A number of Alberta physicians are sounding the alarm on the rising number of COVID-19 cases, with some calling on the province to put in place stricter measures to curb the spread of the virus.
Alberta reported 1,646 new cases of COVID-19 and 11 deaths over two days this past weekend. Saturday marked the single highest daily increase of new cases the province has seen since pandemic began at 919 cases.
On Friday, Premier Jason Kenney announced new restrictions in hopes of bending the curve, including mandatory 15-person social gathering limits for municipalities on the province’s “watch” list.
Voluntary measures were also placed on Edmonton and Calgary, which strongly urge residents not to host parties or gatherings in their homes.
However, some who work on the frontlines say the measures don’t go far enough.
“I do feel that stronger measures are needed in order to combat the COVID-19 case increase,” said Dr. Shazma Mithani, who works in the emergency departments at both the Royal Alexandra Hospital and Stollery Children’s Hospital in Edmonton.
“A lot of my colleagues and myself are very concerned.
“We are making our concerns heard and it doesn’t feel like those concerns are being listened to. We are on the frontlines of the hospital.
“In the emergency department in particular, we are essentially a canary in the coal mine in this kind of situation and we are telling the premier that we are concerned and I don’t feel our concerns are being listened to.”
In the past two to three weeks, Mithani said the number of patients being admitted to hospital with COVID-19 has “increased dramatically.” With cases rising, she worries the hospitalizations will continue to increase in the weeks ahead, putting further pressure on the health-care system.
“We know there is about a two-week lag time between when we see the cases and when they present to hospital and start putting stress on the health-care system,” she said Sunday.
As of Monday afternoon, 192 people were hospitalized with COVID-19, 39 of whom were being treated in intensive care. There are currently COVID-19 outbreaks in all of Edmonton’s major hospitals, apart from the Stollery.
Dr. Stephanie Smith is the director of infection prevention and control at the University of Alberta Hospital. She said hospitalizations are also steady at the U of A Hospital and staffing has also become a concern.
“When we have so much community spread, there are obviously health-care workers that are impacted by that community spread and they have to be isolated at home because their kids have COVID or they’re been exposed in one way or another.
“That’s put a huge stress on the health-care system just in terms of being able to staff the number of beds that we have,” she explained.
What can be done to slow the spread?
Mithani is calling for mandatory measures, as well as what she calls a “circuit-breaker lockdown” to help bring case counts down. She worries the trajectory the province is currently on could lead to upwards of 2,000 cases per day by Christmastime.
“Up until now, all of the measures have been essentially voluntary — or the most recent measures have been voluntary — and that hasn’t worked. Our numbers have continued to go up and the voluntary measures have not bent the curve,” she said.
“I think that any measure put in place should be mandatory, not voluntary.
“Second, I feel that a short, what we call a ‘circuit-breaker lockdown,’ would be very helpful in curbing the spread of COVID-19. So it would be a two- to three-week lockdown of non-essential services and this would hopefully help decrease the cases and give the hospitals a chance to catch up, give the contact tracers a chance to catch up as well.”
Mithani was one of dozens of Alberta physicians who signed a letter to the premier Monday, calling on the province to consider a “two-week shot, sharp lockdown” also known as a “circuit-breaker.”
The doctors said the move could drop the “effective reproductive number and allow contact tracing to catch up, then turn to targeted regional control measures similar to Manitoba, Ontario and British Columbia, which have a sliding scale of restrictions based on the number of cases, hospital admissions and ICU capacity.”
“We believe it is time we had clear direction from our provincial government. We need rules not suggestions,” the letter stated.
Smith isn’t sure a lockdown would be the most effective approach. She is calling on Albertans to “truly” stick to the recommendations that are in place, but admits that may not happen.
“If we could say to everyone, ‘You cannot have any social gathering for the next four weeks’ and people would really stick to that, you do wonder if that would make a bigger difference. But I think that people have to take this seriously,” she stressed.
“That’s where we’re seeing transmission occurring is in these private parties and home settings. So I don’t know if shutting down businesses is actually going to make a big difference. I think that what we really need to do is actually have everyone focus on decreasing your number of close contacts and I think that will make a bigger difference if people truly listen to those voluntary measures and adhere to those… I don’t know if that’s going to happen though and that’s the challenge.
“This is the time to just kind of hunker down and stay within your very small cohort to try to reduce that spread.”
