Dean Bennett
The Canadian Press
Updated Sept. 24, 2021
EDMONTON -
The head of emergency medicine for the Alberta Medical Association, Dr. Paul Parks, says major components of triage have already begun in Alberta - an assertion disputed by the province.
The dispute arose Friday as the Canadian Armed Forces prepared to bring in air transport and staff to deal with a COVID-19 crisis overwhelming Alberta's hospitals.
The province has yet to formally invoke the triage policy, which would see doctors have to make on-the-spot decisions over who gets life-saving resources.
But Parks said it has become routine in hospitals in the last two weeks to have some critically ill patients - most of them unvaccinated COVID-19 cases - kept on main wards rather than in intensive care units on ventilators because they don't have the available intensive care ward staff.
That's on top of previously announced mass cancellations of surgeries, along with patient transfers, as doctors balance medical needs with available space, he said.
“We already are in positions in many hospitals across Alberta where the doctors know that it would be best for this patient to be in ICU and be on a ventilator, but we're not providing that option until they absolutely deteriorate to the point of crashing,” Parks said Friday.
“We already are implementing some of these things that are drastic, and we wish we never would have.
“People will suffer and will die by this.”
Alberta Health Services said in a statement: “We acknowledge that we are operating at a reduced standard of care, however, safety remains at the forefront of all decisions.
“Any patient who requires mechanical ventilation is currently able to receive it.”
Parks said it's not at the point where doctors must make on-the-spot, life-and-death decisions. But he said that's not far away and, when it comes, the second stage of triage will follow quickly, including making those same decisions about children.
Alberta Health Services said triage will only be invoked if all efforts to increase intensive care capacity are exhausted.
There are 368 intensive care spaces with 304 patients, most of whom are critically ill with COVID-19, and most of them unvaccinated or partially vaccinated.
Alberta normally has 173 intensive care spaces but has been converting other spaces, including operating rooms, into ad hoc critical care wards to meet COVID-19 demand.
Alberta has more than 20,000 active COVID-19 cases and is seeing well over 1,000 new cases a day.
Dr. Verna Yiu, head of Alberta Health Services, said Thursday a key reason intensive care wards have not been overwhelmed is because enough COVID-19 patients are dying to free up bed space.
The number of COVID-19 deaths has been on the rise.
There were 29 fatalities reported Tuesday, 20 more Wednesday and 17 Thursday. More than 2,600 people have died in Alberta since the pandemic began.
Premier Jason Kenney has asked other provinces and the federal government for emergency aid.
Andrew McKelvey, a spokesman with the Department of National Defence, said Friday that they have been asked to provide up to eight intensive care nurses, along with air transport for patients to other health facilities in Canada.
The air transport should be ready to go in 24 hours and the nurses within 72 hours, said McKelvey.
Parks and other physicians, meanwhile, are urging Kenney to put in a “firebreak” to reverse the slew of new infections, starting with shutting down schools and banning mass gatherings, such as sports events.
“The (political) decision-makers upstream are not doing what they need to do to stop case transmission,” said Dr. Shazma Mithani, an Edmonton emergency room physician.
“We can't keep going like this. Health care and ICU capacity is a finite resource.
“The only way to stop the influx of patients into the hospitals is to stop the cases, and that has to happen with restrictions - and it is not happening.”
Dr. Tehseen Ladha, an Edmonton pediatrician, said it makes no sense for Alberta to ask for federal help while refusing to impose serious health restrictions, particularly as cases among children rise.
“This is the worst it's ever been,” said Ladha. “We're seeing the rise in cases amongst the (age) five-to-11 group go up faster than any other age group. The curve is almost vertical.”
Dr. David Keegan, a Calgary family physician, said while critical cases grow, so does the collateral damage of thousands of delayed surgeries.
Keegan said one of his patients needs cancer surgery, but the operation has been delayed.
“It means by the time surgery happens you never know, (the cancer) may have spread,” he said.
“Suddenly we go from this person with an easily treatable removable cancer to it has spread and we're into added-on chemotherapy and potentially radiation.”
Dr. Ilan Schwartz, an infectious disease specialist at the University of Alberta, said targeted public health measures and a vaccine passport may have worked a month ago.
But he said only a hard lockdown with a shutdown of schools and on-essential businesses can now stop the crisis at its source - high caseloads.
“It's absurd that we have (hospital) wards that are full, we are cancelling cancer surgeries, we're calling for the military, we're talking about transporting patients 3,000 kilometres in order for them to find an ICU bed and we still have society going on as if nothing is the matter.”
RELATED STORIES
'Unprecedented patient demand': Alberta reports 1,660 new COVID-19 cases, 17 deaths
Alberta's overwhelmed ICUs near capacity, military support being deployed
Triage protocols made public by Alberta Health Services
Alberta looks to other provinces for help as health-care system buckles under record-high ICU admissions
'Boiling point': Alberta doctors warn of health system collapse as COVID-19 cases climb
This report by The Canadian Press was first published Sept. 24, 2021.
