EDMONTON—Dr. Shazma Mithani is tired.
The Edmonton emergency room physician is fresh off a 10-hour overnight shift and is already on her third media call of the day. But her fatigue does not just come from physical exhaustion — she says she’s frustrated to see Alberta once again claim the highest number of active cases in the country after lifting most public health restrictions on July 1.
Alberta reported 1,168 new cases of COVID-19 on Friday, for a total of 9,655 actives province-wide, as well as five deaths over a 24-hour period. Alberta has recorded more than 1,000 new cases each day for the last three days and currently leads the country in new daily and active cases.
The province has about 34 per cent of the total active cases in Canada, with about 11 per cent of the country’s population. And it has the highest daily case count since the third wave in May, when Alberta not only led the country in the number of active cases but also had the highest rate per capita on the continent.
“Every single time in previous waves, in the second wave and then the third wave, front-line health-care workers have raised the alarm bell and said this is not looking good, we need to do something, and every single time the government dragged their feet and delayed putting measures in place to the point where we’re the worst (province) in Canada … again,” Mithani said.
“It’s disheartening. It’s disappointing. It’s upsetting. It’s angering,” she added. “It was entirely preventable.”
Alberta currently has 336 people in hospital for COVID-19, which includes 74 in ICU. About 97.3 per cent of those in ICU are unvaccinated or partially vaccinated.
Of Alberta’s total population, about 59 per cent are fully immunized, compared to 65.5 per cent nationwide.
Mithani is now one of many doctors in Alberta urging the province to reimpose public health restrictions such as indoor masks and capacity limits to quell the fourth wave.
“At minimum, there needs to be a province-wide mask mandate that needs to come back into effect.”
The rising case counts and increase in hospitalizations is having a broader impact on Alberta’s health-care system. On Friday, Alberta Health Services announced it would postpone some non-urgent surgeries and procedures to free up hospital beds and staff.
Other doctors in Alberta who spoke to the Star said they agreed it would make sense for the province to reimpose restrictions at this time.
“It’s become clear that the vaccination rates that we have in place right now are not adequate in terms of preventing excess hospitalizations,” said Dr. Stephanie Smith, an infectious disease physician and professor of medicine at the University of Alberta.
“Adding some of those extra layers of protection back I think would be helpful in terms of trying to decrease transmission.”
She attributes the steep increase in cases seen in July and August to not just the lifting of restrictions, but to the message that accompanied it. At the end of May, Kenney triumphantly declared that this would be the “best summer ever” for Alberta.
“It has been this feeling that we don’t need to worry anymore, that the vaccine is going to be good enough,” Smith said. “And I think the reality is that it isn’t.”
Mithani, who works in an emergency department in Edmonton, said they have been seeing a 10 to 20 per cent increase in patient volumes starting in July. Part of that increase is connected to a delay in care because of the pandemic, opioid overdose deaths as well as what is generally an increase in accidents in the summer season.
“What we’re seeing on top of that now as we started to see case numbers rise is that in addition to the other patients that are coming in, we’re seeing a significant increase in the patients who have complications of COVID-19,” Mithani said.
The added volume is increasing wait times and also putting more pressure on physicians to provide an adequate level of care as efficiently as possible, she said.
“As the volumes have been going up and as the staffing pressures have been leading to bed closures, and then effectively reducing the space within which we can see people, those wait times have been climbing,” Mithani said. “It’s certainly stressful to be working a shift where we’re under-resourced and trying to do our best to work harder.”
The governments of British Columbia and Manitoba have said they will reintroduce mandatory mask policies to address rising case counts in those provinces, but Alberta has remained steadfast in itsintention to not reimpose public health restrictions. Provincial officials have repeatedly said the best way to reduce case numbers is for everyone to get vaccinated.
The increase in case numbers and hospitalizations in Alberta comes as the province’s leadership is accused of being missing in action. It’s been two weeks since Alberta’s medical officer of health, Dr. Deena Hinshaw, held a press conference, on Aug. 13. Premier Jason Kenney has been away on a two-week vacation, which his office said ends next week.
“In the face of this situation with these rapidly rising case numbers, hospitalizations and ICU admissions, leadership is nowhere to be found,” Mithani said. “This is extremely concerning. It’s extremely irresponsible. Albertans want to know what sort of plans are in place to help combat this fourth wave and ensure that Albertans stay safe.”
A spokesperson for Hinshaw’s office said “She and Alberta Health continue to provide data updates online Monday to Friday and continue to monitor the trends closely in Alberta and other jurisdictions.”
Dr. Michelle Bailey, a pediatrician and president of the pediatrics section at the Alberta Medical Associaton, said reintroducing restrictions is particularly urgent as schools prepare to reopen.
“It certainly would be our recommendation when we think about our pediatric population that are under 12 being unvaccinated, that measures like masking would be very helpful for reducing spreads in our communities,” she said, adding that it’s particularly important for indoor spaces such as workplaces, schools and establishments where people gather for social events.
She pointed to measures being reintroduced in British Columbia and Manitoba and said it’s a mistake for Alberta to not follow suit.
“By not doing that in Alberta I think we’re missing an opportunity to reduce spread and to have a really congruent approach across the province, particularly for those populations at risk, like our schoolchildren,” Bailey said.
Mithani expressed concerns with how the fourth wave in Alberta will affect the ability of hospital physicians to provide adequate care.
“We are in a critical staffing shortage across the province and to then have multiple health-care workers have COVID cascade through the units and have 10-day-long isolations for multiple health-care workers, could be pushing staffing issues further into even more critical numbers,” she said.
She said she sees the mental and physical exhaustion affecting her colleagues and said the most frustrating part of the fourth wave emerging is that government officials are not heeding the advice of health-care professionals on the front line.
Mithani was a signatory to a letter sent to Alberta Health Services chief executive officer Dr. Verna Yiu on Aug. 20 that raised concerns over increasing emergency department volumes, staffing pressures and shortages. She said they met AHS officials this week but are still waiting to see changes.
“We’ve been here so many times … We’re burnt out, we’re not being listened to and the thing that’s the most frustrating about this is that the decisions are being made by people who are not on the front lines,” Mithani said.
“We are the ones that have to be there to put breathing tubes into young patients, we are the ones who have to hold a tablet or a phone in front of a patient before they have a breathing tube so they can talk to their young children. And it’s completely demoralizing … All we want to do is the best thing for our patients. And we are not being set up in a way that we can do that.”