Alberta ER doctors have issued an “urgent” invitation to the premier and health minister to visit an ICU in person to witness “the unfathomable horrors we face in the hospitals every day.”
In a letter sent Monday, Oct. 4, the section of emergency medicine of the Alberta Medical Association asked Jason Kenney and Jason Copping to “visit an Edmonton-area ICU as soon as possible to see it for yourselves.”
The letter is signed by Dr. Paul Parks, the head of emergency medicine for the Alberta Medical Association. Parks said in late September that major components of triage have already begun in Alberta, even though the protocol hasn’t officially been implemented.
“Maintaining distance is necessary to get through this pandemic, but when policy leaders maintain distance from the hospitals where policy is implemented, an adaptive mechanism becomes harmful,” the letter reads.
“To break the disconnect, we urgently need you to see what we are experiencing.”
There have been more than 1,000 new daily cases of COVID-19 for weeks and Alberta Health Services has had to reassign staff to handle the surge of intensive care patients. There have been mass cancellations of non-urgent surgeries as a result.
Since the end of August, approximately 8,500 surgeries have been delayed or postponed, AHS said Tuesday. This included 805 pediatric surgeries. During that same time period, AHS completed 9,100 surgeries, including 3,500 emergency surgeries and 1,100 cancer surgeries.
“From a distance, it’s easier to look at numbers on a page and persuade yourself that there is still space because you can’t see the maneuvering behind increasing those numbers,” the letter continues.
“Surge ICU beds are metastasizing into every other part of the hospital, rapidly crowding out every other function our hospital should be able to serve; we are only able to find more space because so many are dying, and urgent surgeries have been postponed indefinitely.
“Even as we create more unconventional beds, we cannot create an endless ability for our health-care workers to carry this impossible burden.
“We will be paying the price of this physical and moral suffering for years to come.
“Unfortunately, we will see the immediate consequences in the days and weeks to come, with staff simply unable to maintain the standard of care necessary to keep such gravely ill patients alive.
“Health-care workers are doing all they can with every fibre of their being, but human capacity is not an infinitely renewable resource,” the letter reads.
ICU and health system capacity
As of Tuesday afternoon, AHS said the province had 374 ICU beds, with 307 beds being used. The “vast majority” of ICU admissions are people with COVID-19, AHS said.
Provincially, the ICU capacity is at 82 per cent. Without the 201 surge ICU beds, Alberta’s ICU capacity would be at 177 per cent.
Alberta has a baseline of 173 ICU beds.
Parks told Global News Tuesday that the ultimate goal of the letter is to show politicians the impact of health measures — or lack thereof — on patient care, how difficult it’s become for front-line workers to handle surge capacity and how it’s devastated the rest of the health system.
“The thousands and thousands of cancelled surgeries that are happening because they continue to basically refuse to implement strict measures to give us a break and reduce transmissions.
“All of us are having difficulty really bridging the disconnect of how our premier can get up there and basically downplay how significant it is and continue to refuse to help us out.”
Meanwhile, Parks says, the president of the AMA, presidents of critical care and emergency medicine “have all pleaded openly for assistance and the government continues to feel like maybe it’s more important to allow people to go to hockey games or to major large gatherings rather than help out what’s happening on the front lines and help the people who are suffering in hospital.”
He says the current situation in Alberta hospitals is “disastrous.”
“It’s extremely important that they see what the real human ramifications of what their policy implementations are doing,” Parks said.
“1,600 cases, 30 new deaths, 30 new ICU patients — I don’t think that means anything to them anymore, or it’s hard for them to grasp what the real human impact of those numbers are, and they continue to do ‘let’s just wait and see.'”
Intensive care physicians, emergency ward doctors, the executive of the Alberta Medical Association and the Canadian Medical Association have called for a lockdown in the province to try to stem the tide of COVID-19 patients.
Kenney said last week he wants to see if recent health measures, including an indoor mask mandate, gathering restrictions and a form of vaccine passport, would boost vaccination rates.
The AMA emergency medicine group said Tuesday it had not received a response to its letter from the premier or health minister yet.
