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Canada Doctors express increased frustration with Sask. government COVID response

14:26  23 october  2021
14:26  23 october  2021 Source:   cbc.ca

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Premier Scott Moe's handling of the fourth wave of the pandemic has garnered pointed criticism from doctors and pleas from health-care groups to bring in more measures to combat the COVID-19 situation in the province. © Matthew Howard/CBC News Premier Scott Moe's handling of the fourth wave of the pandemic has garnered pointed criticism from doctors and pleas from health-care groups to bring in more measures to combat the COVID-19 situation in the province.

As Saskatchewan battles to control the rising number of COVID-19 cases, which have forced it to send ICU patients to Ontario, doctors and medical professionals across the country are calling for more to be done to help stop the health-care crisis in the province.

The situation is so bad that Dr. Saqib Shahab, Saskatchewan's chief medical health officer, broke down in tears this week and Dr. Hassan Masri, an ICU physician in Saskatoon, said he no longer trusts the provincial government.

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And despite plans, announced on Friday, to send up to four ICU patients a day thousands of kilometres away for care, Premier Scott Moe's government has so far refused to implement additional health measures to prevent the situation from getting worse.

Instead, Moe told the Saskatoon Star-Phoenix on Wednesday, that health measures like a gathering restriction, proposed by doctors, are a "blunt" tool.

For his part, Shahab said on Friday that he's recommending people meet with "small, consistent groups," because about 70 per cent of transmissions are from household or small, informal gatherings. He said the government would "monitor closely" the areas where the other 30 per cent of transmissions are occurring.

Doctors have also called for Moe to request federal support on the ground. On Friday night, Prime Minister Justin Trudeau tweeted that members of the Canadian Armed Forces would be deployed to Saskatchewan.

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"We're going to make sure people across the country have the support they need to stay safe. Saskatchewanians, we've got your back," Trudeau said.

Deadly days

Saskatchewan health officials reported 12 newCOVID-19-related deaths on Friday, making it the third-deadliest day the province has seen since the start of the pandemic. In total, 308 people are currently hospitalized with the illness in the province.

During the fourth wave, Saskatchewan's physicians have become more outspoken and critical of the premier and Health Minister Paul Merriman's handling of the pandemic.

And they're not alone. The Saskatchewan Medical Association, the Canadian Medical Association (CMA) and physicians in other provinces have levied criticism at the government too.

The province made international headlines with Reuters and The Guardian reporting on Shahab's emotional plea during a media briefing Wednesday, as Saskatchewan continues to lead all provinces in death and case rates.

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At a physicians' town hall on Thursday night, the Saskatchewan Health Authority shared a slide showing Saskatchewan's ICU admissions are, on a per capita basis, the highest of any province at any point in the pandemic. There were 6.6 ICU admissions per 100,000 people as of Oct. 19.

Still, the provincial government has resisted the calls from its own health-care workers and the CMA to enact further health measures. It's expected that the issues will be raised once the fall legislative sitting resumes, following the speech from the throne on Oct. 27.

Modelling leads Shahab to tears

The modelling shared by Shahab Wednesday showed that even if booster shots are made available to more people, if current behaviour persists, the number of Saskatchewan COVID-19 patients in ICUs could reach well over 200 by Jan. 1.

Over the last eight weeks, Saskatchewan has set and broken ICU admission records. The number of patients with COVID-19 in ICU has exceeded 79, which is the total number of ICU beds normally available. The province has increased the number of ICU beds and redeployed staff to care for the patients with COVID and other health issues in ICU.

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According to the physicians' town hall presentation, a total ICU bed-load of 116 triggers the decision to move patients out of province, something that began happening this week.

"We've always worked hard and we've pulled together and it's been a divisive time many times," Shahab said Wednesday, his voice breaking. "In the past, there's [been a] mention that: 'Dr. Shahab just pleads to the public and he doesn't direct an order,' but I have no shame in pleading to the public.

