Does Yukon have enough ventilators to handle COVID-19? That depends, say doctors

Withconcerns across Canadaabout a possible shortage of ventilators and other medical equipment, the president of the Yukon Medical Association says preventing the spread of COVID-19 in the territory remains the highest priority.

Dr. Katharine Smart saysthere are currently nine working ventilators in the territory, and there are efforts underway to source more. But she emphasized that the number of ventilators needed will be relative to the number of people who contract the novel coronavirus.

"If a hundred per cent of the people [in Yukon] were infected, that's very different than if one per cent of the population is infected,"Smart said, noting the importance of self-isolating and physical distancing.

"This disease is completely avoided by people not going around each other,"she said.

As of Monday, there werefiveconfirmed cases of COVID-19 in the territory. Dr. Brendan Hanley, Yukon's chief medical officer, said at a newsconference Monday that all five patients were doing well and none have required medical care.

Dr. Theresa Tam, Canada's chief public health officer,said Mondaythat of the more than 6,000 COVID-19 cases diagnosed in Canada, seven per cent required hospitalization, three per cent were critical, and one per centdied.

Outlook for COVID-19 patients on ventilation 'quite poor'

Some COVID-19 patients in critical condition require a ventilator, which is a machineused to breathe for someone when they are no longer able to do it on their own.

A manufacturer of medical ventilatorscriticizedCanada for not stockpiling the machines after the 2003 SARS outbreak, but Smart said focusing strictly on thenumber of ventilators "oversimplifies"the requirements for caring for a critically ill patient.

She said intubating a patient inserting a tube beyond their vocal cords into the airway, and putting them on a ventilator is a medically complex process. It requires a team of health-care professionals including physicians, nurses and respiratory technicians, as well as other support staff.

"It's not as simple as just saying we have 50 ventilators or 2,000 ventilators,"said Smart. "What about all the other pieces that go into ventilating a person?"

Smart said COVID-19 patientsrequiring ventilation in other jurisdictions have been on the machines for up to two weeks.

By the time a patient gets to the stage of needing ventilation, the prognosis is "quite poor,"said Smart, depending on the patient's age and any pre-existing medical conditions. She said the latest data shows that the survival rate for COVID-19 patients on ventilation is only about 15 per cent.

How Yukon compares

Ontario has thefewest ventilators per capitaof the provinces, at roughly a dozen per 100,000 people. Yukon has almost double that number, at about 21.British Columbia has about 25 per 100,000 people and Quebec has the highestratio in the country, at approximately 35 ventilators per 100,000 residents.

The federal government has issued acall to actionfor Canadian manufacturers to supply medical equipment, including ventilators.

The possibility of ventilator shortages raises the question of what would happen if COVID-19 numbers spike. Physicians in Italyand elsewhere have already had to makelife-and-death decisions about whogets a ventilator and who doesn't.

Bottom line

The main message from Yukon medical experts is for people to stay the course with self-isolation and physical distancing.

"We may be having to do this for months to come,"Hanley warned on Monday. He talked about the need to fight COVID-19 with "war measures."

"Let's not underestimate how brutal a war this could be if we let down our defences," Hanley said.

Smart echoed Hanley's advice. She said Yukon is ahead of the tide, and it will remain that way if everyone stays on the same page.

"We have total control over what that [infection rate] looks like by being compliant with recommendations," she said.

"We will have a problem if people don't take self-isolation and physical distancing seriously."