'Frankly, I'm quite scared': AHS cohorting patients as hospitals search for more ICU space

Mounting pressure on hospitals and ICUs Alberta continues to set daily COVID-19 case records, Carlyle Fiset looks at how hospitals and ICUs are preparing for the influx of patients

EDMONTON — Alberta's COVID-19 ICU hospitalization rate is going to go up before it goes down, health officials are warning.

On Monday, the province broke its day-over-day record for new cases by two, reporting 1,733 cases.

More than 16,450 Albertans have the disease – 453 of whom have been hospitalized. Ninety-six of those individuals are receiving intensive care.

The impact of Alberta’s new public health measures isn’t expected to show for another week or two – that is, if Albertans comply with the new rules.

So in addition to the province’s 173 general ICU beds, Alberta Health Services has added 20 in Edmonton, 10 in Calgary, and plans to expand the system’s capacity to a total of 425 ICU beds in future weeks.

“Obviously we hope that they won’t be needed, but we are working not only to supply them but also to staff them,” AHS Edmonton medical zone director Dr. David Zygun said during that afternoon’s pandemic update.

But a physician on the Royal Alexandra Hospital’s COVID-19 unit is worried about the health care system’s capacity to handle even more patients.

“Frankly, I’m quite scared,” Dr. Neeja Bakshi told CTV News Edmonton.

What was less than 25 patients in her unit in October has breached 40.

She says about seven new patients are admitted to the unit outside the ICU each day, a dramatic increase even over the previous week.

“It is getting to feel like what we saw in New York and Italy. And maybe not quite to that extent yet, but it’s feeling like we’re in that depth.”

PATIENTS DOUBLE-BUNKING AS HOPSITALS MAKE ROOM

AHS is setting up those extra beds wherever it can – in specialty ICU units, and then operative and post-op recovery rooms, and then even unused or decommissioned spaces.

Patients are being “cohorted” – or doubled up in rooms equipped with two ICU beds, ventilators and oxygen and air supply.

It’s also talking to primary and continuing care private operators in the case patients need to be moved to free space in the community.

As for staff to care for the people lying in beds, AHS is seeking out workers who recently left the ICU, as well as training others who work in related fields to support critical care teams.

Zygun said he was reassured by AHS’ plans.

“We’re first utilizing all of our conventional ICU beds and teams, and we’ll only do that unconventional-type space when absolutely needed – which we hope to avoid with the public health measures and compliance with those.”

But Bakshi is not.

“In the next week, especially if we’re going at this trajectory, we’re going to be running into some problems,” she said.

Alberta’s all-time high of COVID-19 ICU patients is roughly triple the ICU hospitalization rate during peak influenza season.

According to Chief Medical Officer of Health Dr. Deena Hinshaw, the province typically sees about 30 influenza patients in intensive care.

She reiterated on Monday that Alberta’s health care system has room to take on more coronavirus patients, but that it was important to not ever push it to its limits.

“We do need to make sure we’re bending the curve early enough that we never get to that point where we don’t have capacity to care for everyone.”

About 30 per cent of non-emergent surgeries in the capital region continue to be postponed.

With a report from CTV News Edmonton’s Carlyle Fiset