Doctors says it's 'day-to-day survival mode' as Calgary ICUs stretch surge capacity

Calgary's ICU occupancy is below 100 per cent capacity thanks to the addition of 30 beds as part of Alberta Health Service's surge planning, but it's not clear how much more wiggle room there is. 

425 additional ICU beds are being made available across the province, AHS says

Dr. Selena Au works in three of Calgary's adult intensive care units and says COVID-19 patients can stay in the ICU up to 3 weeks. (Submitted by Dr. Selena Au)

Calgary's ICU occupancy is below 100 per cent capacity thanks to the addition of 30 beds as part of Alberta Health Service's surge planning, but it's not clear how much more wiggle room there is. 

"It really is day-to-day survival mode," said Dr. Selena Au, a specialist who works in three of Alberta's ICUs.

An ICU doctor had previously told CBC the surge plans put in place to deal with soaring COVID-19 cases included 40 beds for Calgary that could be put into use in batches of 10.

The latest batch of 10 was released on Friday, bringing the total number of ICU beds in the zone to 96.

CBC News has asked AHS how many beds are still available as part of its surge plan for Calgary, and while AHS didn't specifically say how many Calgary beds are still available, it reiterated that 425 additional ICU beds are being made available across the province. 

On Wednesday, 1,270 new COVID-19 cases were reported in the province. The province has 20,169 active cases and a testing positivity rate of 7.3 per cent. There are 749 people in hospital, including 139 in intensive care.

Alberta's chief medical health officer, Dr. Deena Hinshaw, warned Wednesday that COVID-19 has now killed more people in Alberta than influenza did over the last 10 years combined, a total of 760 since March. She issued a special warning for people ages 20 to 40, warning them that more than 32,000 people in that age range have contracted the virus, more than 380 have been hospitalized and eight have died.

Without added beds, Calgary ICUs would be over capacity

According to AHS, the Calgary zone is currently sitting at 82 per cent in terms of ICU usage and has hovered between 90 and 100 per cent in recent weeks. 

"Without the addition of 30 ICU beds, the occupancy would be 120 per cent," said a spokesperson by email. 

Au said the only way to keep up with the influx of new patients has been to add additional beds, and having patients share rooms — a practice not usually done in ICUs because it can impact care. 

"I was worried several weeks ago when we were looking at daily case rates," Au said. 

Around three per cent of people who contract COVID-19 are admitted to hospital, Au said, so as numbers went up, it was clear hospitals would soon be more stressed.

"Of course, this will impact the care we provide at hospitals because we might run out of ICU beds. The next place we would place patients in the OR which means cancelled surgeries."

Each new batch of beds means workers who don't usually staff ICUs need to be brought in from retirement or other departments, Au said, and staff are working extended shifts and schedules that are more likely to lead to burnout. 

She said as the numbers escalate, there is a high likelihood health-care workers will be tasked with decisions like choosing not to intubate or provide ICU care for an ill patient, because another patient who is more likely to survive needs to be prioritized. 

Patients who enter the ICU don't usually have short stays. 

"So many of the patients are in here for two weeks at a time. Some of my current patients are several weeks in. And so we add, but we don't take away that many [patients] … it's a long journey," Au said. 

Health-care workers tend to an ICU COVID-19 patient at Peter Lougheed Centre in Calgary on Nov. 14, 2020. ICU's in the province are straining under mounting COVID-19 cases. (Leah Hennel/Alberta Health Services)

Dr. Christopher Doig, a professor and head of the department of critical care medicine at the Cumming School of Medicine at the University of Calgary who is also an intensive care doctor in the city, described ICUs as a precious resource for the number of conditions they are needed to address. 

"At times have people who are victims of car accidents, individuals who might have an asthma attack … we see individuals who have opioid overdoses, complications after pregnancy, and, of course, currently individuals who have problems with breathing related to COVID-19," he said. 

Doig said while nobody wants to be in the ICU, he can reassure patients — who are there for COVID-19 or other reasons — that health-care workers are fully prepared to support them, even with increasing numbers. 

"I sound calm, but the thing is, is that it is easy to be calm and reassured when you see the forethought, the planning and absolutely when you work with exceptional people," he said.

Doig pointed to Tanya Harvey, the first person in Calgary to be vaccinated for COVID-19 — she's one of the ICU nurses at Foothills.

"If I was sick, it's people like Tanya that I would want looking after me," he said. 

With files from Jennifer Lee, Sarah Rieger and Drew Anderson