Alberta hospitals are squeezing in extra intensive care unit beds as respiratory virus cases balloon and ICUs fill up.
Alberta Health Services has added 17 adult surge beds since last week — 12 in Edmonton and 5 in Calgary— bringing the total to 240.
“We are seeing quite a bit of influenza coming to the ICU and not just in our frail elderly people. We’re seeing that in 40 year olds, in 60 year olds. Some have an underlying bacterial pneumonia as well. And some just have influenza,” said Dr. Shelley Duggan, an Edmonton-based critical care physician and president-elect of the Alberta Medical Association
“That’s seemingly what’s driving the ICU admissions over the past few weeks.”
According to Alberta Health Services, as of Wednesday at 9 a.m., Alberta ICUs were treating 76 influenza patients, 37 people with COVID-19 and 11 with RSV, respiratory syncytial virus.
Duggan said the influenza patients she’s seeing are very sick and are requiring longer stays in the intensive care unit.
“They have significant lung disease. We have to sedate them and ventilate them for several days and then we have to wean them,” she said. “They can stay with us a long time.”
As ICU surge beds are added, hospitals resort to double-bunking intensive care patients or use post-operative recovery rooms and cardiac intensive care units as overflow ICUs, according to Duggan.
The trouble is, urban hospitals were already overcapacity before the respiratory virus season hit and health care workers are in short supply.
“You can add beds. You can’t necessarily staff them.”
Delayed care
Dr. Ken Parhar said intensive care units are also dealing with fallout from the family physician shortage.
“A lot of this relates to the fact that many people don’t have primary care physicians and can’t get care perhaps as quickly as they need it,” said Parhar, an intensive care physician in Calgary and section president with the Alberta Medical Association.
“Things that might be preventable aren’t prevented.”
For example, he treats people in the ICU with complications from chronic conditions such as diabetes or hypertension.
“If those things aren’t cared for correctly or appropriately and in a timely fashion, what happens is people end up being more sick and those things that could have been dealt with in the community subsequently have to be dealt with in [hospitals].”
Population growth is also a factor, Parhar said.
“My hope is that in the future we can get better primary care resources for our population so that we can minimize that risk.”
Parhar said while Calgary’s ICUs are under pressure, they’re still able to cope. In addition to adding beds, he said, ICU patients can be moved out to smaller centres.
“If there’s an opportunity to get patients closer to home, we’ll send a patient from an ICU in Calgary that can safely return back to Lethbridge or Medicine Hat. So many zones across the province are also helping each other out when it’s safe to do so.”
In a statement, AHS said it will continue to add ICU surge beds as needed.
“AHS has multiple actions underway to support patient flow including adding beds where possible, increasing staffing, expediting patient moves to appropriate continuing care spaces, and working provincially to coordinate and support patient movement,” a spokesperson said in an email.
The health authority said no pediatric ICU beds have been added as of yet.
According to the AHS website, which is updated weekly, Alberta’s ICU capacity had jumped to 95 per cent on Dec.5.
With the added beds, ICU capacity sat at 89 per cent on Dec. 12.
Meanwhile, Parhar expects to see a further surge after Christmas and he’s urging Albertans to be vigilant.
“Take care of your friends, colleagues and neighbours. Make sure that if you’re not feeling well you take time off to rest appropriately. Obviously, if you’re able to, please consider getting vaccinated for the things we have vaccines for,” he said.
“And also know that the health care system is here to take care of you no matter how sick you are.”