By Eric Vandewall
April 29th, 2021
BURLINGTON, ON
Since March 12, 2021, in response to the urgent need to vaccinate as many people in our community and protect high-risk individuals from the COVID-19 virus, Joseph Brant Hospital began operating a Halton Region Vaccination Clinic in the Pandemic Response Unit PRU. The PRU’s flexibility in design allowed us to quickly mobilize the PRU to serve this purpose, using our skilled staff onsite to administer the vaccines. To date, we have vaccinated over 16,000 individuals in our community and will continue to immunize prioritized groups established by Halton Region.
At the same time, daily news reports convey the troublingly high number of new COVID-19 cases across the country. It is important to remember the heartbreaking stories behind those numbers. At JBH, we feel every single loss. With each loss, we know that there are so many families, friends and colleagues in immense grief.
Beds can be moved and a vaccination booth set up in a very short period of time
In Halton, we continue to see high numbers of new COVID-19 cases and it is too soon to determine if we have reached the peak of this third wave. In terms of our hospital’s capacity, today JBH is at 91% capacity. We are currently caring for 28 patients with COVID-19 – 16 of these patients are in Intensive Care Unit (ICU). In recent weeks, the total number of patients (COVID-19 and non-COVID-19) in our ICU units has ranged on average from the low 20s to as high as 29. We have the capacity to surge to 32 patients in ICU if needed.
Understandably, given the dire situation, we have been asked why we continue to use our PRU as a vaccination clinic and why it is not being used for COVID-19 care to help manage patient overflow in regional hospitals dealing with record numbers of COIVD 19 patients.
I hear you and I understand your concerns. While I do not wish to minimize the seriousness of the situation, I would like to provide further context and explain where we are today.
Vaccination is a critical step to reducing the spread of COVID-19 as well as to keep people healthy, safe and well. We stand ready to mobilize the PRU back to providing patient care within 24 hours if additional bed capacity is required. That decision cannot be made solely by JBH. The decision to open the PRU to care for patients is a decision made at the regional level – at the HNHBB (Hamilton, Niagara, Haldimand, Norfolk, Brant and Burlington) Regional Incident Management System (IMS) table. The PRU was intended to be used when all conventional space in hospitals was exhausted across the region, as a “safety valve”, to relieve pressure on conventional hospital beds and to ensure there is sufficient capacity to care for COVID-19 mild to moderate patients who are on their way to recovery and to return home. Hospitals continue to respond internally to the growing demand for ICU care and we are seeing more mobile response units constructed to help expand capacity. The point of requiring the PRU for patient care has not yet been reached.
Everyone who has been vaccinated at JBH and comments said it was “just great”.
The PRU structure is between the hospital expansion and the parking lot. It was set up in a very very short period of time – albeit at considerable expense.
Since the beginning of 2021, JBH has accepted 50 inter-regional patient transfers, including patients from the greater Toronto Area (GTA). All of these were serious cases placed in available ICU and acute care beds on designated units in our hospital. The most appropriate place for these individuals was to be located in conventional hospital space. Many of these individuals required ventilation and constant monitoring for a deterioration in their condition. In addition to using all the available space in our hospital to care for these patients, we have been able to increase the number of ICU beds up to 32. This has been done by reviewing our health human resources and placing all available healthcare staff in roles to support staffing these additional ICU beds, as a result of our surgical ramp down. I am incredibly proud of all of our team members, including those who have been redeployed to support the provision of comprehensive and compassionate care to our patients.
In conclusion, please understand that while our PRU is a well-equipped and robust temporary short stay field hospital space, it does not replace conventional inpatient beds in the hospital. The PRU was designed for individuals who are medically stable, presenting mild to moderate COVID-19 symptoms, who require additional supports before they are ready to return home.
If the decision is made to mobilize the PRU back to providing medical care, we can make that happen in short order, relocating the vaccination clinic to an alternate space onsite. Every day we are working closely with our regional and provincial health partners to monitor the evolving situation, assess risk and determine the need for PRU capacity.
Eric Vandewall, at what was supposed to be a celebratory event at which the Minister of Health at the time was to announce a large provincial contribution to the building of the extension to the hospital. The Minister got stuck in QEW traffic so we all went home. The cheque did arrive.
