Critically ill patients are being airlifted out of Red Deer Regional Hospital as doctors and nurses from its various departments are recruited to care for patients on ventilators due to spiking COVID-19 cases in central Alberta.
COVID-19 hospitalizations in the central zone have jumped 62 per cent (from 83 to 134 cases) and ICU admissions at the Red Deer hospital are up 31 per cent (from 16 to 21 cases) over the past week.
“Nothing like this has happened before. We’re on the precipice of not being able to provide appropriate care to people,” said Dr. Mike Weldon, an emergency room physician who works at the hospital in Red Deer, a city of about 101,000 people, roughly midway between Calgary and Edmonton.
The hospital had been battling bed shortages for years prior to the pandemic. Now physicians who work there say it’s in a crisis.
“Over the weekend, sick patients that needed ventilators that normally would have stayed here are being shipped out to Calgary, because we don’t have any room left,” said Weldon.
According to Alberta Health Services (AHS), 24 patients have been sent from the central zone to Calgary and Edmonton since Sept. 1, because of COVID-19 capacity issues.
An AHS spokesperson told CBC News in an email that the agency is doing everything it can to make sure there is sufficient capacity to meet patient demand at critical-care facilities like the Red Deer Regional Hospital.
“Plans are in place to open additional spaces that have the infrastructure and equipment to support ventilated patients, if necessary,” said Kerry Williamson, executive director of issues management for AHS.
“To support additional capacity, resources — including staff — have been redeployed from other departments. This includes utilizing staff with appropriate training from departments, like endoscopy and the operating room, to provide support on acute inpatient units, who are available as a result of reduced surgeries.”
As of Wednesday, AHS said the hospital was caring for 55 patients with COVID-19, including 19 in intensive care. The hospital has a baseline ICU capacity of 12 beds and has opened 10 additional spaces so far.
‘World falling apart’
Red Deer internal medicine specialist Dr. Kym Jim said stress on everyone is palpable.
“The world is falling apart around these people. First, they’re told, ‘You have COVID,’ … and then you’re told, ‘You have COVID but you’re really, really sick — you need intensive care.’ And then you’re told, ‘You’re … going to be transferred to Edmonton or Calgary,'” he said.
It is unclear how long other hospitals will have capacity to accept Red Deer’s critically ill patients.
“What is going to happen when a person comes to Red Deer, and Edmonton or Calgary tells us we no longer can take your patient? Where is that patient going to go?” said Jim.
Patients are being double bunked in the ICU, the coronary care unit is being used as overflow, and physicians at the hospital tell CBC News that nurses from other departments — including labour and delivery — are treating intensive care patients.
“Would you or your loved one accept care in an ICU that was staffed by labour and delivery nurses, with minimal training on looking after this level of acuity? That is triage. That is rationing care,” said Weldon.
“Just because we’re not shipping people out of province doesn’t mean that we’re not severely strained because of our capacity. In terms of the critical care that’s provided, it’s degraded.”
AHS, however, denies that labour and delivery nurses have been moved into Red Deer’s intensive care unit as demand surges during the fourth wave.
The ICU is so stretched, according to Weldon, staff in the emergency room are preparing to care for critically ill patients on ventilators, when there is nowhere else to put them.
“We’re worried … that we’re going to get ventilated patients in our department because that’s the only other place that they can go,” he said.
“It’s frightening, right? I literally came from the other room … and our nurses are reviewing their training on how to work a ventilator. Like that’s where we’re at here.”
However, AHS spokesperson Williamson told CBC News the ER is not a space that would be used to support ICU patients.
Red Deer intensive care specialist Dr. Adam Hall said staff are working to the point of exhaustion to care for what seems like an ever-growing number of very sick and dying patients.
“We’ve hit the limit for what we can safely manage,” said Hall. “I worry that as that system gets strained, the outcomes for patients are going to be worse.”
According to Hall, patients are being kept on the regular wards longer than usual because there is no room in the ICU.
“Patients are coming in probably a little later than they would otherwise. We’re trying to keep them on the floor as long as we possibly can. And once they don’t require any ICU , they’re going out very early, even if they are still quite ill.”
AHS said patients are not currently being airlifted out of the province.
But Weldon said out-of-province transfers are likely imminent. He believes the AHS critical triage protocol — designed to help doctors make decisions about who gets life-saving care when there aren’t enough ventilators and ICU beds for everyone who needs them — will likely be invoked soon as well.
“It’s almost inevitable, given the trajectory of cases and the delay we know between the number of diagnosed cases and the severe outcomes when they start showing up on our doorstep,” Weldon said.
“We have a choice as a province … and we’ve had nothing but absent leadership and, I would argue, mishandling of the entire situation.”
Alberta reported 1,434 new cases of COVID-19 on Tuesday, out of 11,880 tests.
Provincewide, there are 822 people being treated in hospital, 212 of whom were in intensive care beds. Of those not in ICU, 74.1 per cent were unvaccinated or partially vaccinated, as of Friday. Of those in ICU, 91.2 per cent were unvaccinated or partially vaccinated.
There are currently 18,265 active cases of COVID-19 across Alberta, the highest count in the country.