The ongoing surge in respiratory viruses has prompted emergency provisions to be activated at the Stollery Children’s Hospital.
The Stollery’s medical director, Dr. Carina Majaesic, said this respiratory season is not like years past: patients are older, sicker, and they started coming to hospital months earlier. That pace has not slowed in months.
“This surge is much bigger than normal. It started out with bigger numbers,” Majaesic said in a news conference Tuesday afternoon.
“Now, the numbers are sort of coming down a little bit in terms of the emergency room presentations — but the patients are sicker than they would have been in previous years.”
Influenza was the main virus bringing kids into the hospital earlier this fall but Majaesic said that has peaked and is steady — now, respiratory syncytial virus (RSV) is on the rise.
Normally, hospitals wouldn’t see a surge until mid-winter. Majaesic said the Stollery doesn’t know what to expect this year but is planning for the worst.
“We’re bracing for January and February, but hopefully we will be wrong because the viral infections have been unprecedented so far — so maybe it will be unusual this year and and go away. But we’re bracing for it anyway.”
The current viral surge is affecting children who are older than what health-care providers would typically expect.
RSV causes bronchiolitis, an inflammation of the small airways in the lungs. Majaesic said it normally presents in kids under the age of one but now, the kids hospital is seeing patients who are two, three, even four years old with bronchiolitis-like symptoms.
“Some of them are very sick, requiring intensive care unit treatment.”
The Stollery pediatric ICU is at about 100 per cent capacity, AHS said.
The Edmonton hospital is experiencing sustained high volumes of acutely ill patients requiring care in the emergency department, pediatric intensive care and inpatient units.
The Stollery normally operates 236 beds and is the largest children’s hospital (by bed count) west of Toronto.
Alberta Health Services said some physicians are working extra shifts and if the situation becomes dire enough, vacations for a range of staff could be cancelled.
Read more: Respiratory illnesses put Stollery Children’s Hospital at capacity, doctors concerned about peak
Starting Tuesday, the health provider said staff with previous E.R., critical care, inpatient care experience or appropriate skills are being deployed to areas of greatest need and where their skills can be best utilized, to help boost additional surge capacity at the Stollery.
This could mean more staff in the emergency department, PICU, inpatient units or to support new capacity including additional inpatient medicine surge beds.
The surge of patients has led to the hospital triggering emergency provisions.
It’s not a state of emergency per se — AHS said they don’t have those for individual sites — but rather, Majaesic said activating the emergency provision allows the hospital to move more staff around, gives physicians different accountabilities with the college and alters the hospital’s insurance policies so staff can work on wards they otherwise might not find themselves.
“It allows us to to basically respond in a better and more efficient way than we otherwise would during normal times.”
Majaesic said they’ve already expanded emergency room and inpatient capacity by bringing in more physicians and staff, but that is a finite resource.
AHS said other potential staffing measures could include mandatory overtime, short-notice schedule changes, and in some cases, cancellation of staff vacations, if shifts cannot be filled.
Majaesic said it hasn’t come to that, and hopefully will not, as her staff are tired. She said while pediatric staff were not as directly affected during the COVID-19 surges, many stepped up to help in adult units during the pandemic.
“They worked very hard over the last two-and-a-half years — and now we’re having an onslaught of patients in pediatrics.
“There is a sense of burnout.”
On Tuesday, the United Nurses of Alberta called for an indoor mask mandate in a letter to Premier Danielle Smith, Health Minister Jason Copping and Dr. Mark Joffe, the new chief medical officer of health.
“For the sake of Alberta’s children, and all Albertans, it is imperative that our government cease treating this situation as if it were a political inconvenience and address it immediately as the public health crisis that it is,” wrote union president Heather Smith.
The UNA said the simplest and most effective policy change that could be implemented immediately would be an indoor mask mandate to reduce the spread of influenza, COVID-19 and respiratory syncytial virus (RSV).
The union said even a statement acknowledging the benefits of wearing masks could help. Smith called on Joffe to say something.
“Another measure that could help would be for the Chief Medical Officer of Health to make a public appearance and a statement on the gravity of the situation facing the province’s health care facilities, especially pediatric care facilities right now.
“I implore you to do the responsible thing and act. Now is not the time to put politics ahead of our children’s and seniors’ health.”
AHS said it has the ability to add additional ICU beds at the Stollery if required.
Read more: Stollery Children’s Hospital ER seeing ‘unprecedented’ wait times, surge in patients: Edmonton doctor
To help create inpatient capacity, AHS said a Stollery unit that had temporarily been utilized for adults recently returned to pediatric care. Eight beds have been opened so far, and AHS said that will increase to 13 in the coming weeks.
The majority of the Stollery’s services and beds are located inside the University of Alberta Hospital and the Walter C. Mackenzie Health Sciences Centre. Majaesic said the hospital has worked with its adult counterparts to move older patients whose illnesses can be treated by non-pediatric physicians in other facilities.
To help meet the demand, some existing Stollery physicians are taking on extra shifts.
“We are grateful for the staff and physicians who have been working incredibly hard and stepped up to fill shifts and work extra hours to deliver care during the pandemic and over the past several weeks and months,” a statement said.
While respiratory viruses are surging in the community, AHS is strongly encouraging families to seek care from their family doctor or a walk-in clinic for influenza-like illnesses unless the sickness is urgent or severe — think breathing problems or an inability to keep fluids down.
“If or when you bring your child to Stollery, remember that the physicians and the other staff are tired and they’re doing their best,” Majaesic said, asking for patience and kindness as burnt-out staff struggle to keep up with the surge.
“They’re really working hard to keep everybody well.”
Read more: Rise in respiratory illnesses trigger long wait times at Alberta Children’s Hospital, Stollery
All Alberta hospitals — not just children’s hospitals — have for months been experiencing significant capacity pressures, putting strain on the entire health system.
On Nov. 25, both the Alberta Children’s Hospital in Calgary and Edmonton’s Stollery were at or above 100 per cent inpatient capacity.
Other urban hospitals — in Edmonton, Calgary, Red Deer, Grande Prairie, Fort McMurray and Lethbridge — have been at or above 100 per cent capacity since the summer, AHS said last month.
On Tuesday, NDP health critic David Shepherd said the UCP government should never have let it get this bad but instead, has chased health-care workers out of the province.
“It’s complex and certainly there’s a number of choices that this government has made that has led us to this place,” Shepherd said.
“We had Premier (Danielle) Smith elected on a platform, unfortunately, of appealing to some folks who have fallen prey to conspiracy theory and misinformation and anti-science and as a result, we have a refusal by the government to really take any significant action. They’ve instead undermined public health,” he added.
Alberta Health spokesperson Steve Buick said the ministry is supporting AHS in hiring new staff as fast as possible, and taking any other steps needed to make sure kids get the care they need, with the least disruption possible.
“The pressure on our children’s hospitals has nothing to do with budget or government policy. We’re spending a record health budget, we have record numbers of nurses and other staff working in our hospitals, and AHS is adding more as fast as they can, with our full support,” Buick said in a statement.
The viral season began a week or two earlier in the Calgary area than in Edmonton, Majaesic said: “So we kind of gauge where we are heading by where they’re going as well.”
Majaesic said teams at the Stollery and the Alberta Children’s Hospital work closely together and have meetings twice a week.
“We speak to them very often and they’re still quite under a surge as well.
“They don’t see any particular slowdown, is what I’m hearing from them.”