusion of the major surge event, the alternate hospital site would be required to make reasonable efforts to transfer the patient back to the original hospital site or to another suitable care location which is consented to by the patient or substitute decision maker.

Effective Monday, April 12, 2021, Ontario Health has also instructed hospitals to ramp down all elective surgeries and non-urgent activities in order to preserve critical care and human resource capacity. At this time, the ramp down instruction does not apply to the Northern Ontario Health Region. Pediatric specialty hospitals can also continue their plans to care for children and youth and may help if required to support other regional hospitals.

These time-limited orders remain valid for 14 days unless revoked or extended in accordance with the Emergency Management and Civil Protection Act and will come into effect on Friday, April 9, 2021.