Letter to Albertans from the Alberta Medical Association Section of Intensive Care:

Dear People of Alberta,

We remain on the verge of a health system collapse in Alberta. We are writing this letter because we
believe you are entitled to understand the implications of the decisions made on your behalf by the
Government of Alberta. During each wave of the pandemic, there has been significant strain on our
hospitals and their Intensive Care Units (ICUs). As Intensive Care Physicians, it is our duty to ensure that
we continue to help the critically ill at any time and any place within our province. Unfortunately, our
ability to equitably provide Intensive Care to all Albertans remains under threat. Last week, we as
Intensive Care Physicians from across the province of Alberta met and we would like to share with you
our thoughts and concerns.

Currently Alberta ICUs are running at well over 150% of normal capacity (https://bit.ly/3kcq636). Demand
is driven by critically ill patients with COVID-19. We have responded aggressively by working with Alberta
Health Services (AHS) to increase our provincial ICU beds. To achieve this, AHS made the difficult decision
to divert workers from other areas of our health care system. This comes with major consequences, such
as postponement of surgeries, important diagnostic tests and treatments. Given the magnitude of
disruptions, this very well may have already impacted you or one of your loved ones. Given the
unrelenting pace of infections, it is unclear when these postponements will cease. The impact of this on
the health of Albertans will be profound and long lasting.

ICU care requires many resources, but perhaps the most important is our multidisciplinary team made up
of specialized doctors, nurses, respiratory therapists and allied health workers. Although diverting
workers can provide some additional staffing, there are insufficient numbers of these specialized team
members to care for the increasing numbers of ICU patients. The demand for ICU nurses is currently so
high that we need to increase the number of patients assigned to each nurse. This reduction in staffing
ratio is well below our normal standard of care. This will jeopardize the quality of ICU care that we are
able to provide. If this continues, patients may need to be transported out of the province. In a worst-
case scenario, this could result in the need to activate the pandemic TRIAGE protocol
(https://bit.ly/3nwMN4e), where some Albertans would be restricted from receiving potentially life-
saving therapies. The pandemic triage scenario is one that we believe no one in Alberta ever wants to see
happen. We are closer to this reality than we have ever been before.

How can we stop this before it is too late?

In the short term, we need to reduce the spread of COVID-19. We agree with the Government of Alberta
and the data presented at last week’s press conference. We fully support the decision to implement
proven and effective public health measures. As Albertans, we are strong and resilient, and our sense of
community is powerful. Working together, we have controlled the first three waves of the COVID-19
pandemic. Although the strategy taken by Dr. Hinshaw and our Government over the summer did not
turn out as intended, we cannot make a similar mistake again. This will require Government and Public
Health officials to continue to monitor the current situation and quickly escalate public health measures
when it becomes clear that the current measures are insufficient. Neglecting the timely implementation

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of appropriate measures will allow COVID-19 infections to continue to rise and ultimately result in our
health care system being completely overwhelmed.

We also want to reinforce that in addition to the implementation of public health measures, we need to
prevent the transmission of COVID-19 over the long term. It is clear from the fourth wave that the
unvaccinated are at a much greater risk of requiring hospitalization and ICU care. We applaud those
Albertans who had the courage to be vaccinated to not only protect themselves, but to also protect those
around them. If vaccination rates were higher, we could prevent our emergency departments, hospital
wards and ICUs from being overrun. If more Albertans choose vaccination, our operating rooms will run,
and we will be able to provide those important tests, surgeries and treatments that are currently
postponed.

For those contemplating vaccination, we encourage you to discuss this with your health care providers.
We acknowledge that there can be fear of the vaccine, however we do not want to meet you in one of
our ICUs with a disease that is preventable. Vaccination is a safe and key strategy to improve both COVID-
19 and non-COVID care. We support our Government’s approach to increase vaccination rates with
proven methods, similar to other successful Canadian jurisdictions (https://bit.ly/3nJNC9I).

