Calgary ICUs still stretched even as COVID-19 case rates drop

Calgary's intensive care units remain under intense pressure, even as overall COVID-19 case counts, transmission rates and hospitalization numbers drop.

This week, the city's four adult intensive care units are filled with more COVIDpatients than they've seen since the start of the pandemic.According to Alberta Health Services, that number peaked at 55 on Wednesday. As of Friday afternoon, there were 50COVIDpatients in Calgary ICUs.

"Every night that I've been on call, we are barely squeaking by with enough beds," said Dr. Selena Au, intensive care specialist working at the Peter Lougheed Centre, South Health Campus and Rockyview General Hospital.

According to Au, they're coping by sending the most stable ICU patients to other city hospitals to make room when there are no beds left.

"So even though the numbers look lower from a daily COVID case rate, I think the hospital as well as the ICUs in particular we're still running full steam right now and just barely getting by."

Patients are also routinely being double bunked in in ICU rooms that have the proper space and equipment. And those who would have previously been deemed sick enough to be admitted to intensive care are being kept on the wards longer.

"Patients have to be sicker before they get an ICU bed. So it's a lot of heavy lifting from our ward hospitaldoctors as well."

Long stays in ICU

The pressure on Calgary's ICUs is driven in part by an unusually long length of stay in the ICU for COVID-19 patients, according to Au, who says some patients require critical care for two to three weeks.

"Some of the patients that we have right now are actually fairly young and without any previous medical history. And we really want to make sure that we give any possible chance for survival," she said.

"Many of those patients are very sick and just hanging on. It's a long stay and journey for these patients that get admitted. And so there's many admissions and they're frequent, but there's very few discharges to balance it out."

According to Alberta Health Services, Calgary's intensive care units have been operating at between 86 and 90 per cent capacity all week, including 30 ICU beds that were added in late November and early December to address the surging COVID-19 cases.

"No additional critical care spaces have been added or required since then, and no additional ICU surge beds are planned to open this week," an AHS spokesperson said in a statement emailed to CBC News. "Clinicians continue to monitor and evaluate the situation."

When it comes to overall capacity, AHS says Calgary's hospitals are operating at between 101 per cent and 108 per cent.

Dr. Daniel Niven, an intensive care specialist at Peter Lougheed Centre,says the ICU thereis close to full nearly every day but care teams are managing for now.

"We're pushing our limits, for sure," said Niven who notes Calgary's intensive care units were running close to capacity before the pandemic. He said extra staff continue to be on the unit to manage the extra patients.

"We're still seeing a fairly steady pressure with regard to COVID admissions on a daily basis. So it remains very busy and at a high capacity, still stretched compared to what we would normally be."

What Niven is watching for now is the potential impact of the more highly transmissible coronavirus variants.

Twelve cases of the variant first discovered in the U.K. and threeof the variant first identified in South Africa have now been found in the province. Health officials have said all are travel-related and there is no evidence of community transmission.

"If those variants were to take hold and start to transmit within the community especially to a great degree like what we're seeing in the U.K. then that would be very concerning, just because of how efficient they do transmit and the fact that we're already functioningat a very stretched capacity.

"So it would make it additionally challenging to manage what could be a much larger patient load."