Table 2 Subthemes theme 1, Conditions contributing to resource strain descriptions and quotes, Participant ID_SexAge_Region_InstitutionType

1. Limited equipment and supplies (supply chain shortages)

Lack of equipment, supplies and space needed to care for ICU patients. Could be due to supply chain shortages.

“Our supply chain is already threatened and some organizations are always within 24, 48 h of running out [of PPE]. I know of a hospital in our region that went to Walmart to buy some surgical masks on Sunday. So they’re always a threat with running it within 24, 48 h.” – Participant 5_M60_Central_ Tertiary

2. Staffing shortages

Staffing shortages potentially due to HCP illness

“There’s a lot of planning that’s going on right now. I think there are excellent plans in place, I just am not sure about implementation, and by that I mean it’s really hard to predict the numbers, when we’re going to have to implement the various phases, and also are we going to have sufficient staff to care for all these patients?”- Participant 4_F49_Central_Tertiary

“Another thing, if people are feeling overworked or distressed, then the potential for moral distress and burnout and empathic distress, all of those things would impact people’s capacity to be truly present for their patients and maybe even not able to come into work for psychological reasons as well. So I think both the physical and the psychological aspects of not being supported adequately would be important factors that could contribute.” – Participant 11_F40_Prairies_Tertiary

3. Continuously evolving pandemic conditions

The nature the continuously changing environment makes it difficult to predict what is coming.

“I’m really hoping that this is something that we’ve planned well for, prepared for, and it never really becomes as bad as we’re all worried that it might be. So far numbers seem good, but that can change on a daily basis.”- Participant 8_M38_Prairies_ Tertiary

“The things that would jeopardize that would be the frequency of patients that require admission to ICU, overwhelming our current ability to provide that. So in other words, if too many patients come in all at the same time, then we would potentially be overwhelmed. So that would be likely the biggest threat. In contrast to that, if the patients come in well spread out, even if there’s a lot of them, we can cope quite easily.” – Participant 2_M40_Prairies_ Tertiary