As Alberta inches closer to having its ICU beds overwhelmed by COVID-19 patients, officials are considering everything from postponing complex surgeries to transitioning other hospital rooms to care for critically ill patients, if the need arises.
As of Friday, the province’s ICU beds that are dedicated to COVID-19 patients were 77 per cent full, a number that’s sharply risen in the last two weeks.
Alberta Health Services said Friday it has a “robust and detailed plan to provide the additional and necessary capacity needed for a surge of additional inpatients.”
“Ensuring capacity is available for COVID-19 patients could involve limiting hospital admissions and ICU admissions by postponing scheduled surgery,” AHS said in an email.
“Postponing elective procedures would allow for the potential use of operating rooms and surgical recovery rooms as additional ICU space.”
AHS also said temporarily rescheduling complex surgeries which would require an ICU stay will also be considered to maximize capacity.
“Fully-equipped clinical areas” like post-anesthetic recovery units could also be used to care for patients that would normally be admitted to an ICU, as even though they aren’t typically used for overnight stays, they equipped to care for those patients temporarily.
“In the event that surgical procedures are postponed, the associated clinical staff would be available to assist with the care of COVID patients,” AHS said. “These professionals are fully trained and capable of assisting with this care.”
AHS said that reallocation of staff, many who weren’t working in acute care, has already been done throughout the pandemic, to places like COVID-19 assessment centres and the contact tracing team. In hospitals, staff are working within their usual areas, but in some cases employees have taken assignments in other areas based on their experience and qualifications.
AHS said it’s also working closely with primary care, to ensure any patients whose conditions can be monitored at home for as long as possible can do so.
‘Walking a tightrope without a net’
While the province is currently able to care for all of its ICU patients with the existing beds, doctors continue to sound the alarm about how soon the surge plan could have to take effect.
“This is now walking a tightrope without a net,” Dr. Darren Markland, intensive care physician at the Royal Alexandra Hospital told Global News Friday.
“Our society is based on support — you know, if you get sick, there is going to be somebody to look after you. That cheque will not be cashable in the next week or two if we continue to overwhelm the system.
“We need to do something now because we’re not past December. These numbers will climb until spring, or until we have a vaccine distributed to the entire public, if they take it.”
Markland said he’s worried about his colleagues, who are experiencing significant amounts of burnout, carrying a “constant weight on everyone’s shoulders.”
The doctor said Alberta needs “political will” to put a stop to community transmission, in order to slow the concerning trend.
“The reason why it’s spreading in the community is people are living their pre-COVID lives, and no one is telling them not to,” he said.
Markland called Thursday’s new health restrictions — aimed at indoor fitness, sports and restaurants and bars — “incredibly inadequate,” adding that the opportunity for a “soft closing” passed last week, putting us “exponentially” behind the eight-ball.
“We need a two-week shut down. We need that because our contact tracing is no longer functioning. The premier is using data that is no longer viable — its two weeks old,” he said. “Without contact tracing we’re driving without our headlights on.
“What we’ve been doing is moving our goalposts about when we’re going to introduce these shut downs and as a result, the general public is not taking this as seriously as they did in the first wave.”
Markland said if and when the province goes into its surge plan, “the level of care for each individual patient will drop.”
“It’s math,” he said. “Instead of getting regular ICUs are staffed one-to-one with nursing and 10-to-one with physician contact, when you get into surge you lose that nursing ratio and you definitely lose that physician ratio.”
— With files from Global News’ Lauren Pullen
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