Alberta’s chief medical officer of health acknowledged Thursday that changes to PCR testing eligibility and the amount of COVID-19 data being tracked is likely stressful for many.
“This is a challenging time for all of us,” Dr. Deena Hinshaw said.
The touchstones of testing and daily data gave many Albertans a sense of control, she said.
“This new variant has required us to adapt and change quickly,” Alberta’s top doctor explained.
But due to the nature of the Omicron variant and its high rate of transmission, the province has had to limit who can access PCR testing to those in high-risk settings.
Since fewer people with symptoms can confirm their results through a lab test, Alberta Health is unable to keep track of all COVID-19 cases.
Many Albertans with symptoms also confirmed their test through a rapid antigen test, if they were able to obtain one. Those cases are also not tracked by Alberta Health.
Earlier this week, the federal government said the January shipment of rapid tests was delayed.
Alberta is expecting 16.25-million test kits in January but the premier said no date has been provided. Jason Kenney said two-million kits arrived this week – one million last night.
About 3.7 million are expected this week and millions more next week. Alberta schools have received about 58 per cent of their allotted rapid tests, Kenney said.
However, Hinshaw said there are still points of data that remain unchanged that will track COVID-19 trends, like hospitalization, ICU and positivity rates, as well as wastewater data.
“We still have a lot of information,” she said, “and power to protect our communities.
“It can still show us trends and transmission from this point forward.”
Hinshaw acknowledged the delay in rapid test shipments is “disappointing,” especially for those who don’t have any rapid tests left and who are no longer eligible for PCR testing.
She said Albertans can still do their part by being immunized against COVID-19, staying home when they feel unwell, wearing a well-fitting mask in public, reducing in-person interactions, washing or sanitizing hands, avoiding crowded indoor spaces and maintaining two metres of physical distance from anyone outside their household.
“If your child has any of the core symptoms of COVID-19… you should assume they have COVID and are legally required to isolate,” Hinshaw said. Albertans who are vaccinated must isolate for five days and until symptoms are gone and unvaccinated Albertans must isolate for 10 days and until symptoms resolve.
Hinshaw noted that anyone who is pregnant and has COVID-19 symptoms is eligible for PCR testing.
Daily COVID-19 numbers
Kenney said as of Thursday, there were 62,733 active, PCR-confirmed cases of COVID-19 in Alberta.
Kenney said this is the highest number of active cases Alberta has had at any time during the pandemic.
“Omicron is spreading much faster than any previous strain of COVID-19,” he said. “Our case rates are climbing.”
Since Alberta has reduced eligibility for PCR testing, the number of active and daily COVID-19 cases only captures a portion of actual cases in the community.
The premier thanked lab workers for their efforts, adding that on many days, labs are “doing between 16,000 and 20,000 tests per day. There’s a limit to how many they can do in a day.”
Hinshaw said Thursday that Alberta Health confirmed 6,010 new cases through PCR testing over the last 24 hours out of 14,350 tests.
Alberta’s positivity rate was 40.9 per cent.
As of Thursday, there were 786 people in hospital with COVID-19, 79 of whom were in ICU. Eight new deaths were reported.
Omicron and hospitalization rates
Kenney pointed out that “as Omicron seems to cause less severe illness in the vast majority of vaccinated individuals,” the pressure on ICUs is expected to be less, but the pressure on non-ICU hospitalizations could still be great.
People tend to have a shorter stay in hospital and less severe symptoms with this variant, he said.
Still, “the situation that we’re in today is serious,” the premier said.
Even if only a small percentage of Albertans with COVID-19 end up in hospital, there are so many Omicron cases in the community, even that small percentage could strain hospitals.
“Each of us has a part to play in our response,” Kenney added.
“Over 70 per cent of the COVID patients in our intensive care wards right now are unvaccinated, and they come from the 10 per cent of the population that have not yet received a dose of vaccine.
“Once again, that’s powerful proof of the protective effect of these vaccines.”
Omicron wave peak
The premier said in other regions, the Omicron wave has peaked about four weeks after their waves started.
“When you look at South Africa, United Kingdom, some of the U.S. jurisdictions that were earlier than us, it does appear to be typically about a four-week pattern.
“We hit that hockey stick of vertical growth of Omicron cases between Dec. 16 and Dec. 19, in that period. As I said, nearly four weeks ago.
“I am hopeful that we’re in the latter half, the latter part of that spike up. But as Dr. Hinshaw said, the numbers are just enormous, they’re much larger than our testing can identify, and there will be a lot of cases if and when we come down that peak.”
However, Kenney said every region is different and it’s still not known what exactly will happen in Alberta.
“Every population has different characteristics. I would just say that the fact that we’re now 90 per cent first dose coverage is encouraging and I want to say thank you to those Albertans who have stepped up and gotten that protection.”
Hinshaw said it’s a little too early to determine what Alberta’s overall Omicron trend is going to be and where we are in the wave.
“Our positivity rates are still extremely high and transmission is still high so caution is appropriate.”
Health-care staffing crunch
According to data from Alberta Health, hospitalizations in the province have increased by 59.1 per cent between Jan. 4 and 11.
In a statement Wednesday, a spokesperson said Alberta Health Services is “extremely concerned by the recent surge in COVID-19 cases, both in the community and in our hospitals.
“We are starting to see some impact to health-care services due to staffing challenges, particularly at some acute care services at rural sites due to staff illness or isolation,” AHS spokesperson Kerry Williamson said.
As of Jan. 11, there were 5,862 Alberta health-care workers sick with COVID-19.