Alberta Children's Hospital doctors face criticism for letters opposing vaccine mandate
Author of the article:Jason Herring
Publishing date:Sep 24, 2021 •
Alberta Children's Hospital in Calgary, on Friday October 12, 2018.
PHOTO BY LEAH HENNEL /Postmedia
Two pediatricians at the Alberta Children’s Hospital are facing criticism after recently writing letters outlining their opposition to vaccine mandates for health-care workers.
Dr. Eric Payne and Dr. Michael Vila wrote in their respective letters they are unvaccinated against COVID-19. They both characterized COVID-19 vaccines as “experimental” and call vaccine effectiveness and safety into question.
Alberta data show vaccines are safe and effective at preventing both symptomatic disease and severe outcomes from the novel coronavirus.
Both mRNA vaccines authorized for use in Canada — manufactured by Pfizer/BioNTech and Moderna — are more than 90 per cent effective at preventing symptomatic illness due to COVID-19, and vaccines have been 85 per cent effective against the Delta variant in Alberta.
Among the 243 COVID-19 patients currently in Alberta ICUs, only about eight per cent are fully vaccinated, despite this group making up more than 62 per cent of the province’s population. And only about one in every 2,000 Albertans who have received a COVID-19 vaccine has reported adverse effects.
Two pediatricians at the Alberta Children’s Hospital are facing criticism after recently writing letters outlining their opposition to vaccine mandates for health-care workers.
Dr. Eric Payne and Dr. Michael Vila wrote in their respective letters they are unvaccinated against COVID-19. They both characterized COVID-19 vaccines as “experimental” and call vaccine effectiveness and safety into question.
Alberta data show vaccines are safe and effective at preventing both symptomatic disease and severe outcomes from the novel coronavirus.
Both mRNA vaccines authorized for use in Canada — manufactured by Pfizer/BioNTech and Moderna — are more than 90 per cent effective at preventing symptomatic illness due to COVID-19, and vaccines have been 85 per cent effective against the Delta variant in Alberta.
Among the 243 COVID-19 patients currently in Alberta ICUs, only about eight per cent are fully vaccinated, despite this group making up more than 62 per cent of the province’s population. And only about one in every 2,000 Albertans who have received a COVID-19 vaccine has reported adverse effects.
Teams in a crowded Calgary ICU work on a patient on a ventilator.
PHOTO BY SUPPLIED BY AHS
It’s inaccurate to call COVID-19 vaccines experimental, said Calgary public-health physician Dr. Jia Hu, who noted mRNA vaccines have received full Health Canada approval. He said there is data from billions worldwide who have had at least one shot of vaccine.
Hu said vaccines provide considerable health benefits in all age groups, something that is important with ongoing high levels of community virus spread in Alberta.
“There’s nothing that is perfectly safe. There’s nothing that is perfectly effective, not just in vaccine land but anywhere in the world,” said Hu. “The thing with these vaccines is, no matter how old you are, the balance of benefits over risks is so much higher for taking the vaccine than not.”
Timothy Caulfield, a Canada Research Chair in health law and policy at the University of Alberta, said it is frustrating to see regulated health professionals spread what he characterized as misinformation.
“To suggest there is a lack of efficacy is patently ridiculous. At this stage, it is like denying the pull of gravity,” Caulfield said.
“The data on safety is also incredibly impressive. Not only do we have impressive clinical trials, but the vaccines have been administered to hundreds of millions of people, so we also have mountains of surveillance data.”
The doctors are cherry-picking evidence to support their views, Caulfield contended.
Payne and Vila work at the Alberta Children’s Hospital, which recently closed 75 per cent of its operating rooms due to strain on Alberta’s hospital system during the fourth wave of COVID-19.
In Payne’s letter, he wrote he and his family are otherwise fully vaccinated, and argued the risk of spreading COVID-19 to his pediatric patients and leading to severe outcomes is “minuscule.”
In a statement to Postmedia, Payne said his stance is independent of his employer. He said he has seen first-hand the impact on patient care from strains on ICUs, but said he stands by his letter and supports patient autonomy and informed consent.
“I am particularly concerned about these experimental vaccines being forced on our children as a requirement to attend school or participate in extracurricular activities. I do not feel that parents and teenagers are receiving informed consent,” Payne said.
Payne’s letter was addressed to the College of Physicians & Surgeons of Alberta (CPSA) council. In a statement, the CPSA said though the college can’t speak to specific cases, it said it is aware of a “small number” of physicians making claims that oppose current consensus on vaccines and is “very concerned” about this.
“CPSA recognizes these are trying times for front-line health-care workers. However, spreading misinformation about vaccines that goes against current evidence and advisories does not align with a physician’s professional responsibility to their patients,” the college said.
The CPSA added the college recently surveyed the profession about COVID-19 vaccination and found 96 per cent of approximately 5,100 respondents indicated they are fully immunized.
