The Haliburton, Kawartha, Pine Ridge District Health Unit has declared a COVID-19 outbreak at Hyland Crest in Minden, a 62-bed long-term care home operated by Haliburton Highlands Health Services.

The outbreak at the home at 6 McPherson Street was declared on Saturday (August 6) on the facility’s upper level, with three confirmed resident cases currently associated with the outbreak.

As a result of the outbreak, seven residents have been isolated and both levels of the home are now closed to any further admissions and general visitors. Essential caregivers may continue to visit.

All outings will also be cancelled unless they are for a medical appointment. In addition, volunteers will continue to be restricted from entering the home at this time.

A media release from Haliburton Highlands Health Services states the organization will continue to maintain important infection prevention and control measures, including mandatory masking in all resident care areas, mandatory vaccination, regular surveillance testing, active screening before entry into all facilities, and enhanced cleaning at Hyland Crest Long-Term Care.

Services in the adjacent Minden Hospital are unaffected by the outbreak.

Environment Canada has issued a heat warning for almost all of the greater Kawarthas region for Saturday (August 6) and Sunday.

The heat warning is in effect for Peterborough County, City of Kawartha Lakes, Northumberland County, and Hastings County.

A two-day heat event is expected on the weekend, with maximum temperatures in the high twenties or low thirties. Humidex values are expected to reach the high thirties to low forties. Minimum temperatures overnight will be in the low twenties, bringing little relief from the heat.

Cooler temperatures are expected on Monday.

Hot and humid air can also bring deteriorating air quality and can result in the Air Quality Health Index approaching the high-risk category. The risks are greater for young children, pregnant women, older adults, people with chronic illnesses and people working or exercising outdoors.

Drink plenty of water even before you feel thirsty and stay in a cool place. Check on older family, friends. and neighbours and make sure they are cool and drinking water. Never leave people or pets inside a parked vehicle. Outdoor workers should take regularly scheduled breaks in a cool place.

Environment Canada issues heat warnings when very high temperature or humidity conditions are expected to pose an elevated risk of heat illnesses, such as heat stroke or heat exhaustion.

While there are no plans at this point to reduce emergency department hours or services at Peterborough Regional Health Centre (PRHC), a leading hospital executive says “significant pressures” that “have been made worse by the results of the pandemic” are being experienced.

“In recent weeks, the situation has become more serious,” said Dr. Lynn Mikula, PRHC executive VP, chief medical executive, and chief of staff, during a media briefing held Thursday (August 4).

“We are seeing higher patient acuity, meaning that more people who come to the emergency department are sick enough to need admission to the hospital. For example, during the week of July 17, 191 patients — or 13 per cent of people coming to the emergency department — required admission. This is a high number for us.”

Dr. Mikula noted that, not unlike hospitals across the province, staffing shortages have increased the pressure on PRHC’s ability to provide care across all its departments.

She explained it’s not just nurses that PRHC is short of, but also personnel in a range of disciplines including technologists, respiratory therapists, physiotherapists, and occupational therapists to name but a few. As of June, the hospital had a total of 275 vacancies in job positions across the hospital — a vacancy rate of 9.25 per cent.

“It’s an across-the-board (staffing) shortage,” she said. “This has required us to focus our limited emergency department resources where they are most needed. As a result, wait times are longer than usual for all but the most acutely ill patients. In July, the average emergency department wait time was eight hours.”

“In addition, the hospital is very full, operating at or above 100 per cent of its in-patient bed capacity. And COVID-19 does continue to be a factor. We’ve reported a new outbreak on in-patient unit C3 involving two patients. As of yesterday, the hospital had a total of 18 in-patients who are positive for COVID-19.”

Despite the pressures being experienced, Dr. Mikula said “there’s no absolute threshold” for determining if PRHC will have to reduce emergency department hours — similar to what other Ontario hospitals have done.

“Our staff are absolutely incredible at adapting to the pressures of the moment,” she said. “Pressures on the emergency department fluctuate a great deal, so shift by shift — and sometimes hour by hour — the team is figuring out what they need to do to keep delivering patient care.”

“It’s very difficult for me to say ‘We’ve been one bed away’ or ‘We’ve been one nurse away’ (from reducing hours). I can tell you there have been days when it’s been extraordinarily difficult to keep the emergency department going.”