"We've gone so far. We just have to pull along for the next few weeks or months."

Shahab was asked if he was OK and he responded: "All the evidence is out there. It is very distressing to see unvaccinated, young, healthy people ending up in ICU and dying. I'm watching this from a distance, but the pressure this puts.… We talk about doctor burnout. To see young lives lost to a vaccine-preventable disease — how can we accept this?"

So far in October, 117 people have died — making the month the second deadliest of the pandemic. In January 2021, 151 people died.

Moe defends government approach

Premier Moe did several media interviews this week but has not implemented additional health measures called for by doctors and the Opposition.

The main request is for gathering restrictions to be implemented — something the province's own recent modelling suggests is needed to bend the curve of COVID-19.

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Moe told the CBC on Tuesday, the province could have moved a few days sooner in implementing masking and vaccination policies. Mandatory masking was introduced on Sept. 17 and vaccination polices came into effect on Oct. 1.

When asked why he had not apologized for the government's handling of the pandemic, Moe replied: "I am sorry that we have experienced those [health-care] slowdowns here in the province."

To deal with the fourth wave, the government has redeployed hundreds of health-care workers, which has resulted in cancelled surgeries, procedures, and other services.

Moe pointed to declining daily cases as evidence that things are heading in a more positive direction.

Since Sept. 2, Saskatchewan's the test positivity rate has remained at or above 10 per cent. Shahab said nearly 50 per cent of people showing up in hospital are testing positive for the first time upon arrival — indicating many cases are going undetected.

Patient transfer criticism

On Monday, Moe held an impromptu press conference.

He announced what had been shared on social media by Toronto physician Dr. Michael Warner, that Ontario would be taking six Saskatchewan ICU patients.

The transfer issue got muddier Wednesday when Warner, medical director of critical care at Michael Garron Hospital in Toronto, tweeted the Saskatchewan government cancelled transfers beyond the six already announced.

After physicians were told ICU patients expected to be part of a second airlift to Ontario were no longer going on Wednesday, Saskatoon ICU physician Dr. Masri tweeted he held Moe "personally responsible for the death that is going to happen in the next few days."

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"The premier has decided to cancel all transfers out of province after today. This is going to lead to an immense amount of tragedy. This premier has lost my trust. Unbelievable."

Masri has been one of the most visible voices of concern among health-care workers. Early on, the government used him in its "Stick it to COVID" vaccination campaign.

On Thursday, the province confirmed three additional patients would be heading to Ontario by Sunday. It said Friday, between two and four patients per day would be transferred to Ontario in the upcoming days.

The government released a statement on Thursday in response to questions about patient transfers saying confirmation would come through "official channels."

"All other sources, such as unofficial and unverified social media posts should be disregarded."

Masri tweeted Thursday: "No amount of political spinning can change the fact that things were cancelled yesterday for politics and ego related reasons. This decision by the government was reckless and certainly it was harmful to the care of our citizens and patients.

"The government knows that transferring patients is the right thing to do and the only way to avoid death on a large scale in Saskatchewan."

'Full-blown crisis'

The CMA, Canada's largest association of medical doctors with more than 75,000 members, released a statement on Thursday calling for the Saskatchewan government to: "reinstate strict public measures, as recommended by medical experts, to protect the people of Saskatchewan. Any further delays are simply not acceptable."

CMA President Dr. Katharine Smart, a Saskatchewan-born-and-raised physician who is now based in Whitehorse, called the modelling released by Shahab "alarming and heartbreaking."

"It is time to stop asking nicely," Smart said.

Saskatchewan Medical Association (SMA) President Dr. Eben Strydom called the state of Saskatchewan's health-care system a "full-blown crisis" on Thursday.

Last month, the SMA and the Saskatchewan Union of Nurses had called for indoor and outdoor gathering limits.

"We are not asking for a lockdown," Strydom said on Sept. 29. "We are asking for a temporary measure during the present health crisis."

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