There are more patients in Ontario intensive care units than at any other point in the COVID-19 pandemic and the medical director of critical care at one Toronto hospital is now warning of a “very difficult” January.

According to a daily critical care report obtained by CP24, there were a total of 1,765 patients receiving treatment in the ICU as of Monday, including 267 with confirmed cases of COVID-19.

The report pegs the total number of ICU beds in the province at 2,136, suggesting that there is some capacity for additional patients.

But Dr. Michael Warner, who is the medical director of critical care at Michael Garron Hospital, says that many of those beds exist “on paper” only because overburdened hospitals simply don’t have enough nurses and other personnel to staff them.

He said that with many hospitals in the GTA already “getting overwhelmed” we are now in a situation where things are likely to get worse before they get better.

“Just to give viewers context back in Wave One when we hit our peak of 283 COVID patients (in the ICU) there were only 1,300 patients in all of Ontario’s ICUs. So we are caring for many more patients and although on paper the ministry may say we have more beds we don’t have the nurses to staff the beds that are available which is the major challenge,” he said. “It is really the nursing staff that is in limited supply which means that elective surgeries and other procedures will be cancelled to accommodate all the volume that we have to get through.”

The critical report suggests that an additional 25 COVID patients were admitted to the ICU over the last 24 hours, including five more in the Mississauga Halton Health Integration Network where 123 out of 132 ICU beds are now filled.

In Toronto, there are now 48 patients with COVID-19 in ICU units, including 38 on ventilators.

The number of patients in the ICU in the city stands at 344, leaving only 63 available beds.

Meanwhile, the two local health integration networks that oversee hospitals in Peel Region now list a combined 54 COVID patients in their ICUs, including 32 on ventilators.

Speaking with CP24, Warner said that he believes hospitals will be able to continue to provide care to those who need it but he said that surgeries and other procedures are now at risk.

His comments mimic those of Adalsteinn (Steini) Brown, the Dean of the Dalla Lana School of Public Health at the University of Toronto, who said last week that some communities were now at the point “where important care is being delayed.”

“Hospitals have contingency plans. There is staff that can be redeployed. For example if we start cancelling surgeries, those nurses will move down to the ICU to help expand out bed capacity. So that will help,” Warner said. “But some hospitals will be overwhelmed much more than others. There is much more COVID activity in Scarborough, North York, York Region, Halton and Hamilton. These areas are really getting overwhelmed with COVID activity and will have to start to cancel cases to create new nursing capacity.”