TORONTO (Reuters) – Ontario’s health ministry has asked hospitals to temporarily stop transferring patients to long-term care and retirement homes, according to a memo obtained by Reuters, as coronavirus infections and deaths mount in the homes and thousands of hospital beds sit empty.

The memo, dated Wednesday, means some patients, most of them elderly, could endure long hospital stays in Canada’s most populous province the midst of the pandemic.

Long-term care homes have struggled with shortages of protective equipment, staff, training and space to separate residents. Local media have reported that transfers to hospital are not frequent, increasing pressure on staff when there are outbreaks and they must care for many sick residents.

The memo said that hospitals can continue to care for patients who might otherwise be discharged safely because only 64.1% of acute care beds are in use across the province. Ontario added 1,035 beds and canceled elective surgeries to free up beds as the virus spread.

“We understand hospitals work to discharge patients to the next step in their care journey in order to help the patient receive appropriate levels of care and to create additional bedded capacity within the hospital,” reads the memo in part. “If this action will cause a critical patient flow issue in your hospital, please contact your Regional Lead.”

Reached for comment, the ministry said it would let the memo stand.

Local media have reported that patients are rarely transferred from long-term care homes to hospital in Ontario, even when they are critically ill and could benefit from more care. The Ottawa Citizen described the practice as “widespread but informal” on Wednesday, citing advocates for the elderly and healthcare workers.

“We have every expectation that any patient in need of hospital care would be transferred to one as quickly as possible, including long-term care home residents,” said ministry spokesman Travis Kann in an emailed statement. “Ontario has dramatically increased hospital capacity for this very reason: to ensure that beds are available for COVID-19 patients should they need them.”

On Wednesday, the province reported 145 deaths linked to outbreaks at 98 long-term care homes, and 385 deaths overall.

(Reporting by Allison Martell; Editing by Alistair Bell)

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