Calgary doctors redeployed as hospitals face growing wave of COVID-19 patients

As Calgary hospitals begin to heave under a growing wave of very sick COVID-19 patients, plans originally drawn up in the spring to address a "worst-case scenario" have been unearthed and work is underway to rearrange and redeploy hundreds of health-care providers

As of Monday afternoon, 184 people with COVID were being cared for in Calgary hospitals, including 32 in intensive care.

That number is on track to double in the next two weeks, according to Dr. Yael Moussadji, medical lead for the physician workforce plan in the Calgary zone, who has been involved with Alberta Health Services' COVID task force since the start of the pandemic.

"We are trending along that worst-case scenario and that's scary for everybody involved because it's not a hypothetical. We know we're going to be seeing this. It's a scary place to be," she said.

In the spring, the plan to free up beds and health-care providers never had to be implemented. But that has changed with Alberta's unrelenting second wave.

Hundreds volunteer

According to Moussadji, 623 AHS-appointed physicians in the Calgary zone — ranging from family doctors and internal medicine physicians to surgeons and pediatricians — have volunteered to care for COVID-19 patients in intensive care units, on designated wards and in long-term care. Some are already doing that work on hospital units around the city,

Within that group, about 60 non-ICU doctors (pediatric and adult emergency room physicians and critical care cardiologists) are also in the queue to be redeployed to care for COVID-19 patients in intensive care.

As of this week, four of them have started working in the ICU.

More than 30 pediatric ICU nurses have also volunteered to work in adult intensive care units, Moussadji said.

And an additional 75 community-based physicians (family doctors) have also stepped up but have not yet been called into action.

"The next two weeks are going to be challenging. We're going to see a significant reduction in services as we have to ramp up our staffing and require more capacity in our hospitals," said Moussadji.

COVID beds are being opened in stages, and as that happens, additional groups of doctors and nurses will be brought in to staff those beds. 

Dr. Verna Yiu, president and CEO of AHS, cautioned on Friday that staffing remains a challenge across the province.

AHS and the College of Physicians and Surgeons of Alberta recently relaunched a physician registry. It includes questions on ability to practise, interest in being redeployed, where they can be reassigned and their associated training.

According to AHS, 3,500 of Alberta's 11,000 physicians have responded to the latest redeployment request, indicating they are willing to be contacted by AHS.

For Calgary neurologist Dr. Katie Wiltshire, volunteering to care for COVID patients was the right thing to do.

"I went to medical school to help people.… I have this inherent and strong sense of duty to serve. And that's what I'm going to do," she said.

But the decision is fraught with a host of personal worries.

"I'm fearful of a lot of things. I'm fearful of catching the virus.… I'm fearful of bringing the virus home to my family. I"m fearful of passing it on to our elderly parents who help with child care," she said.

And there are professional concerns, too. Wiltshire says she is confident in the teams working to prepare doctors for redeployment, but the prospect of providing care outside her specialty in the midst of a pandemic is daunting.

"But I"m still fearful that I'm not the best person to be caring for patients with COVID. It's been nearly a decade since I cared for patients whose main concern wasn't neurological. So I'm definitely fearful."

Work to prepare

There is no doubt that health-care providers are battling significant angst as they prepare to take on a growing surge of very sick COVID-19 patients.

"A lot of physicians are concerned," said Moussadji, who believes doctors are growing more comfortable treating people with the virus now that more is known about it.

They're being redeployed — to designated hospital wards and intensive care units — in teams with a specialist in charge to ensure there is built-in support and to protect against over-extending people.

Doctors have been fit tested for the proper personal protective equipment and they're also being offered online education as they prepare to be redeployed.

But health officials are also planning for a time when there simply aren't enough of the designated specialists to act as team leaders.

And they've asked surgeons to step in and set up COVID-19 units if that happens.

"At that point, I would assume we'll have to shut most of our elective procedures down. I don't know if we're going to reach that point," she said.

The next two weeks will very likely determine whether that is a path health officials are forced to take.

"We put our feet down.… We keep doing the work and planning. As long as we're prepared, that's the best we can do. We have phenomenal people working on this and so I have every confidence we can do it," she said.

"Personally speaking, it's scary."