Alberta has cancelled all elective surgery in Calgary, including some pediatric procedures and transplants, and up to 60 per cent of non-urgent operations in other regions as a rush of unvaccinated coronavirus patients overwhelms hospitals.
The province’s intensive care units on Thursday hit 87-per-cent capacity, including temporary beds added over the past week, according to Alberta Health Services. The province’s ICUs are at 130-per-cent capacity when the makeshift spots are excluded, AHS said. Surgical patients often spend days in the ICU after their operations, and the health authority said the crush of COVID-19 patients means it no longer has the space or resources to accommodate other procedures, as well as emergencies such as heart attacks.
“Health care is a finite resource,” Verna Yiu, AHS’s chief executive, said on Thursday.
In Alberta, the number of COVID-19 patients needing ICU care will soon exceed demand in previous waves, according to internal AHS modelling obtained by The Globe and Mail. Despite cutting back surgery and outpatient procedures, the provincial government did not impose new public-health measures to stem the spread of infection. However, Alberta Minister of Health Tyler Shandro softened the province’s stand against proof-of-vaccine requirements to access non-essential services. In Ontario, the number of appointments for vaccines doubled the day the provincial government announced plans to require COVID-19 immunization certificates for access to certain businesses.
“We are continuing to look at that evidence from other jurisdictions and what our opportunities might be here in Alberta,” Mr. Shandro said. “But we have seen businesses take that first step, that leadership role.”
In July, Premier Jason Kenney said he would “discourage businesses” from implementing vaccine requirements and warned they might be illegal. He also pledged not to “facilitate” vaccine passports, but on Thursday Mr. Shandro promised to do just that, noting Alberta is working on a QR code that businesses can use to check immunization status.
Alberta’s hospitals had 679 people with COVID-19 as of Sept. 8. Of those, 154 are in ICU. The AHS system that forecasts the flow of patients in hospitals predicts 193 to 153 people with COVID-19 will be in the ICU by Sept. 16. By Sept. 23, the high estimate increases to 224, and the best-case scenario is 146. The province usually maintains about 173 ICU beds, but has added temporary spaces throughout the pandemic.
About 74 per cent of COVID-19 patients in Alberta’s hospitals are unvaccinated; about 5 per cent are partly vaccinated; and 20 per cent are fully immunized, according to AHS. The unvaccinated population in ICUs is even greater. Vaccines are available to everyone 12 and older, and few people qualify for medical exemptions.
It is unclear how long the pause on surgery and other procedures will last. Fiona Mattatall, an obstetrician-gynecologist in Calgary, said AHS told her to cancel all her operations through to next Tuesday.
“We have no idea when we will get back to doing these surgeries,” she said, noting her schedule is booked until December.
There were 18,292 scheduled operations in Alberta in September, 2019, according to government data. In addition to the delays in Calgary, AHS expects to postpone 60 per cent of operations in the north zone; about 50 per cent of scheduled surgery and procedures in Edmonton; up to 30 per cent of scheduled operations and 40 per cent of endoscopies in the central zone; and another 30 per cent of scheduled surgery, endoscopy and outpatient visits in the south.
David Keegan, a professor of family medicine at the University of Calgary, is among those arguing Alberta needs a two- or three-week lockdown to ease the pressure.
“There’s going to be people dying because they live in Alberta,” he said.
Mary Brindle, a professor of surgery and community health sciences at the University of Calgary’s medical school, said all Albertans will be affected by the consequences of the “horrifying and largely preventable” fourth wave of COVID-19.
“The full impact of these events is unlikely to be ever fully measured or fully understood,” she said.
Linda Everest, who lives near Vermilion, says she understands the consequences. Her husband, Reg Everest, went to the hospital in Vermilion on Aug. 15 after feeling ill for a few days. Doctors sent him by ambulance to hospital in Edmonton so he would have access to heart and stroke specialists.
After tests, doctors decided on Aug. 16 to perform surgery at the University of Alberta Hospital the next day, according to his wife. The next morning, doctors changed the plan, sent the 72-year-old home and scheduled another appointment for nine days later, Ms. Everest said.
Two days later, she found her husband slumped over at home. Emergency responders performed CPR for 45 minutes, but Mr. Everest died.
Ms. Everest said she never received an explanation for why the treatment plan was changed, but she suspects it was because the number of COVID-19 patients in hospitals was already on the rise.
“We got all these guys who are unvaccinated in there, that are taking up beds,” she said. “And I think Reg’s condition was equally as important as the guy with COVID.”
She conceded her husband, who was unaware of heart trouble before last month, may have died even if he had surgery immediately.
“But he wasn’t given the chance to see if it would work,” Ms. Everest said.
With a report from Karen Howlett.
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