With the Kootenay Boundary Regional Hospital COVID outbreak of two cases now declared “over,” the Trail Times is clarifying how the province compiles daily COVID-19 patients cases in healthcare settings.
For starters, all COVID-19 patients in B.C. who require any form of hospital care are counted as one case in daily totals when they first enter a facility.
These patients continue to be included in this count for the duration of the time they remain infectious.
Once a patient in critical care is no longer infectious with COVID-19, the patient is removed from daily critical-care totals. However, for planning purposes, these patients are still included in the overall COVID-19 counts for the hospital.
For some of these patients, COVID-19 can trigger difficulties with other health conditions.
These patients may require longer periods of hospitalization, but for reasons that are no longer directly tied to COVID-19, or they may have contracted COVID-19 while in hospital and still need care for the underlying issue they were admitted for.
This means some patients who entered hospital or critical care as a COVID-19 patient may no longer be counted as COVID-19 patients once they are no longer infectious, even though they remain in hospital.
As of press time Monday, there were 152 of these patients in B.C. hospitals. Within hospital record-keeping, the term for such an occurrence is “discontinued isolation.”
Discontinued isolation reporting is anchored in B.C.’s public-health guidelines. For most cases, isolation is discontinued after 10 days, provided there is no fever and symptoms are improving. These same requirements are in effect in Ontario, Alberta and the Centers for Disease Control and Prevention in the U.S. In B.C., for serious cases, the guideline is 20 days.
That 20-day guideline varies according to each patient’s unique circumstances and is, for this reason, a clinical decision.
These discontinued isolation cases are reported independently from B.C.’s COVID numbers. They are included in reports on overall hospital capacity and critical-care capacity. These cases do not directly contribute to the epidemiological picture of the pandemic, but importantly, make a significant contribution to public awareness and understanding of hospitals’ readiness to provide care.
The Ministry of Health looks at hospitalizations and critical-care beds to ensure the sustainability of the system. It looks at those numbers in the context of the overall capacity to ensure the system is running efficiently at or near capacity, but not over capacity. The ministry frequently provides information on hospital and critical-care capacity to the media and the public.
The BC Centre for Disease Control’s surveillance reports and the numbers in the daily report have a different function. They report the number of people with COVID-19 who require hospital or critical care. This gives an understanding of the severity of illness and only counts the individual once even if they are hospitalized more than once or have several stays in critical care. This data helps determine if, for example, the Delta variant causes increased rates of hospitalization or leads to more people needing critical care. This helps to understand the impact of the pandemic on the population, such as the percentage of people with COVID-19 requiring hospital care, and to plan public-health measures.