Savannah Lantz was 24 hours from boarding a flight south to Edmonton for brain surgery last month when the operation was abruptly cancelled.
Mx. Lantz, who lives in Yellowknife, had waited months for the procedure, which would have removed a tumour in their temporal lobe that had been causing them terrifying seizures – five since January, to be exact.
But a surge in COVID-19 cases in Alberta has thrown the province’s health care system into crisis. With critical care units at capacity, Alberta Health Services (AHS) has had to postpone thousands of scheduled surgeries that could wait longer than three days to be performed. In the past three weeks, about half of all surgeries across the province have been pushed to later dates.
The postponements have highlighted the fact that the impact of Alberta’s overwhelmed health care system reaches far beyond its boundaries. The Northwest Territories has a long-standing service agreement with the province, through which NWT residents are guaranteed the same access to health care in Alberta as Albertans. Now, they face the same disruptions.
“They said that all of the doctors and nurses were redeployed to help COVID patients because there were so many cases,” Mx. Lantz said.
“It was incredibly heartbreaking to get that call. After waiting for months for that date, and to have it cancelled just 24 hours before our flights, was so disappointing. A part of me was relieved, though, because I was so scared of getting COVID from being in the hospital after surgery.”
On Tuesday, there were 19,456 confirmed active cases of COVID-19 in Alberta and 1,094 people in hospital with the disease. The province also recorded 26 more deaths, for a total of 2,778 since the start of the pandemic. There were 307 patients in critical care, including 252 with COVID-19.
Because of added surge beds, the province’s intensive care unit capacity was at 82 per cent. Without the additional spaces, capacity would be at 177 per cent.
Neither AHS nor the Northwest Territories Health and Social Services Authority (NTHSSA) could provide data on how many surgeries involving medical travellers from the NWT to Alberta have been postponed to date.
Since the end of August, AHS has postponed a total of about 8,500 surgeries, including 805 pediatric surgeries, spokesperson Kerry Williamson said. During the same period, AHS completed 9,100 surgeries, including 3,500 emergency surgeries and 1,100 cancer surgeries.
Before the pandemic, in the year leading up to April, 2020, Northwest Territories residents were hospitalized overnight 647 times in Alberta. Over the same period, residents of the NWT made 424 day surgery visits, according to data from the Canadian Institute for Health Information. (The counts represent the number of hospital stays. Patients may have been counted more than once if they were hospitalized multiple times.)
AnneMarie Pegg, territorial medical director for the NTHSSA, said the Government of Alberta has assured the Northwest Territories that the health care agreement will continue. Alberta is still accepting NWT patients on an emergency basis, and it is expected that any contingency plans to transfer those patients elsewhere – if needed – would be the same as any that applied to Albertan patients.
“This is an excellent example, as we’ve seen throughout the pandemic, that no place is an island,” Dr. Pegg said. “What’s going on in one area really affects other areas, and it really shows the interdependency that we have nationally and, to a lesser degree, internationally.”
In Nunavut’s Kitikmeot region, which sometimes sends patients to either Yellowknife or Edmonton for emergency and specialty care, officials say they have not yet felt pressure from Alberta’s health care system, but that they expect to in coming weeks.
In preparation, the region has begun postponing some scheduled surgeries in an attempt to reduce the burden on Alberta’s hospitals.
The Shock Trauma Air Rescue Service (STARS), which provides air medical transport across Western Canada, has seen a “significant” increase in workload related to the pandemic, with 21 per cent of missions now involving COVID-19 patients, said chief medical officer JN Armstrong.
The service has also observed changes specific to Alberta, where it has added an extra helicopter and team to support the pandemic response. While STARS would typically transport patients from smaller centres in rural areas to specialized hospitals in bigger cities, Dr. Armstrong said the service is now taking patients to ICUs it wouldn’t normally fly to.
“For example, our Edmonton team might pick up a patient in Camrose and instead of going back to an Edmonton hospital, they take them to the Red Deer ICU,” he said. “We’ve also been asked by AHS about transporting patients from an ICU in Edmonton, for example, to ICUs elsewhere in the province. That wouldn’t normally be done, because the ICUs in Edmonton are high-level care.”
Verna Yiu, AHS’s chief executive officer, on Tuesday acknowledged the “deep and lasting impacts” of postponing surgeries and other procedures.
“We know that any delay is life altering and can cause unnecessary anxiety, stress and frustration,” she said. “That is why having to postpone surgeries and procedures is an extremely difficult and heart-wrenching step for us to take. However, it has been a necessary step.”
Dr. Yiu said the province is planning to gradually increase surgical activity. The extent to which it will be able to do that will depend on critical care staffing and resources, as well as ICU capacity levels.
“For the past three weeks, we have been performing any emergency surgery that has to be completed within a three-day window,” she said. “We will continue to do that, but we are also slowly expanding, when COVID demand permits us to be able to, so that we can now also perform urgent cases that have to be completed within a 28-day window.”
Meanwhile, Mx. Lantz has no choice but to wait. They have been unable to work since their first seizure, in January, and their mother is working reduced hours from home to care for them. Mx. Lantz has experienced severe adverse reactions to at least two anticonvulsant medications, and has had to tolerate anxiety and headaches that have lasted for days at a time.
Mx. Lantz has barely left the house this year, with the exception of five trips to Edmonton for MRIs and to see neurologists, they said.
A family friend created a fundraising page to support the Lantzes that has raised more than $29,000 to date.
Mx. Lantz’s mother, Tanya Lantz, is pleading with people who have not yet been vaccinated to get their shots.
“I know that there’s a huge percentage of people in the ICU that are unvaccinated,” she said, her voice wavering with emotion.
“My message to those people is: It was never about you to begin with. You’re young, you’re healthy, you thought you could fight it. It was about the elders, the babies, the people who have immune deficiencies, the people who need serious surgeries that COVID has set aside. Those are the people they are supposed to be protecting.”
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