Finally, please continue to follow the guidance of medical experts and public health officials. If you are eligible to get vaccinated, doing so keeps you and your loved ones safe, and brings us one step closer to making our communities safer. If you have vaccine concerns, talk to your doctor or please seek out credible sources of information like Halton Region and the Province of Ontario. I also encourage you to follow JBH on our social media channels to stay up-to-date on the latest news and information from our hospital.
Thank you again for your continued support and understanding during these challenging times.
Boss ? Who’s my boss?
I don’t know to whom you refer.
Anyway, I believe you might find the answers to your questions should you re-read Mr. Vanderwall’s statement.
He does indeed explain the original intended use for the temporary structure.
He also explained that the deployment and use of the temporary structure is not under the authority or control of JBH but is under the authority and control of the HNHBB (Hamilton, Niagara, Haldimand, Norfolk, Brant and Burlington) Regional Incident Management System (IMS) table. HHNBB IMS determined for now it be used as a vaccination clinic.
So the buck stops at the HHNBB IMS not with the CEO or President of JBH.
He also confirmed the temporary structure is not designed for the care of COVID ICU patients but for is for recovering COVID patients who are soon to be released home.
He explained the COVID ICU has stretched its capacity to 32 beds.
He said that the ICU’s patient count (COVID & Non-COVID) has fluctuated between the low 20s and 29.
He says JBH is presently at 91% of its total beds capacity.
He explained there is currently enough non-critical care capacity (beds) within the permanent JBH structure because beds have been freed up due to the cessation of elective and non-urgent surgeries. He says if that situation deteriorates the temporary structure’s use can be flipped from vaccine clinic to patient care “in short order”.
Moving the vaccine clinic off-site would likely involve more testing logistics. Moving nursing and admin staff to a remote location. Not to mention having to install there the specialty freezers needed for the Pfizer vaccine. And anyway, he says the clinic could be re-housed elsewhere within JBH.
I have to ask myself though how would Bob be shrilling now had the structure not been set up and we had found ourselves in a position of desperately needing it.
Please stop the whining about the cost, which it sounds like is being borne by HHNBB. Be thankful the structure has not had to be used to date for its originally intended use.
The President of JBH has given you your answers, but it seems you don’t want to recognize that
“The PRU was intended to be used when all conventional space in hospitals was exhausted across the region, as a “safety valve”, to relieve pressure on conventional hospital beds and to ensure there is sufficient capacity to care for COVID-19 mild to moderate patients who are on their way to recovery and to return home.“
When Mr Vandewall is saying the hospital is at 91% capacity is that including the beds in the PCU? Because the 91% are going to eventually get better and be considered “mild to moderate patients who are on their way to recovery”
Whilst not using the PCU for its intended purpose, those patients are utilizing beds that could have been used for surgical patients who are not being seen and the backlog grows by the hour. Wherever the blame lies, be it with the LHIN, or any other acronym you wish to come up with, failure to use the PCU as its intended purpose has consequences.
Your argument about moving the vaccine clinic to a different location holds no water as it is already in a different location than the hospital. Nurses and doctors do not live there, so them working from anywhere is not valid. The freezers did not grow in the PCU, they were moved there, just as they would be if the clinic were moved to the hospital, and if it were moved elsewhere in the hospital, again it would be taking up space that should be used for health care. There is a lot more going on than just Covid and many people are suffering as they await treatment.
Why should I not complain of the cost? Was it private money built it? If we use a different acronym it is no longer tax dollars? Puleeze
The president didn’t give answers, he gave a political speech that answers questions, just not THE question
Bob. There is no satisfying you. So this is my last to you (I hear cheers from the crowd).
“When Mr Vandewall is saying the hospital is at 91% capacity is that including the beds in the PCU?” He did answer this. Read his statement or my Coles notes.
“Whilst not using the PCU for its intended purpose, those patients are utilizing beds that could have been used for surgical patients who are not being seen and the backlog grows by the hour.” The cessation of elective &/or non-urgent surgeries is province wide. I’m not in healthcare but I suspect the cessation is in effect for a few reasons; such as the redirection of staff and equipment for non-critical COVID patient use, and to minimize the possibility of a COVID outbreak in a non-COVID area of the hospital. Particularly in a surgical recovery area. When I was in JMB last September for a non-surgical cardiac issue there was an outbreak in my ward. Freaking scary.
