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As a fourth wave of COVID-19 threatens to overwhelm hospitals on the Prairies, the Chief Medical Officer for the Saskatchewan Health Authority says the province would not be able to handle a serious collision such as the 2018 Humboldt Broncos bus crash if it were to happen today.

Susan Shaw said Friday that surging COVID-19 cases have stretched resources to the limit and intensive-care unit beds are full.

“I’m not trying to be dramatic,” Dr. Shaw said. “I think handling something like the Broncos collision would be challenging if it were to happen right now.”

Saskatchewan and Alberta have by far the highest infection rates in the country, which has translated to the highest per-capita rates for hospital and ICU admission. Both provinces have cancelled surgeries to free up staff and make room for new COVID-19 patients, which are expected to continue showing up in emergency rooms at least for the next couple of weeks.

Alberta cancelled all non-urgent surgeries on Thursday, and governments in both provinces announced vaccine passport systems, despite insisting for months that they would never implement such a policy. Saskatchewan and Alberta have the lowest vaccination rates in the country.

On Friday, Saskatchewan reported 50 people with COVID-19 are in ICUs across the province, which is close to the historic high of 52 reported on April 23.

The province has entered the first phase of its triage plan, in which choices are being made about which surgeries need to be cancelled to free up space.

Dr. Shaw said having to treat multiple people injured in a crash would push hospitals into unprecedented territory and would result in deciding who gets life-saving treatment. “I think about how we would deal with that when we’re already at full capacity,” she said.

In April, 2018, 16 people were killed and another 13 injured when a bus carrying the Broncos junior hockey team collided with a truck at a rural intersection near Armley, Sask.

Currently, 79 ICU beds in Saskatchewan are filled and the province is building space to have a total of 175 ICU beds for patients who need COVID-19 and non-COVID care.

The Saskatchewan Health Authority projects 125 COVID-19 patients will need a bed in the weeks ahead. It is increasing hospital capacity across the province to care for a total of 350 COVID-19 patients who are not in need of intensive care.

In Alberta, the province now has more COVID-19 patients in the ICU than at any other point in the pandemic, with 215 patients as of the end of Thursday compared with a peak of 182 in May. Officials warned on Wednesday that the province could run out of resources by next weekend unless Alberta Health Services is able to add additional beds. The agency is also seeking help from other provinces, either to send front-line staff or to take patients out of Alberta.

The chief executive officer of AHS warned during a news conference this week that it has moved to its highest level of response to a collapsing health care system. “I cannot stress enough how serious the situation is in our hospitals,” Verna Yiu said.

Dr. Yiu said AHS will activate the triage system if necessary as an “absolute, absolute last resort.” For now, it is educating staff on triage protocols.

In the meantime, the Shock Trauma Air Rescue Service, known as STARS, said it has been busy transferring COVID-19 patients across the Prairies to free up space in ICUs.

“I have needed to personally transfer somebody already in my ICU that I know I’ve been looking after to another ICU in the province [by air ambulance],” Saskatchewan’s Dr. Shaw said. “And that’s to make sure there’s capacity and safety in all units.”

Tracey Steel, clinical operations director for STARS, said between Sept. 1 and Thursday, about 16 per cent of its calls in Saskatchewan and Alberta were for COVID-19 patients, straining resources.

“Any time we are tied up with a patient, certainly a critical-care patient, we won’t be available for that next car accident that comes up,” Ms. Steel said.

She said the service has been asked by the Saskatchewan government to staff another helicopter for a period of time where its primary role will be transferring COVID-19 patients.

This week, Saskatchewan and Alberta announced proof of vaccination systems and brought in additional public-health measures to help preserve their health care systems.

However, health care officials cautioned it won’t help reduce hospitalizations for at least another four to six weeks, as the hospitalizations now are a result of cases from two weeks ago.

As a result, Saskatchewan is bracing for the worst to come.

“We have hit a critical point, and are now on the verge of the largest test our health care system has faced since this pandemic began,” said Saskatchewan Health Authority CEO Scott Livingstone.

With reports from Globe and Mail staff