The Current

As COVID-19 surges in Canada, 'half-hearted' measures leave ICU staff with sense of 'dread': doctor

Dr. Darren Markland, an intensive care physician in Edmonton, says the measures to fight the spike in COVID-19 cases 'are half-hearted and not effective,' despite the fact the second wave was predicted months ago.

Exceeding ICU capacity leads to difficult decisions of who gets care: Darren Markland

A nurse treats a patient inside the COVID-19 critical care unit at Vancouver General Hospital. Cases are rising across the country. (Vancouver Coastal Health)

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An Edmonton ICU doctor says the lack of a "definitive, clear plan" has left him and his colleagues with a feeling of "dread" that rising COVID-19 cases could overwhelm hospital capacity.

"We knew this was coming forever; we predicted it," said Dr. Darren Markland, an intensive care physician and nephrologist at the Royal Alexandra Hospital in Edmonton. 

"Our epidemiologists knew it was going to be an issue, and now it's here and following the predicted curves — and yet the measures are half-hearted and not effective," he told The Current's Matt Galloway.

COVID-19 case numbers in Canada have risen sharply this fall. After flattening the curve of the first wave in spring, the country averaged just over 400 new cases a day from June to the end of August. For the first two weeks of November, that number has climbed to a daily average of more than 4,000.

The second wave has been led by case numbers in Ontario and Quebec, followed by surges in Alberta and Manitoba. Provinces have introduced targeted restrictions to try to curb the spread, but with the exception of Manitoba have so far resisted widescale shutdowns similar to what much of Canada experienced in spring.

Hospitals beginning to feel the stress of rising COVID-19 cases

The National

2 months agoVideo
1:57
In parts of the country the signs of stress on the health care system are already showing. Hospitals are telling patients to wait in their cars, or turning some of them away. And the fear is that COVID-19 is getting worse as the cold and flu season is only just beginning. 1:57

Markland was among hundreds of doctors who signed a letter to the Alberta Premier Jason Kenney last week, calling for a strict lockdown to curb the spread.

Kenney has not directly responded to the letter, but it was released on the same day that he announced two weeks of targeted restrictions, which fall short of the full lockdown urged in the letter.

At a press conference Thursday, he said the two-week measure was the "last chance to avoid more restrictive measures that I and most Albertans desperately want to avoid."

Markland wants to see a shutdown of at least two weeks, but ideally six.

"I don't need half measures," he told Galloway.

Alberta doctors make 2nd appeal for 'circuit-breaker' lockdown

Canada

2 months agoVideo
5:05
Doctors in Alberta have sent a second letter to the provincial government asking it to impose a brief, strict 'circuit-breaker' lockdown to help slow the spread of COVID-19. According to Dr. Darren Markland, the respite would give those running the contact tracing system time to reorganize.   5:05

The Current requested interviews with Alberta's Health Minister Tyler Shandro and Manitoba Health Minister Cameron Friesen. Neither were available. An interview request was also sent to federal Health Minister Patty Hajdu, but did not receive a response.

Markland said he wants to see "an honest, fact-based dialogue with the health minister so that we can actually know where we're going."

Situation in Manitoba 'a nightmare': Union president

Darlene Jackson, president of the Manitoba Nurses Union, says her members are "working crazy overtime hours just to keep up" in her province, and that at least one emergency room — Bethesda Regional Health Centre in Steinbach, Man.— has been pushed to capacity.

"They are going out and triaging patients in their vehicles in the circular driveway of the hospital, just because the emergency department is so jam-packed with patients," said Jackson. 

Patients in severe condition can then be admitted, she explained, but added that sometimes means putting people on stretchers in hallways.

"It's actually a nightmare in this province right now," she said, adding that she hopes Manitoba's current lockdown will be extended.

'Emotionally, that plays a huge toll': ER nurse struggling with high volume of patients

CBC News Manitoba

2 months agoVideo
2:28
Nurses at the hospital in Steinbach, Man., are having to triage some patients in their cars because they don't have space in the emergency department, their union says. There's a "dramatically increasing number of COVID-positive patients" arriving at Bethesda Regional Health Centre, according to Manitoba Nurses Union president Darlene Jackson. The hospital is struggling with capacity, the union says, with patients arriving on their own and by ambulance. 2:28

In Alberta, Markland said his hospital has already cut down on elective surgeries, and has expanded its ICU by drawing staff and resources from elsewhere.

"As that process exceeds our capacity, then you have to make more difficult decisions about things like who actually will benefit the most from care, and that's called triage," he said.

"That's somewhere we don't want to get to, if we don't have to."

Doctors, nurses 'need to know that someone's got their back'

Dr. Ann Collins, president of the Canadian Medical Association, said the problem is that there hasn't "been a co-ordinated plan to address what we're seeing now."

The Public Health Agency of Canada has "been looking at evidence on a daily basis about where to go and how to manage this pandemic ... but I think where the breakdown has occurred is that that information has not necessarily been brought together in a collaborative way with levels of government," she said.

"And by that I mean federal, provincial, municipal — right out to the health authorities in the hospitals."

Dr. Darren Markland, an ICU doctor in Edmonton; Darlene Jackson, president of the Manitoba Nurses Union; and Dr. Ann Collins, president of the Canadian Medical Association. All three expressed concern about the pressure that the pandemic is placing on front-line workers. (Martin Weaver/CBC; Travis Golby/CBC; Canadian Medical Association)

She said her organization is calling for "all governments [to] come together to come up with the best path forward to protect the health of all Canadians."

"We need to protect the health and the ability of our front-line health-care workers to care for these patients and for other patients," she said. 

"Those people working in those emergency rooms, in those ICUs, they need to know that someone's got their back, that they have hope."

Markland said that Canada had already flattened the curve once, and could do it again.

"If we don't start doing the right thing and being civil and coming together on this, we will see deaths and loss of family members like we have never seen before, at least in the last several decades," he said.

"It needs to be done now."


Written by Padraig Moran, with files from CBC News. Produced by Ines Colabrese, Rachel Levy-McLaughlin, and Isabelle Gallant.

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