Over-capacity ERs are dangerous choke points. But hospital challenges go far deeper.

From the article:

Those headlines come from different hospitals and different provinces. But they all point to the same grim problem: Emergency rooms are overflowing while an array of respiratory illnesses — COVID-19 included — keep circulating. And it's happening against a backdrop of behind-the-scenes backlogs that turn front-line ERs into dangerous choke points.

The numbers are staggering. More than 10,000 people are in hospital at once across B.C., the most the province has ever seen, while Quebec grapples with the highest level of patients in its emergency rooms in five years.

In Ottawa, the Queensway Carleton Hospital recently said it was operating at 115 per cent occupancy. By midweek, most Montreal emergency rooms were above full capacity, with some operating at roughly 200 per cent.

The usual slate of viral threats, from influenza to respiratory syncytial virus, or RSV, make this time of year particularly challenging for hospitals thanks to the ongoing influx of sick patients. Canada's health-care systems are also adapting to a new normal where COVID-19 is now firmly in the mix.

…

And COVID's impact is really two-fold — both acute and lingering.

The mass shuttering of surgical sites during the pandemic to make room for deathly ill patients infected with the virus led to massive surgery backlogs. Hospitals are now playing catch-up, rather than risk more patients suffering while they wait for various procedures.

…

Also, shortages in other places cause backups in hospitals:

That clunky term [“alternative level of care”] refers to people who occupy a hospital bed, but really shouldn't be there because they don't actually need the intense level of services that hospitals are able to provide. That could mean someone who's stuck waiting for a space in a rehabilitation centre, long-term care home, palliative care, a hospice, or care at home.

(There are similar capacity issues in Massachusetts and other places in the US, but I didn’t see a good overview article.)