Dr. Paul Parks doesn’t want to put families through this.
With Alberta talking to other provinces to potentially help care for some of its COVID-19 patients, Parks is preparing for the moment he might have to choose who gets sent out of province for medical care.
“Think about how devastating that is for the family and the patient too,” the emergency medicine physician in Medicine Hat told Global News.
“Because whoever it is that ends up getting shipped to Ontario — and we do that if we absolutely needed to save their lives — they’ll be in a far-off province with no support, no family, no nothing. That’s a very drastic move to have to take.”
On Thursday, Alberta activated its highest level of surge response, notifying pandemic units in Edmonton and Calgary to be ready if needed to help, moving patients to homes or continuing care, postponing surgeries, asking retired workers to return and training other staff for intensive care unit (ICU) work.
Alberta is also talking to other provinces about assistance. Ontario has “graciously offered help,” said Dr. Verna Yiu, president and CEO of Alberta Health Services on Thursday. Manitoba and B.C. have also been contacted, she added.
Those conversations are happening while Alberta sees about 18 to 20 patients admitted to ICUs daily, Yiu said. The province is adding capacity where it can, even converting operating rooms, observation spaces, recovery beds and post-anesthesiology beds into ICU spaces.
As of Thursday, there were 310 ICU spaces, including the 137 additional surge spaces. Alberta’s current ICU capacity, including the added surge beds, is 86 per cent but would be 155 per cent without them.
While Alberta has been transferring patients within the province to deal with the Delta-variant-driven fourth wave, Parks hopes it doesn’t get to the point where he has to move patients out of the province.
Should he be faced with it, there’s a process he must follow.
Once a critically ill patient comes into a hospital, Parks said staff will stabilize them and then check to see if there are any ICU beds free in Alberta.
If not, then they will have to decide if the patient is stable enough for transport, and figure out where to send them while in communication with out-of-province colleagues.
Preparing transport involves careful work, he said. Hospital staff has to make sure equipment, like IV tubes and ventilators, are secured so that they don’t move around in an ambulance or aircraft.
Parks added it’s been “devastating” for him and his colleagues to deal with this surge in this 19-month long pandemic.
“When we start talking that there may be choices to be made, that if we can’t send these patients to our colleagues in Ontario or other provinces, then we actually have to start doing decisions about what patients can we not provide that critical care, and just comfort measures. It’s really taking a mental toll on us,” he said.
“Speaking on behalf of my allied health-care workers and nurses, to see people picketing and protesting outside of hospitals while we’re dealing with this kind of stuff just makes it even worse.”
In Ontario, where COVID-19 cases have been trickling upwards throughout the summer, but not to the extremes seen in Alberta, Dr. Laura Hawryluck said moving and caring for patients from other provinces is tough for medical teams.
“We use video, we use phones, we will convey messages from families into patient’s rooms, but it’s hard and we see that pain that people have when they’re separated at times like this,” the Toronto critical care doctor told Global News.
“It’s hard seeing people go through this level of illness, trying day and night to keep them alive and failing – that takes a tremendous toll.”
Agreeing with Parks in the challenges it takes to move patients around, Hawryluck is worried about even more hospital staff burning out.
Statistics Canada reported recently that nearly one in five job vacancies in Canada in early 2021 is in health care and social assistance. Those sectors experienced the largest losses year-over-year compared to all other sectors.
“You know our teams in the ICU are committed to giving it our all – that’s important to us … and you know to see people go through this, to bear witness to this, to try your hardest to change and sometimes succeed, but a lot of times not, it’s grueling,” she said.
“The message that we want to help and it’s important for us to do so, is one that I really want to convey, but I think we also have to be realistic in terms of what our abilities are going to be.”
For Parks, he wants those yet-to-be vaccinated Albertans to roll up their sleeves and get the shot, while also reminding that hospital staff will be there to care for anyone in need of an emergency.
“I got to tell you that every single one of my colleagues who do this, and we’re there on the front lines, we’re there to help people,” he said.
“That’s why we’re doing this job.”
—With files from Emily Mertz