It’s a refrain Alberta officials have stressed throughout the pandemic: we must avoid overwhelming our health-care system.
In fact, until recently, the provincial update on the COVID-19 situation included a line saying the number of hospitalizations and intensive care unit admissions was “well within the health system’s capacity.”
As of Tuesday, there were 116 people were in hospital with COVID-19, 16 of whom were being treated in intensive care. That means 23 per cent of Alberta’s dedicated COVID-19 ICU beds were being used, Dr. Deena Hinshaw said.
The province has seen a daily 3.1 per cent increase in hospitalizations in the past two weeks, the chief medical officer of health added. The latest numbers show 293 Albertans have died due to COVID-19.
Pressure on health-care workers
But the health system is comprised of more than just space — beds and capacity — it’s also carried by human resources — health workers and support staff.
“To consider only hospitalization levels when assessing the pandemic’s toll on the health-care system is not enough,” said Alexander Delorme, spokesperson for the Alberta Union of Provincial Employees.
“Just one staff needing to isolate means their unit is working shorthanded or someone else is picking up extra hours.
“This adds up quickly and is a heavy burden on staff both physically and mentally.”
As of Tuesday afternoon, there were 72 outbreaks listed by Alberta Health. Four of those outbreaks were in hospitals: Leduc Community Hospital, Misericordia Community Hospital, University of Alberta Hospital (Mazankowski Heart Institute) and Foothills Medical Centre.
At the Leduc hospital, two patients tested positive for COVID-19 and six workers were required to isolate, Alberta Health Services said Tuesday.
In the outbreak at the Mazankowski Alberta Heart Institute, three patients tested positive for COVID-19 and 12 staff members are isolating, AHS said.
At the beginning of October, AHS said 290 staff at Foothills Medical Centre, where there were six outbreaks, were in isolation.
“When you take 300 people out of a wheel that large, it’s significant, and it’s going to have impact,” AUPE vice-president Bobby-Joe Borodey told Global News in a previous interview.
She said burnout is imminent as more and more shifts need to be filled in order to cover for those in quarantine.
“The concern is: how can we keep going at this pace?”
Staff having to isolate
“The more and more staff who have to isolate — like we’ve seen recently at the Foothills — the worse the situation gets,” Delorme said.
“Furthermore, staff levels directly affect bed numbers. If there aren’t enough staff to man the beds, then those beds can’t be used.
“So it isn’t just a matter of how many beds are filled with patients,” he explained. “To only focus on COVID hospitalizations is a mistake. The more cases rise, leading to outbreaks and health care staff needing to isolate, the more our health-care system bends under the pressure.”
AHS has since said most healthcare staff are back at work.
“We understand the challenges these outbreaks present and that our staff are fatigued after months of responding to the pandemic,” Kerry Williamson, AHS spokesperson, told Global News on Tuesday.
“We are doing everything we can to support our staff, especially those at sites impacted by outbreaks.”
He said AHS workers can access support through the Employee and Family Assistance Program (EFAP), which offers a range of support services for work, health and life challenges. It is a free and confidential service available 24/7 to AHS employees.
“AHS has also developed a phased mental health and wellness resources strategy to support our people throughout the pandemic and we will continue to leverage existing AHS and EFAP resources,” Williamson said.
“We are encouraging employees to take care of themselves by helping them be proactive by identifying and addressing mental health challenges such as compassion fatigue and burnout.”
He added there are employee and health wellness programs and resources that address topics like stress management, sleep and fatigue.
“We understand that our employees’ health and wellness needs may change over time and our phased approach will ensure that our people get the right resources at the right time.
“AHS continues to use overtime and reassignment to ensure shifts are covered if staff are required to self-isolate to ensure patients are getting the care they need.
“We ask that Albertans do their part to help reduce the spread of COVID-19 and the pressure it puts on our staff and systems.”
Using sick days for 14-day isolation
Cameron Westhead, a vice president for the United Nurses of Alberta, says the kicker is that health workers who must isolate for 14 days have to use their allocated sick days.
The UNA would like to see the government, AHS and Covenant Health reinstate the pandemic pay that was in place when the provincial state of emergency was in effect.
“We’ve been calling on AHS to reinstate a pandemic self-isolation pay,” Westhead said. “They’ve since taken that away when the state of emergency was over… so now staff are running through their sick bank when they have to self isolate.”
Even if the COVID-19 case they may have been exposed to was a work colleague, they must use their own sick days to isolate for 14 days. For casual staff, that means they don’t get paid for those two weeks.
Hospital capacity vs. staff
The pandemic may not be overwhelming the infrastructure capacity Alberta has for ICU beds at this time, but some health-care workers are certainly feeling overwhelmed.
“Sure we have beds available, the ICU capacity isn’t being overwhelmed, but the human resources and the morale of the staff,” Westhead said.
He said it was already tough before the pandemic, with units working short staffed.
“I would say even before COVID hit, people were working short staffed and morale was low,” Westhead said. “We’ve seen the way physicians are being treated by the government… and we knew we were in for the same treatment.”
“There’s a real sense that health-care workers feel disposable. On one hand, the government calls us heroes, then another day they make an announcement to lay off 11,000 of us.”
“We’re dealing with a government who’s hostile to its workforce who’s providing care,” Westhead said.
In addition to the stress of layoffs and contracts, there’s the stress of working on the front lines of a pandemic.
“The kind of work that it takes to care for patients with COVID is much much more intense… putting on and taking off the PPE. You often need more than one person to provide care,” Westhead explained.
And, even when workers are wearing full protective gear, there’s always a risk.
“There’s always the question as to whether they could be infected. It’s very mentally and emotionally draining.
“That’s what we signed up for and we’re proud to do it… but it does have an impact on staff.”
It’s also tough for health workers to work overtime, covering for their colleagues who have either tested positive or who must isolate.
“The remaining staff often have to work overtime, longer shifts… It’s really morally distressing when you know some of your colleagues may have gotten ill providing care and you may be next… We’re like family.”
With files from Heide Pearson, Global News