As Alberta hospitals struggle to keep up with rising COVID-19 case numbers, the province’s chief medical officer of health has suggested the surge is because most health restrictions were removed as part of the government’s “Open for Summer” plan.
The plan saw Alberta lift nearly all COVID-19 restrictions, including ending asymptomatic testing and masking in most settings, no longer requiring mandatory isolation for close contacts of positive cases, and the end of contacts being notified of exposure.
“I don’t believe that that contact tracing change had a huge impact on our trajectory,” Dr. Deena Hinshaw said while speaking candidly with the Calgary Primary Health Care Network on Monday night.
“I think that trajectory was set when we removed all the public health restrictions at the beginning of July.”
Hinshaw said looking at the experiences of all of the different provinces across the country, “those that have kept in some base level restrictions to manage the interactions and close contacts are the ones that are not seeing the significant impacts.
“And those of us that removed them are the ones that saw the significant, very steep rise in some of these acute care impacts.”
On July 28, Alberta announced a number of changes to the province’s COVID-19 approach, which would have seen widespread COVID-19 testing come to an end on Aug. 16.
However, on Aug. 13, the province announced it would push that deadline back to at least Sept. 27.
When 630 CHED reached out to Health Minister Tyler Shandro for comment on Hinshaw’s explanation of the rise in cases while speaking to Calgary Primary Health Care Network, a spokesperson for Shandro’s office noted Hinshaw offered the same explanation during a news conference last week.
The Monday night meeting came on the same day COVID-19 intensive care admissions reached an all-time high in Alberta.
Numbers released by the province early Tuesday showed 198 Albertans with COVID-19 were receiving intensive care — surpassing the previous record of 182 admissions in May.
Alberta Health Services said that as of 11 a.m. Tuesday, 124 additional ICU spaces had been added as part of surge capacity across the province. In the last seven days, 42 additional ICU surge beds have been added, AHS said. In total, there are 297 ICU beds in Alberta.
The health-care provider said there are currently 269 total patients in ICU in Alberta. Alberta’s baseline ICU capacity is 173 beds.
“Provincially, ICU capacity (including additional surge beds) is currently at 90 per cent,” AHS spokesperson James Wood said.
“Without the additional surge spaces, provincial ICU capacity would be 155 per cent.”
The number of patients in ICU has increased by 22 per cent in the past seven days, he added.
The high number of patients needing intensive care has prompted AHS to convert some surgical recovery beds into COVID spaces and redeploy staff — as a result, many operations have been cancelled.
In the Edmonton zone, up to 70 per cent of surgeries set to take place this week are being rescheduled, including elective surgeries and outpatient procedures, and only priority cancer, urgent and emergent surgeries are going ahead, AHS said on Monday.
The move in the Edmonton area came after AHS last week postponed scheduled elective surgeries and outpatient procedures at Calgary hospitals.
“Alberta is in a significant crisis state right now, there’s no dancing around that,” Hinshaw said Monday.
She added that, at the same time, the Delta variant caught many health-care experts unaware.
As of Tuesday, AHS said it has not had to implement the critical care triage protocol nor has it had to transfer any patients out of Alberta.
For weeks, physicians across Alberta have been calling on the Alberta government to introduce a vaccine passport system like other provinces have, which requires citizens to show proof of their immunizations — typically via an app — in order to access public places and events like restaurants, gyms and concerts.
The Alberta government has refused to do so.
On Monday, 65 infectious diseases physicians released a public letter calling for immediate access restrictions at indoor non-essential businesses and services.
The group pointed out that more than 90 per cent of COVID-19 patients in Alberta ICUs are not vaccinated or only partially so. The doctors said at the current rate, the number of COVID-19 patients admitted to ICU will double every two weeks.
The doctors warned the health-care system is “on the precipice of collapse,” and stronger public health measures are once again needed.
The open letter was sent to Premier Jason Kenney, Shandro and Hinshaw.
“Thank you for still talking to me — I know there’s a lot of frustration, a lot of anger, a lot of exhaustion out there,” she said in acknowledgement when joining Monday’s livestream.
“Certainly, clinical colleagues I hear from (are) like, ‘What were you thinking?!?'” Hinshaw said with animation. “‘Why did you say we can go to endemic in July?'”
Last week, Hinshaw admitted the province moved too quickly to switch from treating COVID-19 as an urgent pandemic issue to an endemic disease — that is, one that will never be eradicated from society and needs to be dealt with on an ongoing basis, similar HIV, hepatitis C and other sexually transmitted infections such as endemic syphilis, gonorrhea and chlamydia.
“It was a very abrupt transition. I know it landed very, very heavily for many people.
“It felt like a 180 degree switch, which doesn’t help people understand that endemic doesn’t mean we’ve dusted off our hands and we’re ignoring this,” Hinshaw said.
She said the changes announced in late July were made by “looking at the evidence that was available at the time,” but were premature, adding her team saw evidence indicating the move was made too early in early August.
“But of course, the expectations did not match reality, and very shortly after we started that endemic path, we could see already from that comparison with actuals in the modelling data within a couple of weeks, that we weren’t seeing the decoupling (of case rates versus hospitalization numbers) we expected and really had to shift and walk back about, ‘OK, we’re not ready yet, need to take more time.’
“And as everyone knows, we’ve needed to put additional measures in place.”
Hinshaw said Monday she feels responsible for a “narrative that has made it more complicated to try to put additional public health measures in place.”
“Because whether or not it was my intention, what was heard at the end of July was: ‘COVID’s over, we can walk away and ignore it.’ And that has had repercussions and I deeply regret how that has played out.”
Alberta Opposition NDP Leader Rachel Notley said it was disturbing to hear the chief medical officer of health confirm the cause of the fourth wave of COVID-19 in the province.
Notley said that is particularly the case given that Hinshaw and Premier Jason Kenney have yet to deliver a plan to rescue Alberta from a surge of COVID-19 cases now pushing the hospital system to the brink of collapse.
Notley said the first thing Kenney should do is mandate a vaccine passport.
The passports are being used in many other provinces and limit attendance to restaurants, bars, and other places to those who have been vaccinated.
…to have the kind of impact that is needed and we cannot afford to wait. Increasing vaccination rates is critical, but won’t prevent the course of this current wave fast enough. All options need to be on the table, including vaccine passports. 2/2
— Alberta Medical Association (AMA) (@Albertadoctors) September 14, 2021
The two-hour-long meeting of doctors on Monday night was livestreamed on YouTube, but has since been made private.
Hinshaw spoke for about 35 minutes, giving a presentation on COVID-19 in Alberta.
On Tuesday, Alberta Health said 1,434 COVID-19 new cases were confirmed in the last 24 hours out of about 11,900 tests.
Alberta’s positivity rate sat at about 12.2 per cent.
As of Tuesday afternoon, there were 822 Albertans in hospital with COVID-19, 212 of whom were in ICU. That’s up from 803 and 198 on Monday.
“Of the 212 in ICU, 91 per cent are unvaccinated or partially vaccinated,” Hinshaw tweeted on Tuesday.
Nine additional deaths were reported in the last 24 hours, bringing the provincial total to 2,471.
As of Tuesday, there were 18,265 active COVID-19 cases in Alberta.
— With files from Emily Mertz, Global News, Kirby Bourne, 630 CHED, and Alanna Smith, The Canadian Press
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