Alberta Health Services said late Wednesday afternoon that it was postponing “all scheduled elective surgeries and many outpatient procedures for the remainder of this week” at Calgary hospitals.
AHS said the “difficult decision” was made “to best support adult critical care during this fourth wave of COVID-19 pressures.”
“This move will allow AHS to deploy qualified staff to support intensive care and critical care beds within the zone.”
AHS said, as of Wednesday, there were 95 ICU beds in Calgary — 29 more than the zone usually has (66).
Patients who are impacted by the postponement will be contacted, AHS said, and their procedures will be “rescheduled as soon as possible.”
All urgent and emergent procedures, as well as prioritized cancer surgeries, will continue.
“We do not make these decisions lightly and acknowledge that postponing surgeries has a deep impact on those patients, their families and their loved ones,” AHS said in a series of messages on Twitter.
“Decisions related to other future surgery postponements across the coming weeks will be made based on the evolving situation.”
Alberta’s chief medical officer of health said, as of Wednesday, there were 647 people in hospital due to COVID-19, 147 of whom are being treated in ICU.
Of the 147 patients currently in ICU, 89 per cent are unvaccinated or partially vaccinated, AHS said.
“We strongly urge all eligible Albertans to get immunized as quickly as possible, which is your best defence against a severe outcome from COVID-19.”
“As we said last week, this situation is serious, and we would like to remind all Albertans that we need their help in reducing the transmission of COVID-19 in the community, which in turn will reduce strain on the healthcare system.”
In a series of messages on Twitter, Dr. Deena Hinshaw said 18 new deaths related to COVID-19 were reported to Alberta Health in the last 24 hours.
Over the past 24 hours, 1,166 new cases were identified out of about 10,700 tests, putting the province’s positivity rate at 11.48 per cent.
Once AHS has cancelled procedures, redeployed staff and switched to higher patient-to-nurse ratios, what’s the next step if ICU rates keep climbing?
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“We have to look at alternate care models,” said Dr. Neeja Bakshi, a physician at the Royal Alexandra Hospital in Edmonton.
“How can we still provide care for patients? And maybe untraditionally, which we’re already kind of doing, by off-loading into different departments and different divisions.
“Some of those things might look like off-site care. We’ve talked about the Kaye Clinic in Edmonton, other places — the tent at Peter Lougheed. Those are the types of scenarios where we have to start looking at: can we move our more stable patients out to areas where we wouldn’t traditionally provide hospital care and free up some hospital space?
“And if we run out of space there, I truly don’t actually know what the next step is.
“We have to look at: are we providing care that we can do in hospital to the right patients?”
Dr. Paul Parks, an emergency physician in Medicine Hat, said another future option is critical triage.
“I hope we never get there,” he said.
“We do have a policy developed that may look at making decisions where, if our resources are overwhelmed, we’ll have to choose, that some people may not get the critical care or the extended care that they would have got if the system wasn’t overwhelmed.”
“Today’s update is overwhelming,” NDP health critic David Shepherd said in a statement after Wednesday’s COVID-19 numbers were released. “We lost 18 more Albertans to COVID-19 yesterday.”
“More than that, we see a staggering spike in hospitalizations and once again, a rise in the number of Albertans (in) ICU.
“We are experiencing a serious fourth wave that is having devastating consequences for families across Alberta. Today, we also learned that AHS has been forced to cancel even more surgeries, leaving more Albertans waiting and worrying in pain as their condition worsens.
“To all those Albertans who, for one reason or another, have not gotten your shot, today is a message. Please, listen to your peers and loved ones. Get your shot. Don’t wait any longer,” Shepherd said.
The Opposition also called on the UCP to implement measures that other jurisdictions are, like vaccine passports.
Earlier Wednesday, AHS said it added three more ICU spaces in the fourth wave of the COVID-19 pandemic.
AHS’ baseline number of ICU beds is 173. Since Sept. 1, it’s added 53 additional ICU spaces, bringing the total added ICU spaces to 85. There are currently 258 ICU beds open in Alberta.
“AHS continues to do all it can to ensure we have enough ICU capacity to meet patient demand, including opening additional spaces and redeploying staff,” spokesperson Kerry Williamson said.
“Provincially, ICU capacity (including additional surge beds) is currently at 87 per cent (the average over the past seven days is 91 per cent).”
As of 11 a.m. Wednesday, the Calgary zone ICU was operating at 82 per cent of current capacity, including 38 COVID positive patients in ICU and the Edmonton zone was operating at 89 per cent of current capacity, including 57 COVID positive patients in ICU.
However, Bakshi says the biggest issue isn’t beds; it’s staff for those beds.
“On average, you need four nurses per bed.
“When we talk about how we’re overwhelmed and overcapacity, it’s because the human resources piece of it is not something we can scale up easily.
“Right now, we’re not even operating at the baseline human resources capacity we need… due to burnout… due to people being redeployed elsewhere,” Bakshi said.
The effect ripples down to all aspects of the health system, said Parks.
“When the emerg departments get difficult like that, when we can’t see people in a timely manner, then you have to start talking about disaster planning type thing, where you have to end up cancelling elective surgeries so you can increase capacity or you have to cancel endoscopy or cancer care and even sometimes pediatric care because the nurses in pediatric care have to be repurposed to go take care of COVID patients.”
Parks said capacity isn’t just about space or beds.
“In order to go from our current ICU capacity — say of 173 beds being our baseline, all of our ICU beds in the province without surging and going overcapacity — in order to bump that up so that we’re at the 205, 210, whatever we’re at now, we have to repurpose nurses and staff and RTs and pull them from other areas and pull them into critical care where they may not be as comfortable.”
As of Wednesday afternoon, there were 15,618 active cases across Alberta.
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