Canada: Alberta healthcare system on verge of collapse as Covid cases and antivax sentiments rise
Leyland Cecco in TorontoTHE GUARDIAN
Wed, 15 September 2021,
A surge in coronavirus cases has pushed the healthcare system in the Canadian province of Alberta to the verge of collapse, as healthcare workers struggle against mounting exhaustion and a growing anti-vaccine movement in the region.
The province warned this week that its ICU capacity was strained, with more people requiring intensive care than any other point during the pandemic – nearly all of them unvaccinated.
“It’s not easy to go to work everyday and watch people in their 30s die,” an ICU nurse in Edmonton told the Guardian. “Having to help a family say goodbye and then going through the actions that are required at the end of someone’s life, is worse than anyone can imagine.”
Alberta has long boasted of its loose coronavirus restrictions – including advertising the previous months as the “best summer ever” as it rolled back those few restrictions. It has also been the site of North America’s highest caseloads.
In a province with a long history of skepticism towards government, the pandemic has become fertile ground for protests and anti-vaccine rhetoric, including from elected officials, firefighters and police officers. During the ongoing federal election, the People’s Party of Canada, a fringe rightwing party that has come out against public health measures has seen its largest support base in rural Alberta.
That skepticism towards masks and vaccines has come at a steep cost, say frontline workers.
On Monday, more than 60 infectious-disease doctors wrote a letter to premier Jason Kenney, warning of a catastrophic outcome if the province didn’t address the escalating caseload.
“Our healthcare system is truly on the precipice of collapse,” the physicians wrote. “Hospitals and ICUs across the province are under enormous strain and have reached a point where it is unclear if, or for how much longer, we can provide safe care for Albertans.”
The province has cancelled elective surgeries as resources and space are allocated to Covid patients. ICU beds, meanwhile, are at capacity.
“As soon as those breathing tubes come out, we’re kicking people out of ICU to make space for someone else,” said another nurse. “It’s getting bleak. It’s hard to watch.”
Medical staff in Edmonton, the provincial capital, warned they would soon have to triage incoming patients to determine who could receive lifesaving care.
Kenney, who hasn’t made any public appearances in weeks, held emergency meetings with senior government officials on Tuesday. The province announced a proof-of-vaccine card, with plans to release a QR code in the coming weeks.
Nearly 79% of eligible Albertans over the age of 12 have received at least one dose of vaccine, and 71% of eligible residents are fully vaccinated – one of the lowest rates in the country. An average of 78% of eligible Canadians are fully vaccinated.
While these rates dwarf those in the United States, the relentless spread of the Delta variant highlights how catastrophic outbreaks can occur if even a tiny fraction of the population resist public health measures.
According to the province’s chief medical officer of health, roughly 90% of people in the ICUs are unvaccinated or partly vaccinated.
“No one can ever understand what it’s like to have a Zoom call with a family member whose patient is dying. No one will ever understand that,” said a third nurse. “That is the most awful thing I’ve ever done. And I think we’re all shifting a bit from this very intense sadness to this anger – because this really does feel preventable.”
Joe Vipond, an emergency room doctor in Calgary and vocal critic of the government, called the latest surge the “intentionally cruel” wave.
“This was always part of the plan – letting younger, low-risk people get infected to build herd immunity. I just think they didn’t realize how much illness would result from it.”
He says mounting pressure from a voter base skeptical of public health restrictions led officials to declare Alberta “open for summer” on 1 July and removed many of the mitigation measures they had in place. The government also said it would no longer require people testing positive for Covid-19 to isolate – a plan it quickly scrapped.
“The vast majority of Albertans are good citizens that believe in collective action, that believe in governments. Unfortunately, the political base of the ruling party cannot be described like that,” he said.
One nurse pointed to the bitter irony that those most skeptical of public health measures are those most affected by the current wave.
“All these decisions from the government are clearly to satisfy their voter base,” she said. “But what a lack of insight to see that it’s their base that’s dying and causing us to resort to battlefield medicine.”
In recent weeks, a number of anti-vaccine protests have been held across the country, including out front of hospitals in Calgary and Edmonton, compounding the exhaustion and frustration of frontline healthcare workers.
“I don’t have the energy to make sense of it anymore,” said the nurse. “I’m barely functioning as it is, because we’re pouring from the cup that has a hole. We never get to fill it.”
Instead, nurses say they’re left pleading with a narrow minority of the public that increasingly is ending up in the hospital.
“We’re just asking for them to trust us one more time – we need them to so our entire healthcare system doesn’t collapse,” she said. “And I worry – because I don’t know how to reach those people.”
Vaccine passports brought in as Alberta declares state of public-health emergency
Alberta has brought in a slew of new restrictive health measures, some of which are set to go into effect tomorrow, including limits to indoor social gatherings and capacity limits on businesses, amid concerns the province could run out of ICU staff and beds in the next 10 days.
MOE, LARRY, CURLY, AND SHEP THE THREE STOOGES
On Wednesday Alberta Premier Jason Kenney, Minister of Health Tyler Shandro, Chief Medical Officer of Health Dr. Deena Hinshaw, and Dr. Verna Yiu, president and CEO of Alberta Health Services, announced the provincial health care system is in the worst position it has been in since the pandemic began.
"We are facing an emergency that requires immediate action,” Kenney said.
