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Good morning. It’s James Keller in Calgary.

As COVID-19 infections increase across Canada, the Prairies have become the epicentre of the fourth wave. Saskatchewan and Alberta have by far the highest rates for infections, hospital admissions and deaths compared with other provinces, and both are on track to surpass the severity of previous waves.

Saskatchewan and Alberta also have the lowest vaccination rates in the country – a fact that both provinces are blaming as they cancel surgeries to help their struggling health care systems cope with a flood of patients.

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In Alberta, health officials cancelled all elective surgeries and many outpatient procedures in Calgary for the week to free up resources to staff ICUs, and the province’s health authority, Alberta Health Services, warned that more cancellations were likely.

The province had 686 patients in hospital, including 169 in the ICU, as of Thursday. Those numbers have more than doubled in the past two weeks and that trajectory is expected to continue as officials scrambled to add additional beds. About 70 per cent of the province’s ICU patients have COVID-19, and most of them are unvaccinated.

The province’s Chief Medical Officer of Health, Deena Hinshaw, conceded that the province moved too quickly to treat COVID-19 like an endemic condition such as the seasonal flu. The province changed its approach based on a theory that a spike in infections wouldn’t result in a significant increase in hospital admissions – a theory that turned out to be wrong.

Premier Jason Kenney held a news conference last Friday to announce the return to mandatory masks and a curfew for liquor sales as he pleaded with people to get vaccinated. The Premier blamed unvaccinated Albertans for clogging up the province’s hospitals as he told them to stop waiting and get vaccinated already.

Still, the Premier and his government have resisted pressure to do more to reverse the surge of infections that are driving up hospital numbers. The government plans to wait to see whether the masking and curfew policies have any effect before deciding what else, if anything, to do.

In the meantime, the Alberta government continues to try to boost vaccination rates. The province launched a vaccine lottery earlier this year and recently started paying people $100 to get their first or second shots. Mr. Kenney has repeatedly rejected the idea of a mandatory vaccine passport, which has been introduced in other provinces, but says the government is working on a voluntary system to allow businesses to confirm vaccination status of customers if they choose to.

His Health Minister, Tyler Shandro, appeared to leave the door open to a more strict system at a pair of news conferences in recent days, refusing to rule out a mandatory vaccine passport and saying that his government would be looking at evidence of how such policies work in other jurisdictions.

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The situation in Saskatchewan is also deteriorating quickly, as the province delays elective surgeries and non-urgent services in face of soaring hospital admissions.

Premier Scott Moe said the temporary service reductions are necessary to create capacity for patients in need of acute care. He also said that residents who test positive for COVID-19 will be required to self-isolate for 10 days, but stopped short of making face masks mandatory in retail stores, restaurants and other public places.

Saskatchewan recorded 432 new cases on Friday. The number of people hospitalized with the virus has tripled over the past four weeks to 190, just below the peak of 203 in February.

Despite the renewed pressures on the province’s health care system, Mr. Moe said he is not imposing broader public health measures to reduce the spread of infection, including proof-of-vaccine requirements to access non-essential services.

Mr. Moe said vaccine passports, which several provinces have introduced, are a divisive measure that creates “two classes” of citizens.

This is the weekly Western Canada newsletter written by B.C. Editor Wendy Cox and Alberta Bureau Chief James Keller. If you’re reading this on the web, or it was forwarded to you from someone else, you can sign up for it and all Globe newsletters here.

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