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The weight of the fourth wave is crippling Alberta’s health care system, with hospital and ICU admissions exceeding those in previous surges.
Jeff McIntosh/The Canadian Press
Roughly 80 per cent of COVID-19 patients who were hospitalized in Alberta visited an emergency department within a month of being discharged and nearly 17 per cent were readmitted, putting more pressure on the health care system.
Alberta Health Services said its most recent statistics, from July, show an increasing number of recovered COVID-19 patients discharged from hospital went on to require additional treatment. The statistics also suggest a potential increase of long COVID, where people suffer from health problems months after clearing the virus.
“If you’re able to survive this infection, your life may still be changed in very significant ways,” said Alika Lafontaine, president-elect of the Canadian Medical Association and an anesthesiologist in northern Alberta.
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The weight of the fourth wave is crippling Alberta’s health care system, with hospital and ICU admissions exceeding those in previous surges. The Alberta government has cancelled thousands of surgeries, brought in the military to bolster its health care work force and asked other provinces to take patients or send staff. Unvaccinated people with COVID-19 make up the vast majority of ICU admissions.
“In this fourth wave, it’s clear that patients are coming into hospital sicker and being discharged with chronic issues worse than what we’d originally seen earlier in the pandemic,” Dr. Lafontaine said.
A provincial task force on COVID-19 rehabilitation recommended Alberta create treatment programs for survivors in order to stem visits to ERs and curb hospital readmissions.
A report from the task force issued earlier this year flagged the issue of hospital readmissions and said tens of thousands of Albertans could benefit from rehabilitation services in the weeks after they test positive. This, in turn, could reduce pressure on emergency rooms and lower readmission rates. Alberta does not have a comprehensive rehabilitation program for COVID-19 patients.
Shortness of breath, chest pain and fatigue are the most common reasons why previously hospitalized COVID-19 patients end up back in the system, AHS spokesman Kerry Williamson said in a statement.
“This is placing further pressure on our health care system, as the majority of hospitalized COVID patients are needing some form of follow-up or ongoing care,” he said.
Alberta counted 1,094 people with COVID-19 in its hospitals as of Monday.
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Alberta's COVID-19 patients need further care
% of all hospitalized COVID-19 patients returning for care within 30 days of initial discharge
Visiting emergency department
Re-admitted to hospital
0 20 40 60 80% Peak 2nd wave (Dec. 2020) Peak 3rd wave (May 2021) June 2021 July 2021 25 7 THE GLOBE AND MAIL, SOURCE: alberta health service
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Date Visiting emergency department Re-admitted to hospital Peak 2nd wave (Dec. 2020) 25 7 Peak 3rd wave (May 2021) 77 14 June 2021 51 6 July 2021 80 17
Alberta's COVID-19 patients need further care download csv
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AHS is in the process of setting up a new coding protocol to track long-COVID patients in the health care system, Mr. Williamson said.
In June of this year, about 51 per cent of previously hospitalized COVID-19 patients visited an ER within 30 days of discharge, while 6 per cent were readmitted, AHS said. At the peak of the third wave, 77 per cent visited an ER in the 30 days following discharge, and 14 per cent ended up back in hospital. In the second wave, 25 per cent of discharged COVID-19 patients returned to an ER within the month, and 7 per cent were readmitted to hospital, AHS said.
Hospital readmissions within 30 days of discharge hit 9.4 per cent in the year prior to COVID-19 arriving in Alberta, according to AHS’s most recent annual report.
AHS’s task force on COVID-19 rehabilitation provided a glimpse of how many people may need additional treatment after surviving the infection.
“Based on international prevalence rates, it is conceivable that there could be over 36,500 Albertans who could benefit from rehabilitation services for five or six weeks after testing positive and over 14,600 persons likely require a much longer course of rehabilitation support,” the researchers said in a report from March.
Sunil Sookram, an emergency department physician at the University of Alberta Hospital, said because people hospitalized with COVID-19 suffer the most severe symptoms – and tend to be frail or have health conditions prior to arrival – it is not surprising the majority of these patients seek medical attention after being discharged.
“The ER is the safety net of the health care system,” he said.
The pressure that recovered COVID-19 patients place on Alberta’s emergency departments is compounded by visits from people suffering complications as they wait for surgeries, Dr. Sookram said. AHS last month said all scheduled non-emergency surgeries were on hold in order to create the temporary ICU beds necessary to deal with the influx of COVID-19 patients.
AHS said it delayed or postponed about 8,500 surgeries between Sept. 13 and Oct. 3. This includes 805 pediatric surgeries, AHS said. Meanwhile, it completed 9,100 operations, including 3,500 emergency surgeries and 1,100 cancer surgeries, over the same period.
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