Hospitals scrambling to free up space for the expected crush of COVID-19 patients are looking at moving patients into hotels.

“As we confront the growing challenge of COVID-19, no idea is off the table when it comes to ensuring hospital beds are there for people when they need them,” Health Minister Christine Elliott told the Star Tuesday.

Discussions with hotels in the Greater Toronto Area, Ottawa and elsewhere are exploring using vacant rooms for patients who are stuck in hospital beds even though they no longer require hospital care, explained Elliott’s press secretary, Travis Kann. These patients do not have COVID-19 but are typically frail and elderly.

Known as “alternative-level-of-care” or ALC patients, they have been waiting to move into other settings such as long-term-care, where there are also bed shortages.

“This isn’t a simple proposition as we need to consider accessibility, equipment, food services, infection control and cleaning standards, bio-hazardous waste disposal and staffing, among many other issues that need to be resolved to ensure that patient safety is protected,” Kann said.

The hotels would be staffed by hospital personnel, including physicians and nurses, and by staff from the home and community care sectors, including nurses and personal support workers, he said.

Details of the talks emerged on the same day that the Canadian Association of Emergency Physicians (CAEP) sounded the alarm on the need to increase “surge capacity” in hospitals.

“If you haven’t done it yet, for the love of God, get on it. What we are hearing from international sources is that it is not a gradual onslaught. It just happens overnight. They are just all of a sudden at your door,” association spokesperson Dr. Alan Drummond said Tuesday.

For at least two decades, ER doctors have warned that Canadian hospitals have been too crowded and unprepared for the annual surge of patients during flu season.

A hospital’s occupancy should be 85 per cent, according to CAEP. But in Canada, which has one of the lowest rates of bed availability in the western world, the occupancy rate usually hovers around 100 per cent or greater, and sometimes goes as high as 120 per cent, CAEP says.

The decision by the provincial government to declare a public emergency on March 16 triggered an enormous mobilization of people and resources to try to prepare hospitals to provide life-saving critical care for a very large number of COVID-19 patients, said Anthony Dale, president of the Ontario Hospital Association (OHA).

“The health system mobilization underway in Ontario and across Canada has not been seen on a scale like this since the end of the Second World War.”

In February, there were 5,300 ALC patients occupying hospital beds in the province, according to the hospital association.

That number has since dropped, according to the OHA, but the current tally wasn’t readily available Tuesday.

A move by hospitals to postpone elective surgeries has helped free up bed capacity, the association said.

Kann said the province is also looking at better leveraging vacant retirement home beds to take pressure off hospitals.

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The emergency physicians’ association warns that during a major pandemic there would be a need to double the number of intensive care beds. Other areas of hospitals would have to be converted into intensive care units, such as operating rooms, recovery rooms and clinic areas.

“Hospitals are crowded on a good day,” Drummond said. “We have been concerned that our capacity to respond to emergencies in a pandemic would be compromised.”

Whatever the pandemic brings, hospitals will still have to “provide emergency care to people in collisions, falls, heart attacks, pneumonia, poisonings, that kind of thing,” he said.

He expressed concern that the pandemic is forcing a reduction in mental health and addiction services, in the form of cancelled appointments, as well as a reduction in home-care visits to the elderly and disabled.

That could result in more patients going to the ER.