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Alberta’s COVID-19 positivity rate rises to 10.5%; health system under ‘enormous strain’

The province recorded 1,828 new cases of COVID-19 on Friday and performed more than 17,200 lab tests on Thursday, bringing Alberta’s positivity rate to 10.5 per cent.

“This positivity rate is a grim milestone,” chief medical officer of health Dr. Deena Hinshaw said.

As cases rise and pressure on the health-care system mounts, Alberta Health and Alberta Health Services continue to work on a contingency plan and mobile field hospitals in Edmonton and Calgary, as well as bolstering the contact-tracing team.

Click to play video 'Alberta’s COVID-19 positivity rate hits 10.5%' Alberta’s COVID-19 positivity rate hits 10.5%
Alberta’s COVID-19 positivity rate hits 10.5% – Dec 4, 2020

Field hospital planning

As part of its contingency planning, AHS president Dr. Verna Yiu said the health authority is preparing mobile units to reduce demand on hospitals and help balance non-COVID-19-related care while meeting the increased demand of COVID-19 cases.

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“Staffing these mobile units will be a challenge,” Yiu said.

AHS has been in discussions with external organizations about potential partnerships, including the College of Physicians and Surgeons of Alberta, other post-secondary institutions, the Public Health Agency of Canada (PHAC) and the Canadian Red Cross.

Yiu said AHS is planning for “all scenarios” and the remote hospital plans – for low acuity mobile units – is part of its “ongoing, proactive pandemic response planning.”

Read more: Alberta’s COVID-19 ‘contingency plan’ includes requests for field hospital

The physician registry has been relaunched in partnership with the college, where Alberta doctors enter their availability and willingness to provide care and be redeployed to the pandemic response if needed.

Yiu said AHS is also looking at new models of care, for example, in the ICU. Training programs for people wanting to improve their skills have been expedited over the last few months.

“It is really important for us to make sure quality and safe care continues,” she said. “We are very cognizant that workforce challenges are there.”

Click to play video 'Coronavirus: AHS president says Alberta must prepare for all scenarios' Coronavirus: AHS president says Alberta must prepare for all scenarios
Coronavirus: AHS president says Alberta must prepare for all scenarios – Dec 4, 2020

AHS will be using recruitment, redeployment and maximizing overtime to help address staffing needs.

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“We have the ability to pull from our workforce all over the province,” Yiu said.

New models of care

A nurse who works at Edmonton’s Royal Alexandra Hospital, whose name Global News has agreed to withhold out of fear of losing his job, said they’ve been told to prepare for a new way of caring for patients.

The nurse said the ratio of patients to staff will change. Each nurse will now care for six or eight patients; currently they care for four, he explained. The nurse said healthcare aides will now be used more to help patients. The changes are meant to allow more staff to help with the growing need in intensive care.

“This essentially reduces the numbers of nurses that are on shift for each shift,” he said. “This results in a higher ratio of patients to nurse.”

Click to play video 'Nurses, other health workers redeployed to manage COVID-19 surge' Nurses, other health workers redeployed to manage COVID-19 surge
Nurses, other health workers redeployed to manage COVID-19 surge – Dec 4, 2020

He said he understands the need to do things differently, given the situation at hand. While he said he’s not surprised by the change, he is worried about patient care.

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“This puts patients at risk,” he said. “Countless research has supported having nurse to patient ratios be lower and that when this gets compromised and there’s more patients — upwards of six or eight patients to one nurse — research demonstrates that patient outcomes are affected and that negative patient outcomes increase, as well as workplaces are less safe.”

Click to play video 'Edmonton hospitals at a tipping point: E.R. doctor' Edmonton hospitals at a tipping point: E.R. doctor
Edmonton hospitals at a tipping point: E.R. doctor – Nov 4, 2020

He also added the pressure will lead to further staff burnout.

“Nurses are still going to fill in these gaps and do the best they can to make sure patients are well looked after, but this is going to take a toll. People are also burnt out. The healthcare system is already taxed.”

He believes further restrictions are needed to make sure the pressure doesn’t continue to increase.

“Hindsight is 20/20 in 2020. I would say go back a month and shut everything down. We can’t do that. We need to shut everything down right now,” he said.

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“The point of me making this public is that we need to make the public aware that we do have physical space. However, we do not have sufficient and safe healthcare workforce to maintain the quality of healthcare that Albertans deserve.”

Read more: Hospital beds versus staff: Is COVID-19 overwhelming the human side of Alberta’s health system?

In a statement, AHS said ensuring staff have the capacity to provide safe, high-quality patient care has been a priority throughout the pandemic. AHS said it continues to assess staffing needs and plans may include redeployment “to provide the best care where it is most needed.”

