"A Crisis of the Unvaccinated"

"I think burnout and trauma looks like dreaming about those deaths or seeing those faces [of former patients who died]."

"When I heard 34 deaths [in Alberta, Wednesday], that's what triggered it. I heard, oh my goodness, so many deaths. Now I'm remembering every -- every-- story that I could remember." 

"What bothers us -- or torments us, I guess -- is that these patients often are alone, and nobody should die alone. But it's also difficult that we have the volume that we have -- you can't be with every single patient."

"I think more and more physicians, particularly, and health-care workers are speaking about how they're feeling, how exhausted they're feeling, and there's some comfort in that -- misery likes company."

"You feel better that you're not the only one going through it."

Dr.Neeja Bakshi, internal medicine ward, Royal Alexandra Hospital, Edmonton, Alberta

"What's become really clear is it's really the people, the workforce, that becomes a critical issue."

"It's been tough on morale and people are tired, lots of people are off, being burnt out, and such and it's put a lot of demand on the people that are here."

Dr.Paul Boucher, intensive care, president, Alberta Medical Association

"By the time they come in to us they're so sick that they just can't focus on anything other than just trying to stay alive. This one is hitting us hard and fast every time we turn around and we can barely keep up with the patients."

"Right up to the point where we're saying 'Listen, we're getting to the point where we're going to have to put a breathing tube into you', they're denying that they have COVID." 

"Part of that denial is what's bringing them in so sick in the first place, because they've spent so much time at home trying to ignore the fact they're sick."

Carlene Cooke, emergency room nurse, Royal Alexandra Hospital, Edmonton

 

"Every time there's been a wave, the ICU becomes increasingly more involved."

"Pretty much anybody, when  you come to ICU, you're scared. That's a bad day. So they're unhappy."

"The families, they're fearful, too, no matter what the situation is, and it's made worse by the fact they can't visit."

Dr.Erika MacIntyre, Edmonton Zone Medical Staff Association president, intensivist and respirologist, Misericordia hospital, Edmonton 

A staff member works in an Alberta hospital ICU during the COVID-19 pandemic. On Wednesday, there were 1,084 people being treated for COVID in hospital, 268 of whom were in intensive care beds. (AHS)

 

Of all of Canada's provinces, Alberta is facing the most extreme episodes of hospitalization and deaths due to the Delta variant of COVID, and the fact that it has the highest rate of vaccine rejection among its population, particularly in rural areas. Anti-vaxxer pushback against government and medical authorities' efforts to convince Albertans that the contagion will ebb only when enough people are vaccinated fall on deaf ears. And these are the very people, most vulnerable in the province, who are clogging the health-care system.

A shocking 34 COVID patients died on Wednesday alone, in Alberta representing the  highest death toll due to the SARS-CoV-2 virus since the pandemic began, to take place within a 24-hour stretch. The internal medicine ward at the Royal Alexandra Hospital is where patients are admitted for treatment when they're not yet sufficiently ill to be transferred to the intensive care unit. The former is where patients are told to lay on their stomach, to heave deep breaths, to walk if they can manage it, in an effort to assist the body fighting off the disease.

There are 1,084 people in Alberta Hospitals, according to provincial statics, 268 of whom are now fighting for their lives in intensive care units. The total number of active cases stands at 20,306 in the province where its premier, Jason Kenney speaks of it as a "crisis of the unvaccinated". Seriously ill patients unable to be accommodated in COVID-crammed hospitals have been air-lifted elsewhere, to other provinces willing to take them because their hospitals are in a less parlous state.

Hospitals in Alberta with cases rising since mid-August, are on the verge of implementing a triage protocol which would lead to doctors having to determine who would receive hospital treatment and who would be turned away in a situation where, over the past two weeks, case  rates are escalating in rural areas and among school-age children. Modelling predicts that cases will peak some time around mid-October, leaving hospitals expecting at least another two weeks of continuing pressure on their services.

The crisis is multi-faceted given the reality of a space crisis with patients requiring beds, ventilators, oxygen. Multiple patients are placed together per room doctors and nurses applying their skills in cramped spaces checking on patients keeping up with increasing rates of vital signs reflecting the unpredictability of the virus. All that being a given, the crisis's real and most serious shortage is medical personnel. Morale among medical staff is low, and there are fears that the strain will lead ultimately to people leaving their jobs and their profession.

What strikes doctors on the front lines is not quite only the number of increasing mortalities, but that this is an illness that is preventable, and those who succumb to it without taking the most basic of precautions -- inoculation -- present at hospital seriously ill. And then there is the crux of the problem; misinformation absorbed by people refusing vaccines, demanding instead alternative treatments such as ivermectin, the anti-parasitic many are led to believe represents an effective COVID treatment.

"The ones that are really gung-ho about sometimes refusing intubation, demanding ivermectin, for example, and really not accepting the diagnosis of COVID, those are very, very rare circumstances, but because they're so extreme they're really the ones that stand out."

"You can see the emotional drain that everybody has been facing. The physical exhaustion of managing these patients, managing the current environment in terms of ongoing staff shortages, and people working harder than they normally would be working."

Dr.Shazma Mithani, intensive care unit, Royal Alexandra Hospital, Edmonton

Bernie Cook was hesitant to get the vaccine when he caught COVID. His sickness gave him first-hand experience through one of Alberta's crowded ICUs. Now he's warning others to take action to avoid the same fate.   CBC