A spokesperson for the minister of health said Copping and Kenney appreciate Parks’ offer. The health minister asked his staff to arrange a virtual meeting with Parks to hear his concerns, Steve Buick said.
“The minister and premier are very familiar with the situation in the hospitals and deeply grateful to the physicians, nurses and other staff working in ICU and other areas,” he added.
Copping receives updates from AHS’ CEO daily “and sometimes more often,” Buick said.
“Dr. Yiu has shared with the minister in detail the pressure on the ICUs and the challenges of expanding capacity described in Dr. Parks’ letter.”
Buick said Copping and Kenney are both willing to visit a hospital “to show their appreciation,” but said, “this is not an appropriate time, given the strict limits on visitors due to the current high level of transmission of COVID-19, as well as the pressure on the hospitals, especially the ICUs.”
He said they’d work with AHS to arrange a visit when the risk is lower and when it wouldn’t be a distraction to staff.
When asked on Tuesday, the premier said he hadn’t yet seen the letter but noted Albertans have been discouraged from visiting hospitals if they don’t absolutely have to be there to receive care.
“I’m acutely aware of the extreme stress ICU nurses and physicians are facing.”
Copping said he just received the letter. He said he fully appreciates the strain the health system is under and the capacity and constraint issues.
He said he “hears” the doctors’ concerns but that going into a hospital right now “may not be appropriate” and may “interfere with important work” front-line health-care workers are doing.
“We need you to see, to hear, to understand what is happening in our hospitals right now,” the letter states.
“The distance between numbers on a page and the reality inside these walls is impossible to bridge unless you can see for yourselves what we have been trying to communicate to your government and the public.
“Alberta is at the edge of a precipice, but it is a precipice that right now only we can see. Please let us show it to you.”
Hinshaw, Yiu, Dr. David Zygun (AHS Edmonton zone medical director), Dr. Shelley Duggan (AHS Edmonton zone clinical department head) and Jonathan Koelhi (chief of staff for the ministry of health) were also sent the letter.
Limit on outdoor social gatherings
The province said outdoor private social gatherings are limited to a maximum of 20 people, with two-metre distancing required between households at all times.
“We need people to follow this – and other measures,” Copping said, “to protect yourself, your family and all Albertans… to reduce the strain on our health-care system.”
All other public health measures remain in effect.
Expanded eligibility for COVID-19 boosters
Alberta announced more people would be able to book a third COVID-19 vaccine shot – or booster – starting Wednesday morning.
“Alberta will start offering third doses of COVID-19 (vaccine) to our most vulnerable groups,” Copping said.
Albertans aged 75 and older and First Nations, Inuit and Métis people aged 65 and older can begin booking a third dose once it has been at least six months since their second dose.
The province made the announcement based on recommendations from the National Advisory Committee on Immunization and the Alberta Advisory Committee on Immunization.
Those who are severely immunocompromised, seniors who live in congregate care settings and those travelling to countries that don’t recognize mixed doses are already eligible for a third dose.
Copping said Tuesday that anyone in the general population who received a complete two-dose COVID-19 vaccine series can be confident they have strong protection against severe outcomes.
Third doses can be booked at participating pharmacies and doctors’ clinics by calling those locations, through 811, by using the online booking system or by finding a pharmacy offering walk-in vaccinations.
Daily COVID-19 numbers
Hinshaw said Tuesday that 663 new cases of COVID-19 were identified over the last 24 hours. She said about 8,000 tests had been done.
Alberta’s positivity rate sat at about 8.8 per cent, Hinshaw said.
On Tuesday afternoon, Alberta Health said the province had 19,456 active cases of the disease.
There were 1,094 Albertans in hospital with COVID-19, including 252 being treated in ICU.
Alberta recorded 26 more COVID-19 deaths in the last 24 hours.
As of Oct. 4, 84.5 per cent of Albertans 12 and older have received at least one dose of vaccine and 75.1 per cent had been fully immunized.
“Low vaccination rate is the main driver of the demands on our hospitals,” Copping stressed.
“We need to get that level higher.”
However, he said Alberta’s vaccination rate was 54 per cent higher in September than it was in August.