Experts fear Alberta hospitals will be unable to cope with COVID surge

Many experts across the province fear that because positive cases, deaths and hospitalization rates are "lagging indicators," the health-care system will be overwhelmed in a few weeks.

Diminished staffing and resources worry specialists as hospitalizations increase

Two health-care specialists says hospitals can cope for now, but the rates of positive cases, hospitalizations, ICU admissions and deaths are now rising continuously, and are only projected to increase. (Nathan Denette/The Canadian Press)

Many health-care specialists are increasingly concerned that Alberta hospitals will buckle under the strain of surging cases of COVID-19. 

The province broke all previous records on Monday with an active case count of 7,965, which is an increase of more than 1,000 since late last week.

Hospitalizations broke records, too. There are now 192 people being treated in Alberta hospitals, 63 in Calgary and 106 in Edmonton. Those figures include 39 in ICU beds.

Dr. Jim Kellner, an infectious disease specialist at the University of Calgary, fears that in a few weeks, the health-care system will be overwhelmed.

"All the things that you would … be looking for have all been going in the wrong direction steadily now for several weeks," Kellner said.

"I'm concerned that we are at risk in Alberta of moving toward a place where we are going to really strain our ability to take care of people who are sick."

Trailing indicators

Though Kellner said hospitals can cope at the moment, the rates of positive cases, hospitalizations, ICU admissions and deaths are now rising continuously.

More concerning still, the hospitalizations and deaths that Alberta is recording now are several weeks behind the leading indicators, and likely to balloon in the coming weeks.

This is what epidemiologists call "trailing" or "lagging" indicators of the pandemic's impact: the numbers don't rise until well after the infections were transmitted.

"The number that are in the hospital now, in ICU, and the number that are passing away daily — that's reflecting what was going on two or three weeks ago," Kellner said.

"So these much larger numbers, these record-breaking numbers that we saw last week — we haven't seen the impact of those in the hospitals and ICU and for deaths yet. That'll come in two or three weeks from now."

The upshot is that if Alberta approaches the limit its hospitals can manage, the less capable its facilities are of operating with efficiency, safety, excellence and care, Kellner said.

It would also be a gamble to believe that we can approach the limitations of our facilities without exceeding them, while dealing with lagging indicators and a virus we cannot predict or control.

"If we think we can go up to the limit ... and everything will be fine, I think that's a fallacy. You won't be able to do that. You can't fine tune your response to it that well."

Growing chorus

Kellner is not alone in his concern.

On Monday, a group of physicians from across the province called on the Alberta government to impose an immediate two-week emergency lockdown. Their open letter was addressed to Premier Jason Kenney, Health Minister Tyler Shandro and Dr. Deena Hinshaw, Alberta's chief medical officer of health. 

The group warned that the province's acute-care system could soon be overburdened if no extra restrictions are imposed.

Kenney has refused to enact any new lockdowns, arguing the measures could hurt the economy and affect people's mental health. He has continued to urge Albertans to take personal responsibility and follow guidelines.

Meanwhile, cases are so high in Alberta, the province announced last week contact tracers will no longer notify people who have been found to be in close contact to an infected person, unless they are deemed to be linked to a "high-priority setting" such a hospital, school or continuing care home.

And Matthew Douma, a clinical nurse educator in the emergency department at Edmonton's Royal Alexandra Hospital, told the CBC News that the rate of infection seems to be spiralling out of control.

He said he would add his voice to the growing chorus of scientists and health-care professionals calling for a phased lockdown, and not necessarily because of limited hospital beds or equipment.

Rather, Douma said Alberta is facing a staffing crisis with so many doctors and nurses in isolation, and it will only get worse as hospitalizations rise.

"If we were to increase the capacity of intensive care beds, or emergency department beds, we'd be extremely hard-pressed to find enough professionals to staff them," Douma said.

"We just honestly don't have enough staff to come in to pick up the shifts to provide the care that Albertans may need."

Kellner said Alberta can't wait much longer to act.

"It's pretty urgent right now, and I think that if the number of cases that we're seeing every day remains at this very high number … I think that more restrictions are necessary," he said.

With files from Jennifer Lee, Joel Dryden, CBC Edmonton and CBC Toronto


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