The latest round of public health restrictions in Alberta will last at least three weeks and the province will then reassess. The new rules come as the province’s health-care system is buckling under pressure from both COVID-19 and non-COVID patients.
Premier Jason Kenney said Wednesday that based on current trends, the health-care system could be overwhelmed in roughly one month’s time.
Dr. Neeja Bakshi, a COVID Unit physician at the Royal Alex Hospital, said it is almost there right now.
“We are seeing our usual to higher number of non-COVID admissions and hospitalizations on top of now increasing COVID admission,” she said.
“We’ve got the perfect storm of system collapse.”
Bakshi said surgeries have been postponed, staff are being redeployed and patients are already being admitted to non-traditional spaces, such as day surgery areas.
“We are admitting patients there. We’re already starting to have to adapt very quickly. I am hopeful but at the same time I think this has come too late, unfortunately,” she said.
Dr. Darren Markland said that while the health authority has a plan in place, the situation is looking bad.
“We’re already surging here. We’re adding additional bed capacity. We’ve had to reduce elective surgeries so we can actually get the human resources to staff those beds,” he said.
Kenney announced the latest round of measures after months of pleas from doctors who were concerned about rising case counts that remain stubbornly high. They include a move to online learning province-wide for K-12 students, small outdoor gatherings and smaller retail capacities.
Patios and personal wellness services are also being told to close.
“I don’t think they are going to prevent a collapse. I think it will hopefully shorten a collapse, shorten the duration we are under stress,” Bakshi said.
The premier indicated that if numbers come down in three weeks, the government could consider relaxing restrictions as we head into summer.
However, Dean Eurich, a clinical epidemiologist at the University of Alberta, said it will take some time for the measures to have their full effect.
“Our case numbers are so much higher than what they were in the fall, and it took at least two months to get out of that wave.
“I would expect this to be a very similar type of playbook,” he said.
“If we would have done those lockdowns two weeks ago, I think it would have meant a quicker exit out of the wave than what we are currently going to have.”
Eurich said vaccinations will help, and the province did announce the first step of Phase 3 of the vaccine rollout will begin Thursday, but he notes it takes time to get needles into arms and then for immunity to build up.
Until then, Bakshi said case numbers and numbers of patients going to hospital will continue to go up for the next few weeks.
“People that are being admitted right now had their positive case on April 21, 22, 23, so we haven’t even seen the full impact of the case numbers of 2,400 and 2,000 and the 13 to 14 per cent positivity rate yet. Those patients are going to be coming in in the next two to three to four weeks,” she said.
“We’re still going to see this huge health-care capacity burden well into June.”
What will happen after three weeks is a bit unclear. Kenney said no particular metrics have been defined for Alberta to reopen, though he said a key thing will be for daily case counts and total active cases to decline.
Dr. Parker Vandermeer, a rural family physician who has also worked in COVID wards, said there was not a lot of clarity about what it would take to reopen.
“I would hope it means they’re going to leave the door open to ensuring our case count actually gets lower rather than setting a fixed date and ‘hell or high water, we’re going to reopen by then,’” he said.
“It’s a change in tone from the past, which I think is positive.”
The benchmarks experts said will be critical include a R value consistently below one provincially as well as a substantial drop in case counts, day-over-day as well as week-over-week.
“Until we see those metrics, we really don’t have control of the virus and we have to keep restrictions in place,” Eurich said.
Markland, the critical care physician, said vaccination rates should be at 80 per cent before measures are loosened.
Saskatchewan has tied its reopening strategy to vaccination rates and Kenney said that is being looked at for Alberta.
But doctors say there are some disadvantages to this approach.
Bakshi said a first dose can provide some protection but only one dose does not provide full immunity; she said some patients who received their first dose are still ending up in hospital.
Vandermeer, meanwhile, said vaccination is a vital part of the pandemic response but it is not going to solve the problem.
“I do have some concern that our anti-vaccination rate or people that just don’t want to get vaccination rates in Alberta will be higher than other places.
“That will slow things down,” he said.
Vandermeer said a certain percentage of people must be immunized before there are benefits of herd immunity.
“I’m not sure how it’s going to work as a metric for easing restrictions.”