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Leaked Alberta modelling data projects upwards of 775 COVID-19 hospitalizations by mid-December

Click to play video 'Alberta’s overwhelmed hospitals expect even more COVID-19 cases' Alberta’s overwhelmed hospitals expect even more COVID-19 cases
Alberta's hospitals are already struggling to keep up with COVID-19 cases, and now there are fears a tsunami of new patients is on the way. Heather Yourex-West looks at the life and death decisions doctors and nurses are getting ready to make – Dec 1, 2020

The Alberta NDP says leaked modelling data shows that nearly 800 Albertans are projected to be hospitalized with COVID-19 by mid-December.

The Official Opposition said Tuesday it has obtained internal modelling data from Alberta Health Services that shows the increased strain on hospitals, and particularly intensive care units.

The AHS Early Warning System data, which the NDP says it received from healthcare workers, projects upwards of 775 Albertans could be hospitalized with COVID-19 by Dec. 14, with 161 of those people in intensive care. This is on the high end of the projections.

The low end of the data projects 76 people will be in the ICU by Dec. 14.

As of Monday afternoon, there were 453 Albertans in hospital with COVID-19, 96 of whom were being treated in intensive care.

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AHS Early Warning System data, obtained by the Alberta NDP, showing modelling for ICU beds in Alberta. Released Tuesday, Dec. 1, 2020. Courtesy, Alberta NDP

“The premier went into hiding when he should have been taking action to slow the spread of COVID-19 and ease the massive strain on Alberta hospitals,” Alberta NDP Leader Rachel Notley said in a news release.

“Now, we have frontline physicians warning they will soon face the horrific scenario of triaging patients and deciding who to save. We have hospitals in Calgary with oxygen shortages and we have photos surfacing online of two ICU beds being crammed into a space suitable for one.”

An internal memo sent out by AHS last Friday urged staff in Calgary hospitals to reduce the use of bulk oxygen where possible due to expected constraints caused by the pandemic.

Dr. David Zygun, Edmonton zone medical director for Alberta Health Services, said the memo was part of an “anticipatory” plan to make sure there are ample resources.

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“We do have an adequate oxygen supply,” he said.

Read more: COVID-19: Staff at Calgary hospitals told to ‘engage in oxygen conservation’ as cases rise

The NDP has been calling on the UCP government for weeks to release updated COVID-19 modelling data.

“Many other provinces have made this kind of information public. But, repeatedly, the premier told us that modelling didn’t exist,” Notley said.

During question period Tuesday, Notley asked the premier why he continues to hide this important information from Albertans. Kenney stressed that the information Notley is referring to is not modelling data.

“The data to which the honourable leaders of the NDP refers is not modelling. I repeat it is not modelling,” Kenney said.

“I don’t know whether she is saying that out of ignorance or dishonesty. But Mr. Speaker, it is the Early Warning System about which we’ve spoken many times. These are two-week projections that AHS always maintains for surges or any kind of illness, particularly a communicable one of this nature. And Mr. Speaker, the important thing is that AHS is constantly adding additional capacity to meet the growing demand and we will be providing more information on hospital capacity in terms of details in the days to come.”

Click to play video 'Alberta projects COVID hospitalizations could soon soar to 775 by mid-December' Alberta projects COVID hospitalizations could soon soar to 775 by mid-December
Alberta projects COVID hospitalizations could soon soar to 775 by mid-December – Dec 1, 2020

Kenney went on to say that comprehensive data of COVID-19 hospitalizations, fatalities, new cases and recoveries are released every day, “so Albertans have seen this very worrisome increase in cases evident for the past several weeks.”

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Modelling information previously released by the province showed various scenarios of infection, estimated how many Albertans would require hospitalization or critical care and predicted how many deaths the province could see.

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However, little information about long-term projections for the province has been provided since the second modelling was shared on April 28.

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

Kenney said in early October that Alberta does not have new COVID-19 modelling.

“The department of health, Alberta Health Services, the chief medical officer health and her team are obviously completely focused, every hour of every day, on the challenge of the pandemic, on the trend lines and on our goal of preventing and overwhelming the health-care system,” Kenney said Oct. 9.

At the time, he also pointed out the projections released in the spring, thankfully, ended up being way off from the rates Alberta actually recorded.

