Hospital emergency departments in Canada have long struggled to provide expeditious care. But now, more than two years into the pandemic, many are showing signs of buckling, with lengthy wait times, and in some cases, closings. Before COVID-19, most Canadians waited up to 3.9 hours in emergency to see a doctor for an initial assessment in 2018 to 2019, according to the Canadian Institute for Health Information. By comparison, the estimated wait time to see an emergency physician was close to six hours at Calgary’s Foothills Medical Centre at one point earlier this week and 11 hours at B.C. Children’s Hospital. In Ontario, patients visiting emergency departments waited an average of 2.1 hours to see a doctor this May, and, on average, spent 20.1 hours waiting before being admitted, according to Health Quality Ontario. Meanwhile, many rural emergency rooms across the country have experienced closings or reduced hours, including at least three in B.C. communities that temporarily closed due to staff shortages in May. More recently, the emergency room at the Perth, Ont., hospital has been closed since July 2. In Fredericton, one man reportedly died in a hospital emergency department this week after waiting hours to receive care. Earlier this week, the federal government traded accusations about responsibility for health care funding with provincial and territorial leaders meeting in Victoria. The provincial and territorial leaders said the federal government wasn’t paying a fair share, and called on it to raise its transfer payments. Ottawa said it would increase its share of funding if provinces and territories raised their own contributions and committed to financial accountable for their spending. Beyond resolving funding issues, fixing Canada’s health care won’t be easy. While high rates of burnout and illness among staff have contributed to hospital staff shortages, some have also pointed out that a lack of primary care physicians and community supports are driving patients to seek help in emergency departments because they have nowhere else to turn. In 2019, about 4.6 million, or 14.5 per cent of, Canadians aged 12 and older did not have a regular health care provider, according to Statistics Canada. And it’s only gotten harder to access a family doctor. The College of Family Physicians of Canada stated in a recent open letter that there is a crisis in family medicine, as many of its members are burnt out, overburdened, frustrated and demoralized. More are retiring, the College said, while fewer medical students are choosing to enter family practice. At a time when health care in Canada is more fragile than ever, The Globe and Mail spoke with five Canadians from across the country about their experiences with health emergencies. In the GTA: Ian Collins expected he’d have to wait to receive care when he visited the emergency department at Toronto’s North York General Hospital early this month. But he didn’t expect how long and miserable that wait would be. While seeking treatment after an injury acquired during chemotherapy, Mr. Collins said he spent roughly 13 hours in a waiting room and another 10 sleepless hours on a stretcher in a busy emergency department hallway. When a bed finally opened for him, he found himself placed in one that was set up in an alcove for linen storage. Ian Collins expected he’d have to wait to receive care when he visited a Toronto hospital emergency department early this month. But he didn’t anticipate how long and miserable that wait would be.Handout “It’s not conducive to me getting healthy being in a hall in the middle of the night, with some woman screaming obscenities because of whatever’s going on with her, and people walking by,” he said, explaining he was worried about catching an illness in that high-traffic environment because he has low immunity. Since diagnosed with lung cancer in April, Mr. Collins, 52, said he’s been doing a lot of waiting for appointments, once as long as 4½ hours. During his visits to Toronto’s Princess Margaret Cancer Centre, he frequently overhears overworked nurses asking each other to do overtime or forgo breaks. He wonders whether this led to his injury in the first place. On July 1, during a chemotherapy treatment, his intravenous cannula slipped, allowing the drug to get into his skin instead of into his vein, causing burning. A nurse instructed Mr. Collins to seek help if the swelling he experienced worsened. When it did, he called an oncology nurse, who told him to go to the emergency department. An initial visit was brief; Mr. Collins was in and out of emergency within about 90 minutes with a prescription for antibiotics. But when his arm continued to worsen, he went to an emergency department again at 11 a.m. on a Tuesday. Although it took an hour and a half to see the first doctor, who sought to admit him with concerns he had an infection, it