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An internal Alberta government document shows the province has been planning for more than a week to set up indoor field hospitals to treat 750 COVID-19 patients.
The Alberta Health Services (AHS) document, dated Nov. 28 and obtained by CBC News, details a draft implementation plan for two or more facilities, with 375 beds each in Calgary and Edmonton for patients with mild-to-moderate symptoms. Patients requiring intensive care would remain in city hospitals.
The document shows health officials met to discuss the plan on Nov. 23.
They then toured major sports facilities at the University of Alberta in Edmonton and the University of Calgary on Nov. 24 — the same day Premier Jason Kenney rejected calls for a provincial lockdown and instead imposed what he referred to as the “minimum restrictions” needed to safeguard the health-care system.
Those restrictions included a ban on all indoor gatherings and a halting in-person classes for students in Grade 7 to 12.
The field hospitals draft plan underscores the severity of the public-health crisis Alberta faces — and provides a sobering sign of where officials believe the trajectory of virus infections could be headed.
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“I think what it tells us is that as early as Nov. 23, the provincial government knew what I think many of us knew: that we were heading for a potential disaster,” said Dr. Noel Gibney, a veteran Edmonton critical-care doctor who has publicly criticized the government’s pandemic response.
“It is a little bit like somebody driving towards a cliff and instead of applying the brakes, going over and then phoning 9-1-1 as they are heading to the bottom.”
Alberta continues to set new daily COVID-19 infection records and leads the country in the number of active cases per capita. It has also sometimes led the country in total active cases. On Tuesday, there were 16,628 active cases in Alberta, compared to 14,524 in Ontario — a province with more than three times as many people.
The province on Wednesday reported 1,685 new cases. Alberta has reported more than 1,000 cases each day for nearly two weeks.
Premier calls federal request ‘sign of responsible planning’
Also on Wednesday, CBC News reported a federal source said Alberta has informally asked the Trudeau government and the Red Cross to supply field hospitals to help offset the strain COVID-19 is having on the province’s health-care system.
Alberta Health Minister Tyler Shandro was scheduled to meet with his federal counterpart Patty Hajdu on Wednesday to discuss the field-hospital request and other potential pandemic supports.
The federal source said Alberta would likely receive at least four field hospitals — two from the Red Cross and another two from the federal government.
They said there was no request for people to staff the hospitals and no request for military support.
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The internal Alberta health document discusses housing patients in large indoor recreation centres whose wide-open floor plans were deemed ideal for staffing purposes.
The greatest challenge to making the hospitals operational by December or late January would be staffing, and the document references potentially calling in the military to assist.
At a press conference Wednesday, Kenney dismissed a suggestion that his province’s federal requests for support indicate it has failed to manage the pandemic effectively.
“No, I think it is a sign of responsible planning on our part for [a] potential extreme scenario,” Kenney said.
“The reality is we have and can continue to create capacity as we expect, quite bluntly, the hospitalization numbers to go up, given the new cases in the last few weeks,” he said.
WATCH | Alberta asked for field hospitals from Ottawa and Red Cross:
Alberta asks Ottawa and the Red Cross for field hospitals15 hours agoVideo
2:42
The Alberta government is in talks with Ottawa and the Canadian Red Cross for help in setting up field hospitals, as the number of COVID-19 patients continues to surge. 2:42
But the premier said Alberta’s current number of COVID-19 hospitalizations shows “that we are not anywhere at the point of having to call on that kind of overflow capacity.”
There were 504 people in hospital and 97 in ICUs in Alberta on Wednesday. A total of 561 people in the province have died from the disease since the start of the pandemic.
Document lists three possible locations
The Alberta health document shows officials narrowed the possible field hospital sites down to three potential locations:
The University of Calgary Olympic Oval (Calgary) — potential capacity of 375 patients;
The University of Alberta Butterdome (Edmonton) — potential capacity of 288 patients;
The Saville Community Sports Centre (Edmonton) — potential capacity of 375 patients.