“The freezers did not grow in the PCU, they were moved there, just as they would be if the clinic were moved to the hospital” Do you know that for a fact. I don’t know this for fact, but I suspect the Pfizer type freezers remain located in the JBH permanent structure, not in the PCU and vaccines are moved to the PCU as needed. Moving remotely would entail greater logistics in setting up the IT and other services required to support the remote clinic.
“Why should I not complain of the cost? Was it private money built it? If we use a different acronym it is no longer tax dollars?” Complain all you like. You have that right. But as sure as the sun will rise tomorrow you would be screaming (shrilling) blue murder if the PCU was not there and was urgently needed. We would be hearing from you “whine, whine, where was the worst case scenario planning?”.
Last thought. Bob, contact Vanderwall directly and ask him your questions. Good luck.
Moving the freezers, or believing they have to be at the hospital, there are 6 sites in Halton administering the Pfizer/Moderna vaccines.only 2 are hospitals. I don’t believe FirstOntario Center in Milton, nor Compass Point Bible Church had the freezer capacity before it was brought there.
Mr Vandewall did NOT answer my question of capacity, nor you in your Coles. What he said was the hospital is 91% capacity, 28 with Covid and surge capacity to go to go 32 in the ICU What he did NOT say was what is the hospitals capacity. From what I could find the hospital averages 245 beds, so 91% capacity would be up to 25 free beds, PLUS surge capacity of another 73 to 93 in the PCU, depending on the source I’ve read for that information, so not close to 91% of the hospitals capacity.
My question originally posed in answer to Mr Vandewall which you chose to answer for him is what is the hospitals normal operating capacity when not in a Covid situation? I would be quite surprised if it doesn’t operate at or near the 90% threshold on average.
It’s nice you got to have a procedure in the hospital last summer, in my personal circle of friends I know of at least four, myself including who cannot get necessary
I’ll quit and let you read where I am getting my information
https://globalnews.ca/news/6758358/pandemic-response-unit-joseph-brant-hospital-coronavirus/
https://www.thespec.com/news/hamilton-region/2020/04/01/burlingtons-joseph-brant-hospital-building-large-structure-for-anticipated-surge-in-covid-19-cases.html
Both stories quoting Mr Vandewall and Dr Preyra saying all patients would be treated in the PCU and staffed by volunteers. So there isn’t or wasn’t an issue with staffing as you’ve tried to argue. The PCU was not originally built for recovering Covid patients although that is the story they’re selling us now. The ICU is at 91% capacity by choice. If the PCU was used for its stated purpose the 28 ICU patients would be in a field hospital with between 45 and 65 empty beds.
Gave you my last on this. I hope you find peace somewhere
This report illustrates why the feet on the ground knowledge, competence, and dedication in our hospitals has so far patched over the inexcusable gaps in the “plans” emanating from the leadership in our province.
What a fabulously information piece by Mr Vandewall.
Clearly this piece should help the Bob’s of the world understand the meaning of the capacity percentages quoted from time to time; why a 3% change in that percentage figure only represents 1 patient; why the temporary structure is currently being used as a vaccine clinic; who controls the use of the temporary structure; and much more.
Thank you, Mr Vandewall
Brown nosing to your boss does nothing here David.
All he has done is answered SOME of the questions I originally pointed out a few weeks ago. Questions that you tried to gloss over for him. Mr Vanderwall has NOT explained why the structure was ever built if it never had the staff in the first place, nor why it has never been used for its intended purpose if he is now saying we are running at capacity. Someone decided to build this with bad information and the buck stops at the CEO. End of the day he is the one said go ahead and build a structure that we will never use for its intended purpose even though we’ve had three waves of this virus, each progressively worse. We have now plateaued from the third and probably the worst of the waves. The numbers although still quite high have subsided from their peaks in the mid 4000’s.
All I ever asked and still do, is why was this structure built if there was never a reason for using it in the first place. If you didn’t have the staff to operate it, nor the budget to find staff, why waste our dollars and build a white elephant. To say it is being used now for a different purpose is irrelevant, the vaccines could be given out at Central Arena or at many other unused city buildings that wouldn’t have needed unnecessary taxpayer dollars like the underutilized temporary structure.
These are questions for the CEO, not his PR department or any other shrill
It must be annoying to people who have busy and critical jobs to do when some people expect them to drop tools and engage in a personal debate with them. Especially if they seem to have an agenda and will only hear what they want to hear.