COVID-19 variants reducing hospital capacity, increasing ER wait times: Alberta doctor

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Now that more COVID-19 variants of concern are ending up in hospitals, Alberta is trying to keep patients separate, but what does that mean for rooms, space and overall capacity?

“We’re seeing a dramatic increase in wait times in the emergency department right now,” said Dr. Shazma Mithani, an emergency physician at Edmonton’s Royal Alexandra Hospital.

“One of the main reasons for that is actually our inability to move patients up as readily because of the COVID-19 variant.”

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In waves one and two of the pandemic, Mithani said COVID-19 units could cohort between two and four positive patients in the same room.

“Unfortunately, because of all the variants of concern, we can no longer put them all in the same room until we get the variant testing back. And of course we can’t put wildtype COVID patients with variant patients together.

“So that affectively reduces our hospital capacity in the COVID wards upstairs and that trickles down to the emergency department, where we cannot move patients up as quickly, and that spills into the wait room with increased wait times.”

Mithani said on average evenings pre-pandemic, which tend to be the busiest time, the wait would be about two hours. Now, they can be in excess of three to five hours, she said.

Alberta’s chief medical officer of health confirmed the “current practice is to not have people with different strains of the virus in the same room.”

“If one person has previously dominant COVID strain and another has one of the variants of concern, we, again, don’t want to take the chance of someone becoming infected with the variant of concern when they’ve had the other strain,” Dr. Deena Hinshaw said March 25.

Mithani said the hospital isn’t allowed to cohort patients together until their variant tests results come back.

“If you have multiple four-people rooms and you can only put one patient in there, what are those other three patients going to do? They have to go into other rooms.”

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That capacity crunch then ripples out and affects other units of the hospital, she added.

“In ICU, there was some double bunking happening with the second wave. That can’t happen this time,” Mithani said.

“In the second wave, the ICU was having their over-capacity space in the recovery room — in the operating room recovery room — which is a large, open space that just has patients spaced around the room.

“A big open room is not going to be appropriate when we’re worried about the variants of concern, so it’s also reducing our ICU capacity in terms of their over-capacity plans on what to do when the ICU numbers go up again.”

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Alberta Health Services says the preference is to isolate a patient in a private room before transferring them to a COVID-19 unit if they test negative for a variant strain. If they test positive for a variant strain, they remain isolated in a private room.

“We continue to have adequate acute care and ICU capacity and are able to respond to changes in patient demand,” AHS spokesperson James Wood told Global News on April 6.

AHS says its pandemic planning allows it to “increase the allocation of hospital and ICU capacity to patients with COVID-19 as demand rises. This is not new, and has been in place since the beginning of the pandemic.

“Current case numbers are being managed in our regular and in some of our expanded space,” AHS said. “Neither Calgary nor Edmonton zones have any imminent plans to open further units, however we have the ability to do that if demand on our hospitals increases.”

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On Monday, Alberta Health confirmed 887 new COVID-19 cases, including 432 variant cases. There were 312 Albertans in hospital, 76 of whom were in intensive care. Thirty-nine per cent of Alberta’s 10,582 active cases were variants of concern.

Alberta Health says, generally, the percentage of people in hospitals with a variant strain of COVID-19 is consistent with the percentage of active cases that are variants.

Mithani feels like the daily case numbers are rising much faster than they were in the second wave, driven by the variants, which she finds “terrifying.”

“My worry is that the peak is going to a lot higher than it was in the second wave,” she said.

“And although we may not have as many deaths — because we’ve thankfully protected the most vulnerable from dying, by vaccinating them — we have not protected those at highest risk of being hospitalized with the new variants of concern, and that’s people under 50.

“That’s what we’re definitely seeing with our colleagues in Ontario.

“They’re seeing lots and lots of younger people being hospitalized and admitted to ICU with the variants of concern.

“I’m worried that’s going to be the same case here in Alberta,” Mithani said.

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The hospital is “definitely” seeing more young people admitted, a rise in the number of people in their 30s and 40s requiring oxygen.

The third wave is much more dangerous, Mithani said. The variants mean cases are rising more rapidly, it’s affecting younger people more dramatically, and it will still take months to vaccinate all Canadians, she added.

“I think there’s only one solution to this problem that we have right now and that’s to lockdown in a dramatic way.

“We need to increase restrictions significantly. We need to shut down all non-essential services and non-essential businesses. We need to stay as close to home as possible. We need to get the numbers down rapidly and dramatically and the only way to do that is locking down.”

© 2021 Global News, a division of Corus Entertainment Inc.

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