Dr. Lynora Saxinger, an infectious diseases specialist at University of Alberta, said what’s concerning to her is that she believes a lot of people have been trying to modify their activities and it hasn’t been enough.
However, when it comes to lockdowns she also suggests it’s a difficult balance.
“No one really knows what the right steps are for lockdown right now and no one knows exactly where all of their transmission is occurring, so it’s always going to be an odds game,” Saxinger said.
“If you’re going to do it, I think there’s a real argument to go hard to try to keep it short and then try to buy time to pinpoint the problem.
“To avoid being judged harshly by history, if I can put it that way, I would say taking a pretty broad view of any place where people are getting together inside in a non-essential fashion, is probably what we would want to do up front. The idea is that if you can really reduce transmission across the board, it almost dials back the clock.”
Saxinger said there’s a short window of opportunity for people to act and that the time to act is now.
“If you act early when things are going up, the eventual peak, the length of the peak, the number of extra deaths, is lower. And I think that’s a really important counterbalance to the idea that people don’t like lockdowns, they are restrictive, they are hard on the economy — but the chaos of an uncontrolled pandemic is also very hard on the economy,” she said.
“I worry about overstating things but when you look at the experience across the world, this is not good. This is honestly a pattern that we’ve seen happening elsewhere and people that are a little farther ahead on this path are seeing what we’re afraid of.
“The next few days are almost the difference between even a halfway hope of a decent Christmas versus a really disastrous, disastrous time.”
Government weighs in on restrictions
On Friday, the premier said the province is making decisions based on data and evidence, and that its goal is not to bring the COVID-19 case count to zero, but to “keep the spread under control so it does not overwhelm the health-care system.”
“We’re focusing on an area of much more significant transmission in a much less structured environment, which is at-home social gatherings and social gatherings more generally,” Kenney said Friday.
“Our approach will continue to be informed by the data and by balancing the COVID concern with other broader social economic and health concerns.
“Having said that, I’ve been clear from the get-go that as much as I believe Albertans want to maintain what I call responsible freedom in all of this, if folks don’t respond to the kind of voluntary measures we’re calling on today in Calgary and Edmonton — no more at-home parties — if they don’t respond, we will have no choice but to bring in more stringent measures. I don’t want to do that.”
Opposition Health Critic David Shepherd said Monday that the NDP understands the impact a “circuit-breaker lockdown” could have on the province’s economy, but still believes the government should consider the option.
“The Alberta NDP does not want a full economic shutdown,” he said. “But we do want the government to take additional steps immediately.
“The premier and the government should be taking the word of these… doctors incredibly seriously.”
Health Minister Tyler Shandro reiterated Monday that the government is committed to “following the evidence and making sure that restrictions are narrow, that they’re targeted, they’re not indiscriminate, that they’re not going to disproportionately affect businesses when they’re not needed to.”
“Right now we see a lot of evidence related to private social gatherings and that’s why Dr. Hinshaw has come to us with recommendations related to where we’ve seen those concerns and those outbreaks,” he said.
“Some of those social gatherings have actually seeded outbreaks in continuing care, as an example. So it’s very important for us to begin to work with Albertans on further guidance and further measures to make sure that we’re addressing the private social settings where we have the evidence that that’s the concern.”
Alberta’s chief medical officer of health said it can take one to two weeks to see the impact of additional measures, but added health officials don’t need to wait 14 days before recommending additional restrictions.
Dr. Deena Hinshaw said a number of additional measures are currently being discussed, including the possibility of the short circuit-breaker lockdown.
“I think the circuit-breaker idea is an interesting one,” Hinshaw said.
“When we’re looking at all of our options, we know that there is no one perfect way to manage our COVID-19 experience. We need to look at all options on the table, including that circuit-breaker, including what we’re doing now, which is giving Albertans every opportunity to walk along with us, to come alongside and be a part of the solution before we impose restrictions.
“Right now we’re watching our numbers, we’re watching our hospitalizations very closely, we’re having active discussions about multiple options and trying to make the best decision possible for Albertans,” she stressed. “Ultimately, we know that whatever measures we put in place — mandatory or voluntary — they are only going to be effective if Albertans come along with us and follow those measures.”
Saxinger also noted that while the past several months have been “a real grind,” there is promising news coming from COVID-19 vaccine research.
“We know that anything we are doing right now is really trying to get through to the next stage, that it’s not forever.”
On Monday, 644 new cases of COVID-19 were reported, along with seven additional deaths.
With files from Heather Yourex-West, Global News.
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