Rapid spread of Omicron, staffing shortages could threaten patient care, say Alberta doctors, nurses

Alberta doctors and nurses are bracing for what's to come as COVID-19 hospitalizations surge upward — driven by the highly transmissible Omicron variant — and they're warning this could, once again, have serious impacts on patient care.

The number of people hospitalized with COVID-19 jumped 40 per cent, from 504 to 708, between Friday and Tuesday.

And the rapid increase  comes at a time when hospitals are already struggling with serious staffing shortages.

"We're very vulnerable as a health system right now," said Dr. Mike Weldon, an emergency room physician at Red Deer Regional Hospital, where more patients are showing up with COVID-19. 

"I would estimate we're probably 10 per cent down from being able to cover every shift with a safe margin.… I"m seeing beds closed in our department every second shift that I'm working."

According to the latest Alberta Health statistics, 5,589 health-care workers in the province have active COVID-19 infections. The hardest hit regions are the Calgary zone with 2,919 and the Edmonton zone with 1,852.

It is unclear how many of those individuals work in Alberta hospitals. What is also unclear is how many hospital staff are in isolation due to sickness or exposure. Alberta Health Services is not providing that information.

In addition, many staff are burned out after working through four earlier waves of the pandemic. Some have left the province. And on a regular basis rural hospitals are temporarily closing their emergency rooms due to staffing shortages.

"We're overcapacity, understaffed and everybody's very fatigued and morale is very low," said Dr. Paul Parks, section president of emergency medicine with the Alberta Medical Association.

"We're stretched as thin as you can go, so we have no real elasticity to absorb another wave."

He estimates Alberta's larger hospitals are filled to 110 per cent capacity but can only staff to roughly 90 per cent capacity.

And, according to Parks, that means emergency rooms in Calgary, Edmonton and Red Deer are filling with patients waiting for beds.

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He expects health officials will soon have to start postponing surgeries in an effort to keep the system afloat.

"We're very worried this is going to impact all of patient care, not just COVID patients. It's going to be anybody and everybody that needs to access the acute care system.… We know our ability to deliver timely care is going to be impacted desperately."

In Calgary, Dr. Charles Wong, an ER physician at Rockyview General Hospital and medical director for the Calgary zone urgent care centres, says health-care workers are going to great lengths to keep the system running.

"We're kind of just keeping up with the wave of Omicron that's definitely hitting our health-care staff.… We are still functioning at close to our typical capacity with … everyone making adjustments and sacrifices to show up for extra shifts or covering each other when colleagues are sick."

According to Wong, hospitals are not seeing the same stress on ICU capacity so far during this wave as most patients are showing up with milder illness.

"We are seeing a lot of stress, though, at the front of the front lines — like emergency departments, primary care centres and urgent care centres, where a lot of people are presenting with Omicron," he said.

'Hope and pray'

Heather Smith, president of the United Nurses of Alberta, is worried about what's to come. Nurses, she said, are distressed.

"All we can do is hope and pray we don't become Ontario or Quebec. But there's nothing that would indicate otherwise."

Smith said she's received reports of one rural, northern Alberta hospital — which she declined to identify — where staff recently worked shifts ranging from 20 to 24 hours, which is far longer than their contract allows, because there were simply no replacement staff.

"I think it is out of absolute necessity.… [It's] certainly, from our perspective, unsafe and not ideal. But I can only think that it's a reflection of how desperate the staffing situation has become in those sites."

Surgeries, services could be cancelled, staff redeployed

Alberta Health Services said the number of staff off sick is growing and that number will keep escalating as Omicron continues to sweep through the province.

"This is now beginning to impact some health-care services, particularly some acute care services at rural sites where staff illness or isolation is leading to staffing challenges," AHS spokesperson Kerry Williamson said in a statement emailed to CBC News.

The health authority said its preliminary numbers show the sick rate for December will be similar to the last two years. But with Omicron transmission rates soaring quickly, AHS said there are plans in place to redeploy staff.

"Plans include shifting staff members to areas of highest priority, using alternate models of care and prioritizing [health-care workers] for testing to maximize available workforce," he said.

And surgeries, which still haven't fully returned to normal levels after Alberta's devastating Delta-driven fourth wave, could be cancelled once again.

"If required, reduction in services and surgeries will be contemplated in order to redeploy staff to areas of highest need," the spokesperson said.

"Surgery services are currently above 95 per cent of normal volume in total for all sites. Cancer surgeries are above 100 per cent as we work to rebook procedures that had been postponed," said Williamson.

"We are doing all we can to return to normal surgical volume. However, that plan may have to change should Omicron force us to increase ICU capacity."