MPP Natalia Kusendova on Ontario’s response to COVID-19

Natalia Kusendova at work in the ER department of the Etobicoke General Hospital

Yuri Bilinsky, New Pathway – Ukrainian News.

MPP Natalia Kusendova (Mississauga Centre) is one of the many friends of Ukrainian Canadian community in the Ontario politics. She is also a practicing nurse working in the ER department of Etobicoke General Hospital, which houses one of the designated COVID-19 assessment centres. We asked Kusendova several questions about Canada’s, and Ontario’s in particular, readiness for the pandemics and what the Ontario government is planning to do in the medical sphere based on the experience gained during this outbreak.

Canada is at the lower end globally in terms of the number of hospital beds per 1,000 people. Canada’s indicator, 2.52, compares to 8.00 in Germany and more than 12.00 in Japan and South Korea. Those countries, especially Japan and South Korea, have substantially lower death rates from COVID-19 per 1 million people than on average internationally: 3, 5 and 29 correspondingly. There are other factors at play in this situation, but do you think that the hospital capacity is of importance and that Canada, and Ontario in particular, needs to increase the number of hospital beds going forward? Especially given the fact that Ontario’s hospital capacity was utilized close to 100% before the pandemic.

Kusendova: First, there are different types of hospital beds, among them general, acute care and critical or ICU beds. It’s true that many hospitals in Ontario operated at 100%-120% capacity before the pandemic, especially the emergency rooms. One of the reasons is that the previous government in Ontario has not invested in long-term care beds, in 15 years only 600 of such beds were opened. If we don’t have enough long-term care beds some of our seniors end up staying in our acute care hospitals. There is the same kind of problem with mental health patients. Part of our strategy before the pandemic was to add 15,000 long-term care beds over 10 years. These beds will become live in 2021. But, in the meantime, we have in Ontario a 35,000 waiting list for long-term care and 1,000 of them are waiting in the acute care hospitals. ICU beds are even more specialized and expensive, nurse ratio there is 1/1 or 1/2. Before the pandemic, we have founded 1,000 acute care beds, of which 500 were ICU beds. And, as a result, we are currently using about 50% of the ICU beds that have ventilators. We also have invested in technology which allows to use one ventilator for two patients with just an extra tube. So, we are not too worried right now. The government of Ontario has also procured 10,000 ventilators from the company O-Two Medical Technologies out of Brampton, ON., which are being made right now.

The stable situation in terms of ICU beds use is mainly due to the fact that the quarantine and social distancing measures are working. These measures have been taken, in particular, to avoid a crisis at the hospitals but they are coming at huge economic costs. Where does the balance lie between the hospital capacity on the one hand and economic costs during epidemics on the other?

Kusendova: The priority for our government is to ensure the health and safety of Ontarians. We are a conservative government and our priority is also to maintain the economy and as soon as we were elected we brought down our deficit from $15 billion to $9 billion which helped us save for the rainy day and make a $17 billion investment into the fight against COVID-19. At this point we could speculate what could have been done but I think we have to be very cautious about making these kinds of economic assumptions and judgements. One can’t put a price on the human life. The cost for the economy is devastating but it’s the price to pay to save human lives. As a health care provider, I believe it was the right call to shut down the economy. And we were not alone to have done that, most other jurisdictions are doing the same. Ontario, and Canada as a whole, has been able to avoid a tragic situation of the like that some countries are going through. We have also been able to protect our front-line workers. But we do care about the economy and the premier has announced the three-staged process to reopen the economy.

Going forward, what are the most pressing issues for the Ontario health care, especially, in the light of preparedness for epidemics?

Kusendova: Part of our strategy will be to build more acute beds and ICU beds. But, we will not be able to build enough beds for our ageing population and we have to be innovative in the way we provide health care in Ontario. In particular, we need to apply telehealth and digital health strategies. We introduced these strategies even before the pandemics and are starting to implement them now. This will allow doctors to see patients through telephone and virtual means. Another way is home care because people can have better outcomes if they are properly supported at home. We need to have enough PSWs, nurses and doctors to provide this kind of care at home. We’ve just tabled the Bill on home care support in the legislature.