Alberta’s health system continues to strain under the fourth wave of COVID-19, fuelled significantly by the Delta variant and unvaccinated people needing urgent hospital care.
As of Thursday, there were 679 Albertans in hospital with COVID-19, including 154 being treated in the ICU. That’s up from 647 in hospital and 147 in ICU on Wednesday.
Alberta Health Services’ baseline ICU capacity is 173 beds. An additional 93 surge beds have been added to meet the rising care needs.
As of Thursday afternoon, ICU capacity across Alberta was at 87 per cent.
“Remember, that includes surge beds,” said AHS CEO Dr. Verna Yiu. “If we had not added additional surge beds, we’d be over 130 per cent.”
Of the 231 Albertans in ICU, 70 per cent are patients with COVID-19.
On Wednesday, AHS announced it made the difficult decision to postpone all elective and many outpatient surgeries in the Calgary zone this week to increase ICU capacity and redeploy staff to ICU and COVID-19 units.
Urgent cancer surgeries will continue to be performed, AHS said, as well as emergent operations.
Some less-urgent cancer surgeries may have to be postponed, AHS said.
“These decisions are clinically based, using a cancer triaging document drafted and approved by physicians and clinical cancer leadership,” Yiu said.
“As is the case with all surgeries, clinicians triage cases based on priority. The most serious and urgent cases are performed first.”
Money to hire/retain health care aides
In another attempt to free up space in Alberta hospitals and ICUs, the province is providing money to pay certified health aides more.
Health Minister Tyler Shandro said $22 million is being provided over two years to contracted home care agencies to retain and attract health care aides. It will mean $2 more an hour for the next 13 months.
He also said Alberta is providing $14 million to support short-term staffing increases in home care agencies and continuing care operators to add new staff to help during the fourth wave. The money can be used to increase capacity for COVID-19 screening, cleaning and respite care.
The goal, Shandro said, was to move more patients from the hospital and either back home – where they can receive care – or into a continuing care facility.
Yiu said the investment will help AHS preserve space in acute care and “expedite the discharge of patients waiting in hospitals.”
She said there are about 400 patients in acute care who could potentially go home, 200 of whom could be moved into continuing care spaces in the next two weeks.
ICU capacity, Yiu stressed, is the biggest, most immediate, concern.
The short-term solution to that is postponing or delaying surgeries, she said.
“I recognize that getting vaccinated is a charged topic right now and that there many reasons people have, to this point, chosen not to vaccinate.
“If you have concerns about being immunized and need more information, we have many experts who can help you with factual information.
“You can contact us at 811. If you don’t want to get immunized in order to protect yourself, please consider getting immunized to protect others,” Yiu said.
Daily COVID-19 numbers
Dr. Deena Hinshaw said 1,510 new COVID-19 cases had been identified in Alberta in the last 24 hours out of about 13,800 tests.
Alberta’s positivity rate sat at 11 per cent.
There were 15,977 active cases in Alberta.
Nine additional deaths related to COVID-19 were reported in the last 24 hours.
“We have seen many more deaths recently,” Hinshaw said.
“Vaccines are still making a profound difference,” she said, explaining they offer “a high level of protection against infection and an even higher protection against severe outcomes.”
In the last four months, 84 per cent of deaths in Alberta have been in people who were not fully immunized.
While there have been some breakthrough cases in those who’ve been fully immunized, “the majority of these severe outcomes are in those who are older or have multiple medical conditions.”
In the last two months, not one fully vaccinated person under the age of 60 has died from COVID-19, Hinshaw said.
“We need more Albertans to get immunized.”
Pregnancy and COVID-19 vaccines
Hinshaw also highlighted the importance of pregnant Albertans or those trying to conceive to be immunized against COVID-19.
“With a lot of misinformation about pregnancy and vaccinations circulating online, I would like to assure Albertans that mRNA COVID-19 vaccines are safe for those who are pregnant or breastfeeding. There is also no evidence that COVID-19 vaccines cause fertility problems.”
She said in August alone, six pregnant women were admitted to Alberta ICUs with COVID-19. To compare, only seven pregnant women were admitted to ICU between March 2020 and March 2021.
Hinshaw stressed COVID-19 can be very dangerous for those who are pregnant and their unborn baby. Of the six women admitted to ICU in August, five experienced pre-term births, she said.
Alberta’s chief medical officer of health said the changes to testing and tracing that were originally set to take effect on Sept. 27 have been postponed.
Masking in indoor spaces and workplaces became mandatory again province-wide on Sept. 3, as did the 10 p.m. curfew on serving alcohol.
Other measures that remain in place are:
– Masking in ride shares, taxis and public transit
– Isolation is legally required for those with COVID-19 symptoms and those who test positive
Hinshaw said contact tracers are focusing on case investigations, high-risk settings and outbreak locations. Contact tracers will notify each positive case, ask them to contact their close contacts and isolate.
She admitted the changes announced in late July were made by “looking at the evidence that was available at the time,” but were premature.
“Clearly, the move to endemic was too early.”
Hinshaw said her team saw trends indicating the move was made too early in early August.
Shandro said health officials expected to see case numbers rise when restrictions were eased, but they also expected that increase to be decoupled from a rise in hospital admissions. That hasn’t been the case, he said.
Hinshaw said further easements were pushed back to provide more time to monitor the trends and she altered her recommendations based on the evidence.
She said she doesn’t have control over public trust.
“People will have to choose, as they always have, who to put their trust in,” Hinshaw said.
