Edmonton hospital double-bunking COVID patients as virus strains ICU

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An Edmonton hospital is double-bunking COVID-19 patients receiving intensive care as the province’s rapid increase in infections pushes ICU capacity to its limit.

Doctors raised concerns about intensive-care patients sharing rooms at the University of Alberta Hospital as the provincial health authority’s internal projections show an increasingly precarious situation for the province’s ICUs.

Kerry Williamson, spokesman for Alberta Health Services, confirmed the double bunking, in which two people are treated in an ICU room designed for one patient, but said that is something that could have happened even before the pandemic if the space was required.

“Double-bunking patients safely and appropriately allows us to increase ICU capacity, and ensure we can meet increasing demand on our ICUs,” the statement said.

Hospitals in Calgary are not currently double bunking, he said, though that is also part of the COVID-19 surge plan for the city.

The Alberta government has been attempting to bolster its acute-care and ICU capacity in the face of rapidly escalating COVID-19 infections that have pushed hospitals beyond capacity and caused intensive-care admissions to increase sharply.

Mr. Williamson said in an e-mail that Calgary exceeded its maximum ICU capacity Monday, but had space because 10 new beds had been added. Edmonton was at 95-per-cent ICU capacity.

Twenty acute-care hospitals, including the major ones in Calgary and Edmonton, are dealing with COVID-19 outbreaks of their own.

Last week, the province announced plans to set aside as many as 2,250 acute-care beds and 425 intensive-care spaces for COVID-19 patients. Hitting those targets would require cancelling surgeries, repurposing space for ICU patients and transferring acute-care patients out of hospitals and into continuing-care facilities.

The Globe and Mail reported last week that Alberta Health Services’ early-warning system, a tool that helps hospitals prepare for potential surges, predicted ICU admissions would double in two weeks under the model’s highest projections. A week later, the province is currently tracking above that worst-case scenario and updated projections released by the Opposition New Democrats on Tuesday show admissions are expected to continue to climb.

As of Nov. 22, the system forecast 90 COVID patients in the ICU as of Nov. 30, compared with 97 patients who were actually in intensive-care on Monday.

The updated figures released by the NDP forecast 161 ICU patients by Dec. 14 under the worst-case scenario. Those projections also said non-ICU hospitalizations could hit 775 by mid-December, up from 479 as of Monday.

Deena Hinshaw, Alberta’s Chief Medical Officer of Health, said the grim ICU projections show the need for recently announced restrictions on social gatherings, businesses and schools.

“The work we’ve been doing with Alberta Health Services to make sure the system is prepared should those cases continue to rise is an important part of preparation, but the question of whether we track on that high, medium or low line, that really is in the hands of all Albertans,” she said.

NDP Leader Rachel Notley said the numbers suggest the United Conservative government waited too long to act, then introduced ineffective half measures to combat the rapid spread of the novel coronavirus.

Premier Jason Kenney has defended his government’s approach as a balance between public health and the economy and on Tuesday he accused the NDP of politicizing the pandemic.

Ilan Schwartz, an infectious disease specialist at the University of Alberta Hospital, said the ICU is not full yet but he said the double bunking is a sign of things to come. He said ICU rooms are designed to have one person being treated at a time and it will be a challenge if patients require care that needs extra staff or equipment.

“The writing is on the wall – that’s what we’re facing in the next one to two weeks,” Dr. Schwartz said. “There are going to be uncomfortable decisions no matter what if we want to increase capacity.”

With a report from The Canadian Press

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