“We have never achieved a fraction of the number of active cases, of hospitalizations, ICU admissions or COVID-related fatalities that were projected in that modelling,” Kenney said.

“At this point, we don’t believe that creating hypothetical numbers is going to improve our COVID response.”

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Read more: Alberta hasn’t provided COVID-19 models since April; NDP wants new data released

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

In a statement Tuesday, AHS said it is constantly monitoring the current and future demand on the healthcare system, including the growth in COVID-19 cases. It added that the Early Warning System is one tool used to predict hospitalization and ICU numbers.

“It provides a point-in-time forecast, and is updated constantly throughout the day. Yesterday, it forecast a low (76), medium (113) and high (161) number of ICU spaces needed to meet demand. AHS is already increasing capacity to meet this forecast, and the potential for higher demand due to COVID-19,” AHS said.

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

In the coming weeks, about 2,250 acute care beds will also be allocated for patients with COVID-19 across Alberta, AHS said. In the past two weeks, an additional 20 critical care beds have opened in Edmonton and 10 additional critical care spaces opened in Calgary this past weekend, according to AHS.

“Our ICU occupancy is very high and we thank our incredible front-line teams for the care they are providing in challenging circumstances,” AHS said. “We need everyone’s help to reduce demand on our healthcare system.”

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Alberta’s chief medical officer of health said Tuesday that she has been concerned about the trajectory and impacts to the healthcare system “for some time.”

“Which is, of course, why I have been making recommendations to put interventions in place that will bend the curve,” Dr. Deena Hinshaw said.

She said the AHS projections “simply take into account the number of cases that we’re actually seeing and the trajectory out, should we continue to see the same kinds of growth trends.”

“That really is based simply on actual numbers within that calculation if nothing were to change looking at that worst-case scenario,” Hinshaw said.

“So those projections do not take into account the impact of changes and of course, that is exactly the point of those restrictions that were announced last week is to prevent us from hitting those high projections because what we need to do is to bend that curve down.”

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

Dr. Craig Jenne, an infectious disease specialist from the University of Calgary, said the models look fairly accurate, keeping in mind that multiple scenarios are being presented. He said the question that remains is where Alberta sits on the scale. Based on the record rates of infection in the past few days, Jenne believes Alberta is leaning more toward the higher-burden models.

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“These high-burden models are showing a near-doubling in ICU occupancy over the next two weeks,” he said Tuesday.

“We do know, unfortunately, ICU numbers tend to follow case numbers by two to three weeks. So it is the people being infected today that will be the ICU admissions in the next two weeks. So unfortunately, it looks as though those numbers may already be predetermined by the viral load in the community and record numbers that we’ve seen over the past several days.

“The hope though is over the next 10 days the curve begins to flatten and then that will have an impact on hospitalizations and intensive care units. But unfortunately, not for four to five weeks from today — or the new restrictions — will we see a dramatic impact on intensive care unit admissions if the restrictions work. And that’s another big if at this particular moment.”

New restrictions announced last week by the premier were designed to address COVID-19 hot spots while keeping the majority of businesses open. Retails must limit their capacity to 25 per cent and dine-in restaurant seating is now limited to one household per table. Indoor gatherings were also banned across the province.

Read more: Alberta enacts 2nd COVID-19 state of public health emergency. Here’s what it means

Jenne said it’s too soon to say if the new restrictions will have a big impact on the COVID-19 curve in Alberta, but suggested they may not go far enough.

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“So far from the data we have not seen any hint that the curve had begun to flatten here in Alberta,” he said.

“Unfortunately, we do know in the next few weeks we will continue to stress the system. There’s nothing that can be done today that’s going to stop new admissions for the next two weeks. The big question is, how well will the restrictions work going forward? It looks as though evidence from other jurisdictions that the restrictions we brought in may not be enough. Again, even with more strict restrictions, curves have not completely flattened and so as a result — it would be a guess — but based on the evidence, lighter restrictions are going to be less effective at bringing that curve under control.

“So I’m not overly optimistic that the current level of restrictions will be enough. Hopefully they’ll help. Hopefully they’ll slow things. But I don’t think this will be enough to flatten that curve or to — at least in the short-term — ease the healthcare burden.”

Hinshaw said Monday 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.”

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

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