More Albertans are in ICU with COVID-19 than ever and it's expected to get worse

Alberta's fourth wave of COVID-19 has put the greatest strain on its health-care system to date, with about 200 patients now in intensive care units and internal modelling suggesting the situation could get worse for weeks to come.

Modelling by Alberta Health Services (AHS) obtained by CBC News suggests that, by early October, there could be as many as 365 patients in need of the province's current 286 ICU beds.

That's under the model's "high" or worst-case scenario. The "mid" scenario puts the number of patients at 280; the "low" at 191. The number of ICU beds could also fluctuate.

"AHS is already increasing capacity to meet this forecast, and the potential for higher demand due to COVID-19," said AHS spokesperson Kerry Williamson.

"The current situation is serious and we are extremely concerned with the rapidly rising hospitalization and ICU numbers."

Doctors say the health-care system is already buckling under the weight of current ICU demands.

"Alberta hospitals really are on the brink of collapse," said Dr. Ilan Schwartz, a physician and assistant professor in the division of infectious diseases at the University of Alberta.

"I think it's important that Albertans know just how deep we are into this disaster. This isn't something that we are projecting. This isn't something that is potentially down the road. We are in the midst of a disaster."

Schwartz was one of 67infectious disease physicians to sign an open letter to Alberta Premier Jason Kenneyon Monday, calling for stronger actions to curb the spread of COVID-19, in particular restrictions on non-immunized individuals to access non-essential public, indoor spaces.

"This measure can immediately decrease new infections, thereby alleviating pressure on hospitals, while avoiding widespread lockdowns, now and in the future," the physicians wrote.

Kenney has repeatedly rejected calls forvaccination requirements, which are increasingly common in other provinces when it comes to accessing bars, restaurants, gyms and otherpublic venues.

CBC News requested comment from the premier's office to the physicians' letter. In response, Alberta Health provided a link to a YouTube video in which Health Minister Tyler Shandro discussed vaccine mandates at a news conference last week.

The exact number of COVID-19 patients in ICUcan fluctuate hour by hour.

Alberta Health said on Monday afternoon there were 198, eclipsing the previous high of 182 set back in May, amid the pandemic's third wave.

AHS the arm's-length agency that administers health care in the provincesaid Monday there were 202.

Alberta's health-care system typically comprises 173 general, adult ICU beds. But the actual capacity has expanded and contracted during the pandemic.

AHS said Monday 113 additional ICU spaces were available, for a total of 286.

These beds are not just used to treat COVID-19 patients, but also people suffering from a wide variety of ailments, injuries and post-surgery complications. All told, AHS said there were 256 patients in ICU on Monday.

Consequences of ICU expansion

While more ICU space has been made available, physicians say staffing those additional beds is already a challenge.

Dr. Erika MacIntyre, president of the Edmonton Zone Medical Staff Association, said the ICU projections are troubling because staff are already tired.

"We're running out of ICU nurses and we're running out of respiratory therapists," she said.

"They're done;they're burntout," she said of the nurses. "They have worked every day this summer and this is the fourth wave sothisisn't the first time this has happened."

MacIntyre said there used to be one ICU nurse for each patient. Now it's one for every three patients.

"What this means is a reduction in services," MacIntyre said.

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Staffranks may need to be increasingly bolstered by calling in doctors and nurses who aren't specialists in intensive care.

"You can imagine if you're not trained for a task, it's going to be hard to do," said Dr. Joe Vipond, an emergency physician in Calgary. "The quality will suffer."

Cancelled surgeries

The reallocation of resources has also led to reduced levels of care and cancelled surgeries for non-COVID patients.

Albertans awaiting procedures such as kidney transplants and brain cancer operations have recently seen their surgeries postponed.

AHSsaid Monday all elective surgeries and most outpatient procedures in Calgary will again be postponed this week, as staff are redeployed to intensive care duties.

During the height of its largest COVID-19 wave earlier this year, Manitoba's ICUs were overwhelmed and patients had to be flown to other provinces.

Schwartz worries Alberta may soon face the same situation.

"We're really on the cusp of no longer being able to accept any patients into the ICU," he said.

"This is what we mean when we talk about health care collapse. We're talking about evacuating sick patients out of the province."

Vipondnoted both of Alberta's neighbours British Columbia and Saskatchewan are also dealing with significant surges in COVID-19 and their own ICU capacitiesmay be limited.

The result, he said, may be the rationing of intensive care to those who need it most.

"I think the reality is we're looking at triage," he said."And we're looking at preventable deaths that will be occurring over the next few weeks in Alberta."