Vila wrote in his letter he is not an anti-vaxxer and he has consistently advocated for children to receive other vaccines when parents are hesitant to do so. He told Postmedia he is advocating for the best possible health outcomes for his patients.
“Should we have seen a large volume of hospitalizations within the pediatric population, or if it had been obvious and supported by the evidence that being vaccinated reduced transmissibility to my patients, I would have adjusted my decision to reflect that,” said Vila in his letter, which was sent to AHS leadership.
AHS announced Aug. 31 its staff must be fully vaccinated against COVID-19 by Oct. 31 or risk being put on unpaid leave. The health authority said Friday the “vast majority” of health-care workers are already fully immunized, with their goal to reach 100 per cent uptake. More than 49,000 staff have already submitted their proof of vaccination, AHS said.
Hu said doctors casting doubts on vaccine efficacy and safety can provide fuel for those who oppose vaccinations.
“It’s quite dangerous when you even have a few doctors saying stuff like this, because they are really good nodes for anti-vaxxers to organize around,” he said.
“When an anti-vaxxer can hang on the words of a physician, someone with ‘MD’ behind their name saying that vaccines aren’t safe, they’re much more powerful.”
It’s inaccurate to call COVID-19 vaccines experimental, said Calgary public-health physician Dr. Jia Hu, who noted mRNA vaccines have received full Health Canada approval. He said there is data from billions worldwide who have had at least one shot of vaccine.
Hu said vaccines provide considerable health benefits in all age groups, something that is important with ongoing high levels of community virus spread in Alberta.
“There’s nothing that is perfectly safe. There’s nothing that is perfectly effective, not just in vaccine land but anywhere in the world,” said Hu. “The thing with these vaccines is, no matter how old you are, the balance of benefits over risks is so much higher for taking the vaccine than not.”
Timothy Caulfield, a Canada Research Chair in health law and policy at the University of Alberta, said it is frustrating to see regulated health professionals spread what he characterized as misinformation.
“To suggest there is a lack of efficacy is patently ridiculous. At this stage, it is like denying the pull of gravity,” Caulfield said.
“The data on safety is also incredibly impressive. Not only do we have impressive clinical trials, but the vaccines have been administered to hundreds of millions of people, so we also have mountains of surveillance data.”
The doctors are cherry-picking evidence to support their views, Caulfield contended.
Payne and Vila work at the Alberta Children’s Hospital, which recently closed 75 per cent of its operating rooms due to strain on Alberta’s hospital system during the fourth wave of COVID-19.
In Payne’s letter, he wrote he and his family are otherwise fully vaccinated, and argued the risk of spreading COVID-19 to his pediatric patients and leading to severe outcomes is “minuscule.”
In a statement to Postmedia, Payne said his stance is independent of his employer. He said he has seen first-hand the impact on patient care from strains on ICUs, but said he stands by his letter and supports patient autonomy and informed consent.
“I am particularly concerned about these experimental vaccines being forced on our children as a requirement to attend school or participate in extracurricular activities. I do not feel that parents and teenagers are receiving informed consent,” Payne said.
Payne’s letter was addressed to the College of Physicians & Surgeons of Alberta (CPSA) council. In a statement, the CPSA said though the college can’t speak to specific cases, it said it is aware of a “small number” of physicians making claims that oppose current consensus on vaccines and is “very concerned” about this.
“CPSA recognizes these are trying times for front-line health-care workers. However, spreading misinformation about vaccines that goes against current evidence and advisories does not align with a physician’s professional responsibility to their patients,” the college said.
The CPSA added the college recently surveyed the profession about COVID-19 vaccination and found 96 per cent of approximately 5,100 respondents indicated they are fully immunized.
Vila wrote in his letter he is not an anti-vaxxer and he has consistently advocated for children to receive other vaccines when parents are hesitant to do so. He told Postmedia he is advocating for the best possible health outcomes for his patients.
“Should we have seen a large volume of hospitalizations within the pediatric population, or if it had been obvious and supported by the evidence that being vaccinated reduced transmissibility to my patients, I would have adjusted my decision to reflect that,” said Vila in his letter, which was sent to AHS leadership.
AHS announced Aug. 31 its staff must be fully vaccinated against COVID-19 by Oct. 31 or risk being put on unpaid leave. The health authority said Friday the “vast majority” of health-care workers are already fully immunized, with their goal to reach 100 per cent uptake. More than 49,000 staff have already submitted their proof of vaccination, AHS said.
Hu said doctors casting doubts on vaccine efficacy and safety can provide fuel for those who oppose vaccinations.
“It’s quite dangerous when you even have a few doctors saying stuff like this, because they are really good nodes for anti-vaxxers to organize around,” he said.
“When an anti-vaxxer can hang on the words of a physician, someone with ‘MD’ behind their name saying that vaccines aren’t safe, they’re much more powerful.”
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