Dr. Eddy Lang, department head for emergency medicine in the Calgary Zone, said the main pressure point in this wave is staffing and isolation space.
“The infection is so rampant and so infectious and so widely prevalent that people coming into the hospital with other conditions like appendicitis and a broken hip often tell us: ‘oh, by the way, my throat is a bit scratchy.’ Then we do a swab and sure enough, they’re positive, and that puts a lot of strain on our system because they now need a special room and can’t go to an ordinary hospital room because they’ve tested positive for COVID.”
The space issue is compounded by what’s referred to as “access block,” Lang explained.
“It’s when the emergency department is overloaded with hospitalized patients who don’t have a bed upstairs… We, the emergency physicians, often don’t have a patient to see because the waiting room is full but we have no place to bring them inside.
“And this is, of course, exacerbated by unfortunately having many of our nursing colleagues either off because of COVID infections or off because they’re isolating. And that further limits our ability to see patients.”
Still, Lang doesn’t believe the fifth wave will collapse Alberta’s health-care system.
“The U.K. is now clearly on the downside of the fifth wave. Many U.S. states are on the downside in terms of hospitalizations and cases. Wastewater reports in many American cities are showing that things are falling.
“So, as critically rapid as the Omicron wave started, it looks like it’s hopefully going to be very short lived.”
He also noted that, if needed, Alberta could still create capacity by postponing surgeries again or implementing stricter lockdown measures.
“I’m not worried that we will be overwhelmed and calling in field hospitals and Red Cross.”
COVID-positive patients are also exhibiting different symptoms in this wave, Lang said.
“Fortunately, the terrible air hunger that we saw in the fourth wave and in previous waves of patients whose lungs are totally destroyed by COVID is a relatively rare occurrence.
“People do still have to come into the hospital for a few days of oxygen, but usually they’re staying for a shorter period of time than before.
“For the most part, the patients we are seeing with COVID, thankfully, are having upper respiratory issues, not lower respiratory issues or pneumonia.
“Yes, they’re unwell, they’re coughing, they have scratchy throats, they’re not sleeping well, they have fever. But especially if they’re double and triple vaxxed, their symptoms are lasting, at most, a day or two. The patients who, not surprisingly, are getting into much more serious trouble are those who are unvaccinated.”
Lang said only about 10 to 15 per cent of patients being hospitalized are being admitted for COVID-19.
“Most of the people coming into the hospital have the usual things that bring people into hospital: strokes, heart attacks, skin infections, hip fractures, trauma. Life still goes on.”
AHS says it has been planning for a rise in staff illness due to the Omicron variant.
“Plans include shifting staff members to areas of highest priority, using alternate models of care, and prioritizing HCWs for testing to maximize available workforce,” Williamson said.
“If required, reduction in services and surgeries will be contemplated in order to redeploy staff to areas of highest need.”
AHS said its staff sick rate for December 2021 was “in line” with previous months. However, “we know we will see increased sick rates in the days ahead as Omicron spread continues,” Williamson said.
AHS is currently gathering sick rate data for December 2021 and January to date.
In December 2019, 5.3 per cent of AHS employees were off sick. In December 2020, that number was 5.6 per cent. In November 2021, it was 5.4 per cent.
According to its website, AHS has 108,600 direct employees, 12,500 employees of subsidiaries, 12,000 volunteers, 11,000 doctors, and 9,000 AHS medical staff.
Continuing care site outbreaks
Alberta is experiencing a spike of outbreaks at continuing care facilities. This wave, it’s the staff who are getting sick — putting a strain on resident care.
Alberta Health publicly reports locations of outbreaks where there are two or more people with confirmed COVID-19.
As of Thursday, there were 184 long-term care or supportive-living facilities listed under outbreak status. Alberta Health Services confirmed to Global News that many of the outbreaks are limited to staff cases.
St. Michael’s Long Term Care Centre is one of the facilities currently under outbreak status.
“I can’t give you numbers, but it’s higher with staff than it is with residents,” said Sharon MacLean with St. Michael’s Health Group. “We are grateful for the tremendous resiliency of our staff… It has affected our workforce, but we strive to do our best to care for the residents.”
She said there are a number of staff members out sick due to the Omicron variant. MacLean said that shortage hasn’t impacted residents at the facility because other staff members have picked up overtime shifts or moved to other departments.
Many care facilities added or maintained protocol beyond the provincial recommendations.
“We continue to exceed Alberta Health and Alberta Health Services protocols with staff rapid screening,” read a statement from Shepherd Care Foundation. “In consultation with our families and overall risk tolerance, we have made the decision to restrict in-person visitation to the designated support persons only.”
Jason Maloney, a spokesperson for Alberta Health, told Global News that while the Omicron variant has seen cases surge in continuing care as it has in the wider community, “deaths in continuing care have fallen dramatically, showing the remarkable effect of vaccines in reducing the severity of cases.”
“As of Jan. 12, there have been just three deaths associated with continuing care COVID(-19) outbreaks in the current wave, compared with 153 deaths in the fourth wave (Delta) and 1,042 deaths in the December-January wave (second wave) prior to widespread vaccination,” he said.
“As we have seen in previous waves of COVID-19, the rise in outbreaks in continuing care facilities is result of the increase in community transmission and the increase in contagiousness of the Omicron variant.”
Maloney said health authorities continue to work with continuing care facilities to protect both residents and staff, “while also ensuring residents can enjoy quality of life through opportunities for social interaction.”
“We are not currently exploring visitation changes, but are closely monitoring the situation and will make additional recommendations if needed to protect residents and staff.”
–With a file from Phil Heidenreich, Global News