“All I can do is show up every day and continue to do my best.”
She said she continues to make decisions with the best interest of Albertans’ whole health at heart.
“We are in another difficult time in the pandemic… and there’s a lot of anger and fear.”
“Kindness matters. This is no small thing. Respectful dialogue… has never mattered more.”
Reasoning behind 10 p.m. liquor curfew
On Sept. 3, in addition to bringing back masks in indoor settings and offering $100 as a vaccine incentive, the province also enacted a mandatory restriction on alcohol service, ruling it must end at 10 p.m. in all licensed establishments.
Both Hinshaw and Shandro were asked about the data that informed this restriction.
The health minister said the decision was made based on the lower vaccination rate in younger adults and the information gathered from contact tracers about where transmission was likely taking place.
“It’s first looking at the vaccination rates, demographically, in those that are younger,” Shandro said.
“But also on the ground, the experiences of our public health officials that were seeing the transmission among the young and where they’d been two weeks before their transmission, and some of the behaviour that some of the unvaccinated displayed before they were infected.”
Hinshaw added that the data shows transmission rates are higher among those who are younger, “which isn’t their fault.”
The social habits of people in the 20-49 age group often include socializing and crowded indoor gatherings where people aren’t masked or distanced, like bars and dance clubs.
She said alcohol also tends to make people disinhibited.
“We looked at the experience of other countries as well as our own,” Hinshaw explained. “These types of settings… many people together in close proximity, using alcohol and they are disinhibited.”
The 10 p.m. curfew was “one measure we can take to minimize those interactions,” she added.
What about a provincially-mandated vaccine passport?
Shandro was asked why Alberta wasn’t following other provinces and requiring vaccination in order to use certain non-essential services, like gyms and restaurants.
“It’s not an easy answer,” the health minister said.
He said Alberta is “moving forward” with its “own provincial QR code” so that Albertans can show their immunization status easily “if they choose to do so.”
Shandro also said businesses can choose to require proof of vaccination.
“The largest employer in the province has moved forward in showing that leadership,” he said, referencing AHS.
However, Shandro wouldn’t say what other potential measures, like a provincially-mandated vaccine passport, were on the table should the ICU situation worsen.
“We’ve implemented a requirement for masking.
“We are… advising those who are unvaccinated of the danger to themselves and others… advising them to limit transmission… the need to limit their contacts for indoor social settings to two families, to a maximum of 10 people.”
Shandro said the province continues to look at other ways to increase the vaccination rate, especially in the lower uptake demographics and geographic regions.
Critics call update ‘shockingly tone-deaf’
The Opposition called the UCP government’s announcement “totally inadequate” and “shockingly tone-deaf and dismissive of the crisis.”
“We are seeing more deaths, a spike in hospitalizations and the mass cancellation of surgeries for Albertans who are sick and suffering, and the government has given up,” NDP health critic David Shepherd said.
“We are no longer stopping the spread of COVID-19, we are only making more room for Albertans to suffer or even die from it and that includes some who did the right thing and got their shots.
“We are in a crisis and this is not a crisis response.
“This is continued cowardice from (Premier) Jason Kenney as he fails to address the real problem which is the unchecked spread of COVID-19 among the unvaccinated.
“The (health) minister claims today he can’t be asked to predict the future. Two months ago, he seemed pretty certain the pandemic was over and declared Alberta was open for good. The UCP removed every protection and left Alberta vulnerable to this devastating fourth wave and now we are left to wonder: How many more Albertans will suffer — and for how long — because of Jason Kenney’s refusal to lead?”
The Alberta Union of Provincial Employees called Thursday’s update “laughable.”
“Albertans expected the government to offer a serious response to the surging fourth wave,” AUPE vice-president Mike Dempsey said in a statement. “Instead, Minister Shandro announced a Band-Aid solution and Premier Kenney did not even show up.
“We are drowning in the Delta variant’s fourth wave and Kenney doesn’t even have the courage to address Albertans.
“During the update, Minister Shandro announced funding for continuing care facilities and homecare. He said some patients in hospitals will be transported to continuing care facilities to help the health-care system deal with surging COVID-19 hospitalizations, but it is not clear how this would immediately address the ICU capacity crisis or help the cancer and transplant patients whose surgeries are postponed.”
Impact of postponed surgeries
Several Albertans who have had procedures postponed due to the pressure put on the health system by COVID-19 spoke to Global News on Thursday.
“I literally cried,” said Annie-Claire LePage. “I was frustrated and I don’t know where to turn any more because my life needs to keep going and I need that surgery to keep going.”
LePage has Stage 4 endometriosis and is waiting to have a full hysterectomy.
“It’s lots of pain… every day… I miss work, I miss vacations, fun times with friends,” she said.
“Some days, I can be fine in the morning and in five minutes, I swell up to nine-months pregnant and I can’t move.”
Bibana Silva’s daughter was born with a genetic disorder called Neurofibrotosis Type 1.
“She’ll be turning 18 next month. This was going to be surgery to excise a tumour in her face and we were hoping to have it before she turned 18.”
The operation was scheduled for Wednesday.
“They called me two days ago to cancel,” Silva said. “That was very upsetting for everyone. It does take a toll on everyone in the family because we have to put a number of things on hold and organize a number of other factors… everything changes when this happened.
“I immediately thought about the people who had not gotten the vaccine because I understand how they feel about it, but… the repercussions go way more than they even realize.
“Surgeries, even if they are non-critical, they are important — they are necessary.”