Alberta’s health care system struggling with overflowing hospitals

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Alberta’s health care system is being crushed by demand for its services, according to physicians across the province, with children waiting for cancer treatment, hospital wards overflowing and prenatal appointments delayed.

The crisis has spread beyond Alberta’s biggest cities. Regional hospitals, such as the one in Lethbridge, are now converting patient lounges into care spaces. The strain, comparable to the most devastating days of the pandemic, coincides with Alberta’s lowest rate of vaccination against influenza in at least 13 years.

The current situation is in some ways a legacy of the pandemic, which exhausted health care workers and led many to leave the field. That lingering strain, combined with a rise in serious cases of influenza and other respiratory illnesses, once again has the system teetering.

“Our hospitals are functioning in internal disaster mode,” Paul Parks, the president of the Alberta Medical Association, said in an interview. “We always try to do whatever we can to MacGyver it, just try to get some care to some people and find an extra bed in another space. We’ve just been doing that for so long, and there’s not much give left.”

Alberta Health Services, which administers most health care in the province and is now being dismantled into smaller units by the governing United Conservative Party, added 17 intensive care beds over the past week, and is moving patients to other facilities to ease the pressure. But physicians say the system, in addition to being short on beds, is experiencing a shortage of health care workers.

Alberta Health Minister Adriana LaGrange has been relatively quiet as doctors across Alberta have sounded the alarm. But she acknowledged, in a social media post on Tuesday, that the challenging respiratory virus season is placing pressure on emergency departments. She emphasized that no patient has been turned away.

Physicians, however, say patients are dying or getting sicker because of long wait times.

Alika Lafontaine, a physician in Grande Prairie who until earlier this year was president of the Canadian Medical Association, said Alberta’s situation mirrors that in other health care systems across the country. Asked whether hospitals are in worse shape than they were at the height of COVID-19, Dr. Lafontaine said the system is less resilient after going through repeated cycles of stress without fixes for underlying problems.

“The people in the system are suffering more. Folks who can’t get access are suffering more,” he said. “People trying to keep the system working, in administration and leadership, they are all suffering more.”

Ms. LaGrange, in a statement on Thursday, said she has been in “constant contact” with Alberta Health Services leadership and Dr. Parks. She said crowded emergency departments are a symptom of limited access to family doctors and nurse practitioners.

The government recently announced that nurse practitioners will be able to set up their own publicly funded clinics – a decision that drew outrage from some physicians, who said it devalued their work. Ms. LaGrange also pointed to the UCP’s plans to break Alberta Health Services into four separate agencies, which she said will ensure Albertans have “the access they need when and where they need it.”

She did not detail any immediate plans to improve acute care.

Dr. Parks said some people are abandoning hospital waiting areas after waits as long as 10, 15 or even 20 hours, or are skipping emergency departments altogether. He described patients who came in with chest pain, left without seeing doctors and later died. Others have come back with serious heart damage.

Hospital overcrowding is the worst he has seen in more than 20 years, he said.

The emergency department at the University of Alberta hospital in Edmonton recently had 76 patients admitted, despite only being funded for up to 65 beds, Dr. Parks said. Patients had to be double bunked, which caused what he described as “pure gridlock.” Health care facilities in the Edmonton area have been operating under a disaster plan for about six weeks.

The acute care occupancy rate in Alberta’s health care facilities exceeds full capacity, according to provincial data obtained by The Globe and Mail.

Care is being deferred for “a lot of really sick patients,” such as those with metastatic cancers, or those who have suffered strokes, Dr. Parks added.

Kerry Williamson, an Alberta Health Services spokesperson, confirmed that a small number of children with cancer in Edmonton had to wait to start chemotherapy, but are now receiving treatment. He noted the measures the service has taken to ease crowding: the new intensive-care beds and the moving of patients to alternative facilities, some in rural areas.

“These measures are required in order for us to continue to maintain capacity at our hospitals and deliver timely care to those who need it most,” he said.

Finola Hackett, a physician who works in Lethbridge and neighbouring communities, said the crisis is spilling into rural regions. She said she had never witnessed so-called “hallway medicine” in her part of the province until this latest crunch. Now patients are being treated in converted lounges and television rooms.

Lethbridge’s Chinook Regional Hospital operated under its overcapacity protocol almost every day last month, she said. Dr. Hackett also cares for low-risk pregnant patients, and said her group has not been able to keep up with prenatal appointments. The overall situation, she said, feels worse than it did during the height of the pandemic.

Roughly 21 per cent of Albertans have received the flu vaccine so far this fiscal year, a period during which the province’s immunization campaign has been more limited than in previous flu seasons. Alberta has averaged 31-per-cent uptake over the past six years, with a high of 37 per cent in 2020-21.

Premier Danielle Smith, who voiced skepticism about the COVID-19 vaccine and has championed “alternative science,” has deflected questions relating to immunization, and so has Ms. LaGrange. Both were non-committal when asked by reporters in September if they would get the COVID-19 booster, saying they were healthy and that it was a personal and private decision.

There have been no recent public appearances by health officials, such as Chief Medical Officer of Health Mark Joffe, on the importance of getting vaccinated to protect against respiratory illnesses. Dr. Joffe’s last public appearance was in September, during an outbreak of pediatric E. coli.

The Alberta government, at that time, was also facing scrutiny for being absent from that crisis for too long.