Widespread outbreaks of the coronavirus in Alberta’s continuing care network have forced operators to close hundreds of beds in their facilities, creating a bottleneck in the broader health care system that could soon translate to reduced access to elective surgeries and other procedures.
Continuing care facilities across the province have collectively closed more than 500 beds in their effort to contain the coronavirus, Alberta Health Services said in its most recent memo to medical staff. People who would normally fill these spots are, in turn, stuck waiting in hospital beds, which then crimps the flow of patients in acute care facilities. This pressure is compounded as hospitals in Calgary and Edmonton close beds in rooms that normally accommodate three or four patients to create makeshift isolation spaces for COVID-19 patients.
Hospitals in Calgary and the southern part of the province are planning to create “surge capacity” over the next seven to 14 days in order to cope with rising COVID-19 admissions and fewer available beds. The measures would be similar to those adopted earlier this month in Edmonton, where roughly 30 per cent of elective surgeries are being postponed to manage the load in hospitals. Acute care facilities in Alberta’s two largest cities frequently exceed capacity right now, and some units are running at 125-per-cent occupancy.
“Ultimately, we need Albertans to work hard to reduce the amount of COVID-19 transmission in our communities to ensure we have the capacity to care for those who need it most,” the memo, dated Nov. 13, said.
Kerry Williamson, a spokesman for AHS, said hospitals in Calgary and southern Alberta have yet to postpone any surgeries but are ready to do so. If necessary, frontline teams would be redeployed to areas in most need of help and operating rooms and surgical recovery rooms may be used for other purposes, he said.
Alberta’s intensive care units accommodated 57 COVID-19 patients as of Monday, up from 28 at the start of the month. In all, 268 people with COVID-19 were in hospital Monday, compared to 139 on Nov. 1. But COVID-19 admissions complicate capacity problems. Hospitals in Edmonton and Calgary have patients in about 1,200 isolation beds, even though isolation capacity tops out around 800, the AHS memo said. Hospitals created the additional 400 spaces by closing beds in multi-bed rooms. This isolation juggling, coupled with unit outbreaks, has put 250 acute care beds out of service in Edmonton and Calgary, Mr. Williamson said.
COVID-19 has killed 432 people in Alberta since the pandemic started and 296 of these individuals lived in continuing care facilities. Zoe Cooper, a spokeswoman for Alberta Health, on Tuesday said 102 continuing care facilities are experiencing active COVID-19 outbreaks. As a result of the active outbreaks, 1,254 continuing care residents contracted COVID-19 and 33 of them died. Continuing care includes home care, supportive living, long-term care, hospice, and end-of-life care.
Laura Tamblyn Watts is the chief executive of CanAge, which advocates for seniors nationally. Alberta’s situation, she said, underscores how problems in the long-term care system can threaten to topple other parts of the health care system.
“We know that the consequences are lives lost, families ruined, and a health care system that becomes broken," she said.
Earlier this year, Ontario placed restrictions on new admissions to nursing homes in order to combat COVID-19. It prohibited older facilities from placing more than two people in one room, essentially shuttering beds in rooms that previously accommodated up to four people, until December. The fallout in Ontario could foreshadow what awaits seniors elsewhere, according to Amy Friesen, the chief executive officer of Ottawa’s Tea & Toast, a service which helps seniors navigate the long-term care system and search for retirement homes.
Ontario’s bed restrictions, she said, backed up the long-term care system and forced seniors into the private retirement system. It also put vulnerable elders at risk.
“People are obviously staying home longer than they should,” she said. “It has created a lot more caregiver burnout.”
Alberta placed 8,521 people into continuing care last year, according to AHS’ 2019-2020 annual report. Of those, 5,113 were moved from hospital beds and the remaining 3,408 entered care from their home. Albertans had to wait an average of 54 days before they could get into continuing care, with those in hospital beds waiting an average of 36 days. Alberta counted 1,412 people waiting for a continuing care space at the end of the last fiscal year and 410 of those were in hospital beds.
There were 27,774 continuing care spaces in Alberta at the end of March, according to the report. Of these, 15,665 were long-term care beds, 11,853 were designated supportive living beds, and 256 were community palliative and hospice spaces.
“Continued growth in community and home care capacity is the key to efficient system flow in emergency departments, acute care and community,” the report said.
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