The province has declared a state of public health emergency, as intensive care unit patients have hit a record high for the province. On Tuesday the province reached 270 ICU patients, a 29-per-cent increase in the last seven days, which is 156 per cent of the normal health-care capacity.
Alberta will be reaching out to other provinces to see if they have any additional ICU spaces and asking for skilled front-line health workers to come to Alberta to help add critical-care capacity.
"Recent trends show we are exceeding that high-end projection [of hospitalizations] and that we may run out of staff and intensive care beds within the next 10 days," Kenney said.
To deal with the crisis, Kenney will be implementing dozens of new restrictions on both the vaccinated and unvaccinated, with a vaccine passport exemption system for some businesses to work around the new rules.
Kenney apologized to the province for the move toward an endemic approach rather than a pandemic approach, which he said he believed was the right thing to do because of the data from other jurisdictions.
"It is now clear that we were wrong, and for that I apologize," Kenney said, though he said he does not apologize for lifting public-health restrictions through the summer.
"I do apologize for predicting we could be open for good, when clearly the Delta variant and behaviour pattern we are now seeing are posing a threat to the health-care system."
The premier has reluctantly implemented a vaccine passport system, even though he had previously said he would not bring the system into the province, because he said he was left with no choice.
“The government’s first obligation must be to avoid large numbers of preventable deaths. We must deal with the reality that we are facing. We cannot wish it away,” Kenney said.
“Morally, ethically, and legally, the protection of life must be our paramount concern.”
The move came after several days of the UCP caucus meeting to finalize the new slate of restrictions.
In Alberta, some 79 per cent of people over the age of 12 have received at least one dose of the vaccine, compared to 84 per cent across Canada. Some 71 per cent of Albertans have received both doses of the vaccine, while across Canada the number sits at 77 per cent.
On Thursday starting at 12:01 a.m. private social indoor gatherings will be restricted for fully vaccinated residents to those of the same household and one other household, up to a maximum of 10 people, with no restrictions for those under age 12.
Albertans who are unvaccinated and over the age of 12 are prohibited from attending any indoor social gatherings.
Outdoor private social gatherings are permitted to a maximum of 200 people, with two-metre physical distancing maintained at all times.
Mandatory work-from-home measures will be in place unless the employer has determined a physical presence is required for operational effectiveness.
Schools will move to mandatory masking for students in Grades 4 and up, plus staff and teachers in all grades. Schools that can implement an alternate COVID-19 safety plan can be exempted from mandatory masking. Elementary schools will be moving to class cohorting.
For physical activities in schools, youth aged 18 and under are not required to mask or maintain two-metre distance when engaged in physical activity and there are no restrictions for outdoor activities.
Indoor sports and performance is permitted with two-metre physical distancing, when possible.
Places of worship will be limited to one-third fire code capacity, with mandatory face masks and physical distancing between households or with two close contacts for those living alone.
Restaurants will be limited to outdoor dining, with a maximum of six people per table from one household, or two close contacts for those living alone, unless they implement a vaccine passport system, which would exempt them from the rules.
Liquor sales and consumption must be wrapped up at 10 p.m. and 11 p.m., respectfully.
Weddings and funerals will have all indoor ceremonies capped at 50 attendees, or 50 per cent of the fire code capacity, whichever is less. No indoor receptions are permitted unless the host facility implements the vaccine passport restriction exemption program.
All outdoor ceremonies and services for weddings and funerals must be limited to 200 guests and must follow the liquor sales and consumption restrictions although the facility can apply for the vaccine passport restriction exemption program.
Retail, entertainment, and recreation facilities will have attendance limited to one-third fire code capacity and attendees are only permitted to attend with their household or two close contacts for those living alone. Attendees must be masked and have two-metre physical distancing between households. The facilities can implement the vaccine passport restriction program.
Adult sport, fitness, performance, and recreation will have indoor activities limited, with no indoor group classes or activities permitted. One-on-one training or individual workouts are permitted but three-metre physical distancing is required, no contact between players, and indoor competitions are paused (except where vaccine exemptions have been granted). These facilities and programs are eligible to implement the Restrictions Exemption Program.
There are no restrictions on outdoor activities.
As of Sept. 20, vaccine-eligible individuals will be required to provide government-issued proof of immunization, or a negative privately paid COVID-19 test from within the previous 72 hours to access a variety of participating social, recreational, and discretionary events and businesses throughout the province.
To enter certain spaces that are participating in the program, including restaurants, bars, and indoor organized events, people aged 12 and older will be required to show their proof of vaccination or a negative recent test result.
Businesses could immediately and without restriction serve any individual eligible for vaccination who has proof of double vaccination, has documentation of a medical exemption, or has proof of a recent negative COVID-19 test. Children under the age of 12 would not need to provide proof of vaccination or a negative test result.
On Wednesday, the province identified 1,609 new COVID-19 cases in the last 24 hours after 15,831 tests with a positivity rate of 10.5 per cent.
There are currently 877 Albertans in the hospital with COVID-19 with 218 of those being treated in intensive care.
There are 18,421 active cases in the province.
Another 24 deaths have been reported in the last 24 hours, bringing the death toll up to 2,495
Jennifer Henderson, Local Journalism Initiative Reporter, St. Albert Gazette