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Hospitals are overwhelmed and wait times for vital procedures are at crisis level. It’s so bad that the local city council declares a state of emergency and warns that people’s lives are at risk.

Sounds like what every hospital is facing as the Omicron wave breaks over Ontario, threatening to inundate the health care system. The twist is that this happened in January, 2020, two months before the pandemic started, at a time when COVID-19 was just an ugly rumour out of China.

And it happened not in some remote community, but in Brampton, a city of 600,000 souls in the heart of the GTA.

Mayor Patrick Brown highlighted that incident this past week as he, along with many others, drew attention to an ugly fact that Canadians are going to have to face up to once we finally get past COVID: even in “normal” times our hospitals run at near-crisis levels, without enough beds and staff to keep up with demand.

Canadians love their health-care system. But the reality is that Ontario, and Canada as a whole, are near the back of the pack when it comes to the number of hospital beds, acute care beds, as well as doctors and nurses per capita, when compared to other developed countries.

This is how governments of all political persuasions chose to run things for many years before COVID hit and shone an unforgiving light on the flaws in the system.

The result has been plain to see for the past 22 months: when COVID sends a few hundred extra patients to fill Ontario’s intensive care beds, the system is overwhelmed, or comes very close to it. Thousands of non-emergency but important procedures get postponed, and the government shuts down whole areas of public life.

Whatever money has been saved by skimping on hospital beds, especially resource-heavy acute care and ICU beds, and the staff needed to keep them running, is vastly outweighed by the enormous cost of shutting much of the economy and spending hundreds of billions to support people through the pandemic.

This was quite foreseeable; indeed, many people did foresee it. Consider, for example, a prescient article by Carleton University economist Frances Woolley back in March, 2020, just as the pandemic hit hard.

Governments were calling on us to “flatten the curve” of COVID cases, but Woolley pointed out that the system runs at near 100-per-cent capacity all the time. “Our hospitals cannot cope with the most flattened of curves,” she wrote. “Indeed, they cannot cope with any kind of curve at all.” How right she was.

The cause is chronic under-funding, especially in provinces like Ontario, Alberta and British Columbia where population growth has outstripped health resources. At the same time, governments essentially ration care by restricting the supply of hospital beds; that caps the number of procedures that can be performed. It keeps health-care budgets under control, but leaves the system without spare capacity.

We’ve now had almost two years to see the results of this approach. It’s no doubt true that any severe pandemic would likely “overwhelm” even a more generously resourced system. But surely we’ve learned by now that when it comes to health care we were living in a fool’s paradise; government “savings” have cost us hugely in terms of lives, health and social well-being.

Spurred on by the COVID crisis, governments are trying to undo some of that damage. Ontario, for one, had just over 2,000 ICU beds when the pandemic struck. The Ford government managed to add 777 more on a temporary basis when hospitals were flooded last spring, and the number is now a touch over 2,300.

Ontario has also hired some 6,700 more health care workers and budgeted $342 million to add more nurses and personal support workers. It’s hard to see that right now, when staff shortages brought on by Omicron are biting hard and the province’s nurses rightly complain that their wage increases have been capped at a measly one per cent. But it does go in the right direction.

Other provinces, such as Alberta, are taking similar steps. But it will take years and a national approach to get our health care system to a point where it will be much better equipped to deal with a future pandemic whenever that hits — as it inevitably will.

It will also, no doubt, take a lot more money. But if we’ve learned anything from the trauma of COVID, it’s that cheaping out on hospital care will cost us even more in the long run.

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