“The trajectory over the last few weeks has been very difficult,” Dr. Mikula said. “If you’re asking me how are we going to keep coping with rising patient volumes and ongoing staffing shortages, the answer is we can’t. At some point, we will have to scale back something. We’ll have to do some very hard thinking.”

Saying the pressures on the hospital are going to be experienced “for the foreseeable future,” Dr. Mikula added “It’s an extremely acute and fragile situation.”

To that end, she’s urging that those considering an emergency department visit “assess the urgency of their condition” and consider “alternative options before coming to the hospital, including walk-in clinics and virtual clinics that can be found on our website.” That list can be found here.

“People who are registered with a family physician or practitioner should seek non-urgent care through that office before coming to the hospital,” she said.

Dr. Mikula acknowledged it’s difficult to suggest people not to come to the emergency department when they are need in care.

“If you are sick and you think you need the hospital, come in,” she stressed. “We would much rather see you than have you be at home when you need us … I don’t want anyone to get the impression that, if you’re really sick, we won’t be here for you. What we’re asking is that people who can have their condition managed through an alternative channel seek out that channel first.”

The ongoing doctor shortage in the region is exacerbating the situation, Dr. Mikula noted.

“We have quite a large number of people in the city and county who don’t have a primary care physician. We direct people to a virtual care clinic or an urgent care clinic (and) to a number of other options, like TeleHealth Ontario. We ask that people do what they can to seek alternative options for non-urgent care.”

“People do generally know if they’re very ill. If you’re having crushing chest pain, if you’re having symptoms of a stroke, severe abdominal pain, or if you’ve broken a bone, there are all fairly obvious things.”

As for a solution to the pressures being experienced, Dr. Mikula said “There’s no easy answer.”

“It’s going to require all aspects of the health care system work in a coordinated fashion, probably much more than we ever have before. The solutions don’t necessarily live in the hospital. They live with the entire system working together. Those conversations are ongoing but there’s really no easy thing we can do at this moment.”

As for what people who must come to the hospital can do to alleviate stress on staff, Dr. Mikula had some suggestions.

“Be kind to the people looking after you, wear a mask when you’re asked to wear a mask, and understand they’re doing their best under very difficult circumstances. That’s something each of us can do when we seek health care.”

As for PRHC’s ability to handle an influx of patients resulting from an expected fall wave of new COVID-19 infections, Dr. Mikula assured the hospital will be ready for whatever comes its way.

“If there’s one thing the last two years has taught us, it’s that we need to be prepared to manage another wave at any time,” she said, adding “We’re waiting and we’re ready.”

Work to replace the Scotts Mills Dam at Lock 19 in Peterborough has reached a “significant milestone” according to Parks Canada, but area residents should be prepared for higher levels of noise for the rest of the summer and into the fall.

Parks Canada announced on Wednesday (August 3) that all work on the new dam below the waterline is now complete.

The remaining work includes the placement of decking and railings on the dam, log lifter rails on the remaining sluices, and wall work on the east bank of the river adjacent to the dam. Following removal of the cofferdams and trestle bridge, grading and landscaping of the east access, and construction laydown area will take place.

The remaining construction activities will involve using a vibration attachment to remove steel piles from the existing cofferdam and bridge structure and are expected to continue for the next few months. The grading and landscaping will involve large equipment movement on the east bank.

“These activities will generate higher levels of noise than experienced in recent months,” Parks Canada states in a media release.

Activities that generate heavy noise are limited to 7 a.m. to 9 p.m. Monday to Saturday and 9 a.m. to 9 p.m. on Sunday.

Construction at the dam, located south of Lansdowne Street where it crosses the Otonabee River, began in spring 2019. In February this year, Parks Canada estimated construction would be completed by the fall, but has not provided an updated timeline.

According to Parks Canada, once completed the new dam will respect the historic look of the site and will have a life expectancy of more than 80 years. It will optimize hydraulic capacity, increase the safety of water management operations, and will allow improved access for maintenance activities.

In addition, the project will be the first step in creating a more public-friendly lock site. Once restored, the dam will include pedestrian access onto the dam itself.