We have been and remain here for you

As ICU physicians, we are committed to doing our best for all Albertans who require our care. We remain
strong and vocal advocates for our patients and our communities. We continue to work closely with AHS
to make all efforts to ensure an ICU bed is available for anyone who needs one. We applaud our
community and business leaders for making changes to conduct business in a manner that helps keep the
people of Alberta safe.

Unfortunately, despite all this, we still need your help. The time to act is now. If we continue on this path,
the demand for ICU will soon outstrip our capacity. As Albertans, there are many ways that you can help.
First, advocate to our provincial leaders to continue to control the spread of COVID-19 through public
health measures. Second, although, we recognize that the majority of Albertans have been vaccinated,
support others to get vaccinated if they can. Third, follow public health measures and continue to wear
masks where appropriate, wash your hands, stay home if sick and follow public health guidelines –
especially if you have symptoms of COVID-19. We still have the opportunity to prevent this crisis from
becoming any worse.

For our politicians, we ask that you continue to focus on working together – independent of your political
ideologies – at this difficult time to help lead our province through this unprecedented challenge.

We believe it is not too late to change course. By continuing to support public health measures, together
we will save the lives of many of our fellow Albertans.

Sincerely,

The Alberta Society of Intensive Care Physicians

The AMA Section of Intensive Care

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Dr. Clint Torok-Both, President, AMA Section of
Intensive Care
Dr. Ken Parhar, Vice-President and President
Elect, AMA Section of Intensive Care
Dr. Luc Berthiaume, Past President, AMA Section
of Intensive Care
Dr Dan Zuege, Calgary
Dr Shelley Duggan, Edmonton
Dr. Kevin Solverson, Calgary
Dr. Brian Buchanan, Edmonton
Dr. John Kortbeek, Calgary
Dr. Stefan Edgington, Calgary
Dr. Rachel Jeong, Calgary
Dr. Alexandra Barriault, Calgary
Dr. Jason Lord, Calgary
Dr. Natalia Jaworska, Calgary
Dr. Jason Waechter, Calgary
Dr. Michael Dunham, Calgary
Dr. Richard Novick, Calgary
Dr. Lee Oviatt, Lethbridge
Dr. Juan Posadas, Calgary
Dr. Brent Winston, Calgary
Dr. George Alvarez, Calgary
Dr. Tom Stelfox, Calgary
Dr. Paul McBeth, Calgary
Dr. Dan Niven, Calgary
Dr. Jessica Wang, Calgary
Dr. Brandon Hisey, Calgary
Dr. Tavish Barnes, Lethbridge
Dr. Selena Au, Calgary
Dr. Sean Spence, Lethbridge
Dr. Julie Kromm, Calgary
Dr. Derek Townsend, Edmonton
Dr. Elizabeth Rokosh, Edmonton
Dr. Hugo Bertozzi, Grande Prairie
Dr. Vincent Lau, Edmonton
Dr. Matthew Simmonds, Edmonton
Dr. Rachel Khadaroo, Edmonton
Dr. Mark Heule, Edmonton
Dr. Jon Davidow, Edmonton
Dr. Sandy Widder, Edmonton
Dr. Dat Chin, Edmonton
Dr. Pierre-Marc Villeneuve, Edmonton
Dr. Constantine Karvellas, Edmonton
Dr. Darren Markland, Edmonton
Dr. Dennis Djogovic, Edmonton
Dr. Michael Meier, Edmonton
Dr. Jocelyn Slemko, Edmonton
Dr. Andre Ferland, Calgary
Dr. Sean Norris, Edmonton
Dr. Erika Macintyre, Edmonton
Dr. Neil Gibson, Edmonton
Dr. J.D. Maetheson, Edmonton
Dr. Allen Liu, Edmonton
Dr. William Murtha, Edmonton
Dr. Monica Henry, Edmonton
Dr. Sean Van Diepen, Edmonton
Dr. Andrea Robinson, Edmonton
Dr. Dominic Carney, Edmonton
Dr. Peter Brindley, Edmonton
Dr. Jonathan Gaudet, Calgary