Excitement is building for FIFA World Cup soccer games in Toronto and Vancouver in June and July, yet Canada's overburdened health systems may buckle with any additional demand, cautions an editorial published in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.252094 .
"Canada is increasingly vulnerable to events that may result in a surge in health care utilization, including climate emergencies, mass gathering events, infectious diseases outbreaks, and global defence escalations," writes Dr. Catherine Varner, an emergency medicine physician in Toronto and Deputy Editor, CMAJ.
World Cup organizers are planning for a range of scenarios with the help of local and provincial health and emergency authorities, but can they plan for increased volumes in health systems already stressed and over capacity with current patient loads?
Dr. Varner, an emergency physician who worked during Games 1 and 7 of the 2025 MLB World Series, has direct experience with how stretched health care capacity is in Toronto. She calls for urgent action on a national plan to bolster health systems to meet potential needs from large-scale events like the World Cup and others.
"A coherent, feasible, actionable, and national plan is urgently needed to increase hospital beds and train the required personnel such that quality of care can be maintained," she writes.
This year's flu season has placed exceptional burden on hospitals, patients, and health care providers, with emergency departments across Canada facing huge patient volumes and long wait times for care.
"Health care providers in Canada are accustomed to flexing and triaging acute care and public health resources," Dr. Varner writes. "Being in a constant state of surge capacity is actually the norm. However, even when anticipated surges occur, bedside experiences and provincial quality metrics suggest that systems cannot absorb more load when they are already operating at or above capacity without compromising the quality and safety of patient care."
A potential solution would be for hospitals near the World Cup sites in the two cities to increase staffing to cope with higher demand for health services, but Dr. Varner cautions that "increasing staff, even for the duration of these events, is likely not feasible since Canadian hospitals and public health systems already face health human resource challenges and budget shortfalls in these years following the COVID-19 pandemic, a problem that has been widely recognized in other important spheres of governance."
Recent reports have identified health care system capacity and health care personnel as major weaknesses in Canadian sovereignty and defence, a priority area for the government under Prime Minister Mark Carney. Scenario planning for a large-scale war in Europe made it clear that Canada's health care systems would struggle to function if health care personnel were sent overseas or wounded soldiers returned to Canada for care.
"With the recent commitment to increase defence spending in the 2025 federal budget, increasing acute care capacity should be prioritized as part of Canada's emergency preparedness systems to support national defence and security purposes."