was 11 a.m. on Wednesday, a full 24 hours after he arrived, by the time he got a bed. He was discharged the following morning when his arm improved. The experience was “pretty traumatizing,” he said. He’s annoyed at politicians for failing to keep promises to end hallway medicine and for not compensating nurses adequately. “The important thing I got out of this is just how hard the nursing staff work and how I really feel they’re mistreated by the government,” he said. – Wency Leung In Quebec: It wasn’t the best first impression: Ji Yoon Han had only been living in Montreal for a couple of hours before finding herself in one of the city’s overcrowded emergency rooms. It was the night of June 30 and she had just flown in from Toronto to take up a new job. In the hostel where she was staying before moving into her apartment, she cut her knee while getting out of the shower. Bleeding heavily, she made a tourniquet out of a Toronto Blue Jays T-shirt – a “symbolic” rupture with her old hometown, she joked. Soon she would get a bracing introduction to her new one. Ji Yoon Han outside her home in Montreal on July 15. Han recounts finding herself in one of the city’s overcrowded emergency rooms when she had just arrived in the city.Christinne Muschi/The Globe and Mail After taking an Uber to the city’s CHUM mega-hospital, she arrived around 1:30 in the morning of July 1. In the packed waiting room she took a slip, which was soon covered in her blood, and tried to remember her French numbers as they were called over the intercom. “I must have looked really pitiful,” she said. A triage nurse took her information, put gauze on her wound, and warned her that it was busy and the ER was short staffed so it could be a long wait. It would prove to be. After 30 minutes she was called for registration that involved filling out another 30 minutes’ worth of paperwork so the hospital could bill Ontario for her care. By about 3 a.m., Ms. Han, 27, noticed she had bled through her gauze, which got her sent back to triage for another thick application of bandages. When she was finally summoned to the examination room, 30 minutes later, she was only the second person to leave the waiting room since she arrived two hours earlier. One man in a wheelchair told her he had been there since 6 p.m. Still, there awaited more waiting. She looked at her phone in five-minute spurts to kill time and ration battery. A doctor came and gave her stitches after about an hour. Then she waited another hour for her tetanus shot from a nurse. But she recognized she was one of the lucky ones: She had gotten through and gotten patched up. On her way out of the ER, five hours later, Ms. Han saw many of the same faces she had seen at the beginning of the morning, including the man in the wheelchair, now in his 12th hour of limbo. “One thing that was very memorable to me when I walked out was that the crowd in the emergency room was the exact same,” she said. “I felt almost survivor’s guilt.” – Eric Andrew-Gee In Alberta: Graham Mosimann didn’t need a morning alarm on June 19. The “excruciating, wake-up-screaming” pain coming from his shoulder was enough to launch him out of bed at 6 a.m. Graham Mosimann had popped his shoulder back into place because a nearby urgent care centre wasn’t open and the ER wait times were hours long.JASON FRANSON The 29-year-old wasn’t a stranger to the painful sensation pulsing from his upper arm. About 15 years ago, while refereeing a hockey game, he dislocated his left shoulder and tore the labrum, which is rubbery tissue attached to the rim of the socket that works to keep the joint in place. “My shoulder has since dislocated so many times there’s now a groove where it can slide out of its socket easier,” he said. Sometimes he can pop it back into place, by leaning against a wall or even body-checking a hard surface. But his usual methods weren’t working. He looked up urgent care clinics in Edmonton. It was a Sunday and the only clinic he could find didn’t open until 3 p.m. “I could not describe to you the level of rage and pain I felt,” said Mr. Mosimann. His options were limited, so he checked emergency room wait times in the city despite feeling like it wasn’t the appropriate place to go for his injury. They ranged between five and six hours. He briefly considered going to Stoney Plain, about 40 minutes west of the city, but decided it would be unnecessarily painful to drive – especially since his vehicle had standard transmission. The pain was unbearable, he said, so much so that he had been put under anesthesia during previous visits to emergency care centres while they popped his shoulder back in place. He felt as if the only option that remained was doing it on his own. “It was a matter of me sitting quite literally on my couch and making like tiny, painful, miniscule movements to try and wedge my shoulder back to a place…
