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Alberta identifying ‘unconventional ICU spaces’ as COVID-19 cases, hospitalizations rise

Alberta Health Services said it has plans in place to utilize “unconventional ICU spaces” should the demand for beds continue to rise in the days and weeks ahead as COVID-19 numbers in the province continue to climb.

Alberta reported 1,733 new cases of COVID-19 on Monday — a new daily record. Eight additional deaths from the disease were also reported, bringing the provincial death toll to 541.

Hospitalizations also increased to 453 province-wide. Of those in hospital Monday, 96 people were being treated in intensive care.

Dr. Deena Hinshaw said she is “alarmed” by the active case numbers reported Monday and over the past weekend. She suspects case counts and hospitalizations will continue to increase over the next several days, “as we wait for the impact of the restrictions that were announced last week.”

“If we have continued spread, we are nowhere near that COVID-19 peak unless we can collectively bring our numbers down.”

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Read more: Alberta nurse practitioner describes ICU during pandemic: ‘We’re feeling a bit defeated’

Dr. David Zygun, zone medical director with AHS, who joined Alberta’s chief medical officer of health for Monday’s daily COVID-19 update, said “there is no doubt that the hospital system is under significant strain.

“Having said that, we’ve planned extensively for it and we are executing those plans as the demand increases.”

Zygun said there are currently 173 general adult ICU beds in the province and AHS has plans to expand that up to a total of 425 ICU beds.

In the last week, 20 additional beds were added in Edmonton and over the past weekend, 10 additional beds opened in Calgary to keep up with the demand, Zygun said.

“As we start to expand capacity, we do have some capacity within our current ICU, so unfunded beds, and those are the first beds that are utilized,” he said. “As the need for ICU beds increase, we will go into unconventional ICU spaces.”

Zygun said the spaces that would be utilized first include specialty ICUs like a cardiac ICU. If a more extreme need arises, AHS would turn to “really unconventional spaces.”

“This would be areas like post-operative recovery rooms, operative rooms or other spaces.”

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Click to play video 'AHS doctor says Alberta hospitals are under ‘significant strain’ amid COVID-19 pandemic' AHS doctor says Alberta hospitals are under ‘significant strain’ amid COVID-19 pandemic
AHS doctor says Alberta hospitals are under ‘significant strain’ amid COVID-19 pandemic – Nov 30, 2020

 He went on to say that beds and equipment aren’t the only need; staffing those areas is one of the “key challenges.”

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“First of all, we utilize those providers that are trained and are usually working in ICU environments — and that’s physicians, nurses and respiratory therapists and social workers and our rehab colleagues,” he said.

“As we expand out, we’ve obviously looked at those who have recently been in ICU and maybe moved on to other jobs to be redeployed. We’ve also taken proactive measures to provide training for those in like-type specialties that could support our critical care teams. So this may be… operative room staff, post-operative recovery staff, emergency staff.

“What the teams have developed is a sequential level of support such that as the teams expand, we would use those non-traditional providers but be supported by the traditional providers in that so that we can provide safe and effective care.”

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While Zygun said is reassured by the plans he has seen, he hopes it doesn’t get to that.

“We’re first utilizing all of our conventional ICU beds and teams and will only do that unconventional-type spaces when absolutely needed, which we hope to avoid with public health measures and compliance with those.”

Overall hospital capacity

Earlier Monday, Premier Jason Kenney told Global News Radio 770 CHQR that Alberta’s largest hospitals are at 91 per cent capacity due to COVID-19 cases.

“Our top 15 hospitals are increasingly under stress,” Kenney said. “Ultimately, if we get more and more COVID patients in hospital, the response to open up (COVID) capacity will be widespread surgical cancellation.”

He said Alberta has 8,500 hospital beds. Some 2,400 are being set aside for pandemic patients and one-quarter of those beds will be in intensive care.

“We have a plan to get back to that level of availably given the current surge that we see,” Kenney said.

In October, the Edmonton area began cancelling 30 per cent of non-urgent surgeries to deal with mounting COVID-19 caseloads.

Read more: AHS postpones some surgeries, ambulatory care in Edmonton zone as COVID-19 cases rise

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Hinshaw stressed that “at this time, there is adequate capacity to care for all those with COVID.”

“However, we do need to make sure we’re bending the curve early enough that we never get to that point where we don’t have capacity to care for everyone,” she said.

“These are exactly the reasons why we all need to work together to minimize our spread.”

Alberta records highest daily COVID-19 count to date

Alberta’s 1,733 new cases of COVID-19 reported Monday breaks the previous daily record of 1,731 cases reported Saturday.

Of the eight additional deaths reported Monday, three occurred in the Calgary zone: a man in his 80s, a woman in her 80s linked to the outbreak at The Hamlets at Cedarwood Station and a man in his 70s linked to the outbreak at Wing Kei Care Centre.

Three deaths were reported in the Edmonton zone: a man in his 40s, a man in his 60s linked to the outbreak at Good Samaritan Pembina Village and a man in his 90s linked to the outbreak at South Terrace Continuing Care.

A man in his 80s linked to the outbreak at Newbrook Lodge in the South zone died, as well as a man in his 90s linked to the outbreak at Rosealta Lodge in the Central zone.

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Click to play video 'Coronavirus: Alberta records 1,733 new cases, 8 additional deaths Monday' Coronavirus: Alberta records 1,733 new cases, 8 additional deaths Monday
Coronavirus: Alberta records 1,733 new cases, 8 additional deaths Monday – Nov 30, 2020

 Monday’s cases bring the total number of active cases in Alberta to 16,454.

Of the active cases, the majority were located in the Edmonton zone, where there were 7,388 cases.

Grades 7 to 12 move to at-home learning

Monday also marked the start of new school-related restrictions in Alberta, with students in grades 7 to 12 shifting to at-home learning until winter break starts on Dec. 18. Students in Kindergarten to Grade 6 will remain in the classroom until winter break.

After winter break ends on Jan. 3, all students in all grades will learn at home for one full week before returning to in-person schooling on Jan. 11.

Hinshaw said Monday there are currently active alerts or outbreaks in 376 schools, which is about 16 per cent of the schools in the province. The schools have a combined total of 1,405 active cases.

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“We can expect to see a reduction in the number of cases, outbreaks and alerts attributed to schools in the coming days,” Hinshaw said.

“I do want to be clear, there is a lag time between action and results. While cases may not be attributed to schools as students are at home, they will still be reflected in our overall active cases.”

Read more: COVID-19: School board chair says she got no ‘heads up’ from Alberta government about new measures impacting schools

Hinshaw is slated to provide an in-person update on the COVID-19 situation every day this week.