The number of COVID-19 patients in Alberta’s intensive care units could more than double over the next two weeks, according to the provincial health authority’s internal projections, and hospitals are training additional staff on how to use ventilators in preparation for the surge.
Premier Jason Kenney, who was in isolation over the past two weeks because of potential exposure to the coronavirus, joined a cabinet committee on Monday afternoon to review recommendations from the province’s chief medical officer on new measures to curb the spread of COVID-19. The meeting followed a week of near-daily records for new infections and hospitalizations as the government prepared to announce its decision on new restrictions on Tuesday.
The province has an infection rate among the highest in the country, but has acted more slowly than other jurisdictions to expand restrictions, arguing that widespread economic shutdowns were more harmful than the pandemic itself.
The most recent data show that as of Sunday, 328 people with COVID-19 were in hospital, 62 of them in intensive care. The province had set aside 70 ICU beds for COVID-19 patients, but has added to that. There are outbreaks at many of the province’s hospitals, some of which have been operating beyond their capacity for weeks and also have staff off sick or in isolation.
Alberta Health Services’ early warning system, a tool that helps hospitals prepare for potential surges, predicts 129 people with COVID-19 could be in intensive care by Dec. 7 under its worst-case scenario, according to data obtained by The Globe and Mail. Intensive-care admissions would hit 90 in the mid-range scenario. The model’s most optimistic prediction shows admissions roughly flat over the next two weeks, peaking at 61 — one fewer than were in the ICU on Sunday.
The province has 173 ICU beds, with patients ranging from car crash survivors to those with COVID-19, according to AHS. ICU occupancy hit 90 per cent in Calgary and 92 per cent in Edmonton on Friday, AHS spokesman Kerry Williamson said.
AHS said in a statement that the early warning system is just one of the tools it uses to predict hospitalizations. Mr. Williamson said AHS plans to make space in hospitals through measures such as discharging people as soon as possible, putting COVID-19 patients together to free up beds in other areas, and reducing the number of operations.
“AHS is able to increase the amount of hospital spaces available to patients with COVID if we reduce the number of other patients in hospital,” he said. “This situation is serious, and we would like to remind all Albertans that we need their help in reducing the transmission of COVID-19 in the community, which in turn will reduce strain on the health care system.”
Hospitals are also planning to open “fully equipped units not currently in operation” and equip other spaces, he said.
Hospitals in Edmonton and Calgary are adding 20 intensive care beds in each city, according to AHS’ weekly update to medical staff. Temporary ICU beds come at the expense of space for patients who need other specialized services, such as coronary care, postoperative recovery, and other areas able to support ventilators and cardiac monitoring, the memo said.
“More ICU and acute care beds will be added in the days and weeks to come,” the memo said. AHS is also training additional staff to use ventilators, which are needed in 60 per cent to 80 per cent of COVID-19 patients in ICU, the note said.
AHS’s early warning system also predicts a deluge of COVID-19 admissions beyond the ICU. Under the most aggressive forecast, 699 people with COVID-19 will be admitted to hospital, excluding ICU, in two weeks; 489 admissions in the mid-range forecast; and 329 in the most conservative scenario.
The province added 1,549 new cases on Monday — a per capita rate that is more than three times higher than that of Ontario — and has averaged more than 1,000 cases a day for a week. The percentage of tests that come back positive is about 8 per cent.
Deena Hinshaw, the Chief Medical Officer of Health, said she expects hospital admissions to continue climbing for the next two to three weeks, even if new measures are implemented, because many cases do not need to go to hospital immediately.
“That is something that we would expect to see independent of any measures that are introduced at this time, again because of that lag,” she said on Monday. “The health system is working very hard to create additional capacity for these patients, but as I’ve said before, unfortunately, that can come at the expense of services becoming available for other health needs.”
Dr. Hinshaw said she planned to recommend “strong measures” to the provincial government, but declined to say what. She added that her job is to make recommendations and the decision is up to the cabinet.
Mr. Kenney has rejected calls for a short lockdown that would include widespread business closings to bring infections under control. He has called lockdowns an infringement on people’s rights and appealed to Albertans’ sense of “personal responsibility” with largely voluntary guidelines. Still, he also warned he would consider stricter measures if the situation deteriorated.
Aidan Hollis, an economist at the University of Calgary and the director of Incentives for Global Health, said putting the economy above public-health measures is worse for the economy over the long term. He said strong measures now would prevent a more severe lockdown later.
“If people know that they’re not safe and if there’s a big public-health crisis in the province, that’s not going to sustain foot traffic into restaurants that governments seemed to long for,” he said.
“It’s going to be impossible to let the economy thrive while people say, ‘I really think that going out to the store is going to be risky for me today.’ ”
The Globe and Mail
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