“These sites were selected because they have the largest potential patient capacity, allowing maximized use of staffing in one location,” the draft plan says.
Three options are outlined for securing the necessary infrastructure for the hospitals, which are to:
Order a Canadian Red Cross “Health Emergency Response Unit,” a modular structure that can be set up in various configurations indoors. Under this option, there are 150 beds available for deployment in as little as three days, the document states. The cost is more than $5.1 million per 100 beds, with some additional associated costs;
Order a “Mobile Health Unit” from the Public Health Agency of Canada (PHAC). Like the Red Cross option, it is a modular structure that can be erected indoors in various ways. The document says there are 200 beds available for deployment in about three weeks. The cost: $7.5 million to $15 million per 100 beds, likely on the lower end of that estimate;
Have AHS purchase the beds and other equipment and infrastructure. The timeline for procurement would depend on availability, and the cost for the initial purchases would be about $1.4 million for every 100 beds.
In a series of social media posts Wednesday night, AHS said it had no current plans to open these additional beds, “however it is vital we have the required agreements in place with our external partners should we need them.”
“Throughout our response to the COVID-19 pandemic, AHS has proactively planned for all scenarios and ensured we have access to all resources available, both within and external to the organization,” the posts said.
Province considering asking for military support
The document recommends a “phased approach” that would create 350 beds — 150 in Edmonton, 200 in Calgary — by late January at the latest.
An additional 400 beds (225 in Edmonton, 175 in Calgary) would then be deployed as needed between January and March of next year.
The Nov. 28 draft plan states the provincial government is exploring asking for military support to help staff the field hospitals.
“Staffing is expected to be the area of greatest need in terms of operationalizing these alternate care centres,” it says.
“Neither ready-to-deploy field hospital model includes any ongoing clinical/operational staffing — AHS would be expected to provide this.
“Further exploration of staffing options (including military) is in progress.”
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The field hospitals would have hubs of 48 to 52 beds, the document states. About 55 staff would be required for each hub on every shift.
The facilities would only admit patients with mild to moderate COVID-19 symptoms who cannot be supported in their home or have risk factors that require observations when acute-care inpatient beds are not available.
Patients would also be admitted who are recovering from acute care admissions and still require limited support.
WATCH | An intensive care physcian speaks out against strategy
Intensive care doctor decries prospect of field hospitals in Alberta3 hours agoVideo
6:03
‘This is damage control,’ said Dr. Darren Markland, an intensive care physician in Edmonton, speaking about an internal government draft plan to treat 750 COVID-19 patients in field hospitals. 6:03
Logistical challenges
The document also outlines logistical challenges. For example, none of the three proposed sites have adequate toilet, shower, and handwashing facilities for the expected patient volume.
There also is the challenge of running oxygen through facilities not created for that purpose.
“Oxygen supply is an area of major concern both from a feasibility perspective and a safety perspective in relation to running extensive oxygen infrastructure through a temporary facility,” it states.
Alberta Premier Jason Kenney dismissed a suggestion that his province’s federal requests for support indicate it has failed to manage the pandemic effectively. (The Canadian Press/Todd Korol)
The document lists four “next steps” for Alberta officials.
The first is to deploy the Red Cross’ modular structure to the Saville Centre in Edmonton where it would create 150 beds. The second is to deploy the PHAC structure to the Olympic Oval in Calgary, which would create 200 beds initially.
These tented structures would be ideal for the environment of both facilities, since there are temperature control issues at these sites, the document shows.
AHS would then proceed with a locally-built option in the Butterdome. That would supply as many as 225 beds on an as-needed basis, the document states.
Finally, the province could request an additional deployment from the federal public health agency for up to 175 additional beds in Calgary.
Gibney said the field hospital planning is sensible due diligence planning, but he said the government has clearly not told the public the degree of risk they are now facing while continuing with policies that downplay the risk.
“On one hand, we are having provincial planning at a disaster level or for an upcoming disaster,” he said.
“And on the other hand, we are being told everything is fine.”
