By Alex BoydCalgary Bureau
Omar MoslehEdmonton Bureau
Wed., Sept. 22, 2021timer5 min. read
updateArticle was updated Sep. 23, 2021
Dr. Paul Parks wishes people could see through his eyes when he walks into the emergency room of the regional hospital in Medicine Hat, Alta.
In recent days, he’s seen more sick children than ever before; multiple members of the same family arriving critically ill; people in their 30s and 40s coming in feeling crummy and seeking advice, only to return, days later, desperately sick.
As Alberta endures a punishing fourth wave, fuelled by lax public health measures and the super-spreadable Delta variant, doctors and patients are warning of “nightmare” scenes as intensive care units are pushed to the brink.
Meanwhile, speculation swirls about the political survival of Premier Jason Kenney, whose COVID-19 response faces major pushback from within his own party, both from those who say he did too little — and those who say he did too much.
“I wish that I could share those stories that I’ve seen every day,” Parks says, speaking Wednesday on his way to yet another emergency room shift.
“Because then I truly believe that everybody would understand how devastating and how difficult this is. And they would, they would understand the seriousness.”
Depicted in numbers, the situation in Alberta is stark. There are currently 348 intensive-care beds across the province, and at this point, there are more surge beds, recently opened to try to deal with the crowds of sick people (175), than regular ICU beds (173).
Eighty-seven per cent of those beds are currently occupied, mostly by COVID patients, most of whom are unvaccinated. This is not only the busiest intensive care has been since the beginning of the pandemic, it’s also the busiest it’s ever been.
On Wednesday, Alberta saw its first COVID death in someone under 20.
Inside hospitals, this new wave looks like patients who are younger, sicker and waiting longer to come to hospital — Parks questions whether the provincial insistence that the pandemic was ending has lessened the urgency with which people are seeking care.
The province remains perilously close to having to implement a triage protocol, which would see doctors making life-and-death decisions over who gets intensive care treatment and who does not. If that happens, it would be the first pandemic use in Canada of a measure that terrifies health-care workers.
Referring to intensive-care beds can be slightly misleading, in that it’s not the beds themselves that are in short supply, but the specially trained staff who care for the people in them. To squeeze more people into intensive care, staff are being asked to do more with less.
Normally, an ICU nurse would give all their attention to one patient. Now, one or two ICU nurses are being asked to care for as many as four patients, with the help of nurses with different specialties who are pulled from other departments.
The demand for critical-care beds is creating a bottleneck, meaning people in the regular hospital beds are sicker, on average, as intensive care is being reserved for the sickest of the sick, Parks says.
“They’re being managed on the floors when, in normal resource times, for sure, they’d have been transferred to the ICU,” he says.
“Now, they essentially get to the point where they have to have an emergent rescue intubation and ventilation and that’s the only way they’re getting transferred to our ICU.”
Intensive-care units are usually relatively calm, but in recent weeks they’ve devolved into “chaos,” says Holly Champney, a respiratory therapist at the Red Deer Regional Hospital Centre, who spends her days operating ventilators, helping to insert breathing tubes and placing and maintaining arterial lines.
Tuesday was one of her worst days in the fourth wave, she said. Normally they would have about two to seven patients on ventilators this time of year. They now have 12 ICU rooms serving 25 patients on ventilators, forcing them to double-bunk and move one patient into the coronary-care unit.
“For me, it feels like I’m doing my job in fast-forward,” Champney said. “It’s two times the speed, it’s always like from one task to the next with very little time to contemplate if I’m doing the absolute best job.”
She can’t help but feel frustrated when she hears of another unvaccinated patient in the ICU. But it melts away when she hears them calling their loved ones, their voice cracking as they inform family they won’t be able to speak going forward because they’re getting intubated.
“It is a very humanizing experience to be with that person when they’re making their phone call to their loved one before they get intubated … They are people and they know they’ve made the wrong choice, because they find themselves getting a breathing tube,” said Champney, who works as a respiratory therapist at the Red Deer Regional Hospital.
“You can feel the regret.”
Kenney has been challenged by some of his own legislature members over some of his decisions on COVID, which has escalated into a crisis that has overwhelmed the provincial health system and forced Alberta to seek outside help. A letter signed and then tweeted out by Alberta Municipal Affairs Minister Ric McIver asked for help with “augmentation” of intensive care staff, and with transporting ill patients out of the province.
One worrying trend is that emergency room staff are starting to see fewer non-COVID patients, leaving them to worry if people with things such as heart attacks and strokes are staying home longer than they should for fear of how busy the hospitals are.
Parks stresses that while intensive-care units are indeed under siege that emergency departments are handling the influx well, and that staff are still doing their absolute best to care for everyone. In words, if you’re sick, please still come to the hospital, he said.
Like many health-care workers, Champney begs people across the country to heed Alberta’s cautionary tale.
“Alberta is the canary in the coal mine. We are the example of what happens when people choose not to get vaccinated … We were ready to have the best summer ever. And now, we have the worst fall ever, because we had a deadly combination of low vaccination rates, and no public health measures. And now, our hospitals are inundated.”