“When AHS deploys teams of staff to provide specialized care, those teams may have a mix of providers. While the ratio of nurses to patients might change, the team will have support from other professionals with appropriate skill sets to ensure patients continue to receive safe and timely care from their care team,” AHS said.

“Redeployed staff who are working outside their usual areas of responsibility will be part of teams that are led by experienced staff with the necessary training to oversee patient care.”

Adding more contact tracers

As case numbers surge, it has become more and more difficult for contact-tracing teams to keep up with demand, Yiu said.

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She said AHS continues to hire more contact tracers, train and onboard them.

Alberta started with about 50 contact tracers and increased that number by five times in July before doubling it again in September. There are about 900 now and Alberta wants to increase that number to 1,600 in 2021, Yiu said.

Read more: Alberta aims to have 1,600 contact tracers by end of 2020 as COVID-19 cases surge

AHS is posting jobs in regulated and non-regulated sectors: registered nurses, licensed practical nurses, occupational therapists, physical therapists, speech and language pathologists and Statistics Canada workers.

About 350 people currently in AHS’ volunteer database have expressed interest in joining the contact-tracing team.

Yiu said anyone interested can apply at AHS.ca/careers.

Click to play video 'AHS president on COVID-19 contact tracing: ‘We are doing everything that we can to manage this’' AHS president on COVID-19 contact tracing: ‘We are doing everything that we can to manage this’
AHS president on COVID-19 contact tracing: ‘We are doing everything that we can to manage this’ – Dec 4, 2020

Daily case numbers

As of Friday, there were 18,243 active cases in Alberta.

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There were 533 people in hospital, 99 of whom were in ICU.

Read more: Alberta to receive COVID-19 vaccine by Jan. 4 as province confirms another 1,685 cases

Alberta Health confirmed 15 additional deaths on Friday. The fatalities occurred between Nov. 28 and Dec. 3. Nine of them are linked to outbreaks.

Seven are connected to the outbreak at Edmonton’s Chinatown Care Centre (all with comorbidities), including four men in their 90s, a man in his 80s, a man in his 100s and a woman in her 90s.

Click to play video 'Family members called in to help at Edmonton Chinatown Care Centre due to staff shortages' Family members called in to help at Edmonton Chinatown Care Centre due to staff shortages
Family members called in to help at Edmonton Chinatown Care Centre due to staff shortages – Nov 30, 2020

A woman in her 70s linked to the outbreak at Clifton Manor in the Calgary zone (with comorbidities), a man in his 80s linked to the outbreak at Capital Care Lynnwood in the Edmonton zone (with comorbidities) and a woman in her 90s from the Calgary zone (with comorbidities) also died.

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A man in his 60s with no known comorbities from the Edmonton zone died, along with a man in his 70s, a man in 60s and a man in his 50s, all from the Edmonton zone. A woman in her 70s from the Central zone also passed away.

“These are our friends, our children, our parents and our great-grandparents,” Yiu said.

“My heart goes out to everyone impacted by this pandemic. I also want to thank everyone who works in our health-care system.”

Yiu reiterated the health-care system is under “enormous strain and pressure.”

Read more: Alberta sets another daily COVID-19 record with 1,854 new cases

She specifically thanked all health-care workers for their tireless efforts and commitment to care.

“You are all heroes.”

 

Hinshaw thanked everyone who reached out to send messages of support and encouragement to her and her team.
She also had a message to Albertans.

Click to play video 'How is Dr. Hinshaw coping? Alberta’s top doctor says she’s keeping up with the strain of the job' How is Dr. Hinshaw coping? Alberta’s top doctor says she’s keeping up with the strain of the job
How is Dr. Hinshaw coping? Alberta’s top doctor says she’s keeping up with the strain of the job – Dec 4, 2020

“We are heading into the first weekend of December. I know this last month may be the toughest,” she said.

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During a time of year that’s usually full of parties and family gatherings, “we feel the restrictions more keenly.”

But she emphasized the seriousness of the rising case numbers and encouraged Albertans to hang in there.

“This is the time for staying home and staying safe… avoid anywhere with crowds.”

She challenged Albertans “to fully embrace not just the specifics of the measures; but the spirit of them, which is to reduce as many in-person interactions with people outside your household as possible.

“You are not only protecting yourself and those closest to you, but you’re playing a critical role in breaking the lines of transmission… You’re supporting our dedicated health care workers.

“You’re helping to prevent spread and protect our health care system… You’re sparing someone the worry of watching a loved one battle COVID-19.”

“We have the power to change this,” Alberta’s top doctor said.

“Be wise, be kind, and go the extra mile.”

— With files from Caley Ramsay

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