TORONTO -- Hospitals across Canada have begun taking drastic measures as a way of limiting the spread of COVID-19 inside their doors.

At the Sunnybrook Health Sciences Centre in Toronto, security guards have been stationed near the entrances to ensure people clean their hands before entering. Those entering must also identify if they have a cough or fever.

The measures may seem extreme, but they are meant to protect hospital staff and patients from the spread of viruses.

“The fewer people around, the less likely we’re going to have transmission,” Dr. Avery Nathens, head of surgery at the Sunnybrook Hospital, told CTV News. “We also don’t want people to be bringing COVID-19 it in the hospital if they don't require care in the hospital.”

As of Monday evening, there were 441 confirmed and presumptive cases of COVID-19 in Canada, spanning every province. Health officials in British Columbia announced three additional deaths on Monday as well, bringing the total Canadian deaths to four.

To help treat those with the virus, hospitals in British Columbia and Ontario have already begun cancelling elective surgeries.

“We're expecting such an influx of patients that patients who do not require the ICU, will require an inpatient bed, perhaps on a surgical ward,” Dr. Michael Warner, Medical director of critical care at Michael Garron Hospital. “By cancelling elective surgeries we're creating capacity for those patients.”

Warner said purely elective surgeries, such as cataract surgery and cosmetic surgeries, have all be cancelled at his hospital. Doctors have even had to cancel some cancer surgeries.

Cancelling these operations not only frees up hospital beds for patients, but it also frees up the medical staff if any of them need to be quarantined as well.

“Some number of our own staff will either be quarantined or get sick and that will reduce the people available to provide surgical care,” said Nathens.

Several hospitals across the country have already set up screening facilities offsite to help test patients who think they may have the virus.

To help with a potential influx of patients in the next few days, some nurses and physicians in other departments are being trained for roles in intensive care, if they become needed.

“We're also starting to cross-train nurses who don't normally work in the intensive care unit, but also have those skills,” Warner said. “Today I'm working on a program to help train non-intensive physicians to fill my role, if I become unable to work.”

Treating COVID-19 has already shown to be a labour-intensive process. It takes two people to put a gown on a doctor, while it takes three to someone on a breathing machine.

The Public Health Agency of Canada has also sent out a job posting for additional nurses needed to handle the COVID-19 outbreak.

The agency is looking to hire nurses in nearly all major Canadian cities “to support effective co-ordination of federal, provincial and territorial preparedness and response to the emergence of novel coronavirus (COVID-19) in China,” according to the posting. 

Meanwhile the Registered Nurses Association of Ontario is also stepping up.

On Thursday, the organization put out a call for additional registered nurses and nurse practitioners to potentially make themselves available to help with Ontario’s telehealth program. To date, they’ve received more than 3,000 responses.

A spokesperson for RNAO said late Sunday that 59 of these nurses are already working in Ottawa.

WHAT CAN THE PUBLIC DO TO HELP?

The public can also ease the strain on hospital facilities, Warner said, by following government and medical experts’ advice to practise social distancing.

“As a frontline physician who will be taking care of life-threateningly ill patients with this disease, I want to limit the number of patients who face this and also make sure that the healthcare system’s able to accommodate patients with other illnesses,” he said.

Social distancing involves avoiding large gatherings and maintaining a space of about two metres between yourself and someone else.

Otther recommendations include self-isolating if neccessary and frequently washing your hands.