Dr. Debakanta Jena had heard stories from the front lines of Alberta's COVID-19 units, but it wasn't until the Medicine Hat orthopedic surgeon volunteered to work there, at the end of September, that he fully understood.
"The first day I went in, I realized I had been chief of surgery for four years, I've attended many COVID meetings — [I] kind of know what's going on but really did not know until I got into the unit how intense and how soul-crushing the situation was," he said.
That feeling of intensity, according to Jena, was sparked by the volume of patients coming in needing high amounts of oxygen, the pace at which doctors, nurses and other health-care providers were working to care for them and the raw emotion of the front-line staff.
"You could see that they're making quick, real-time decisions that will suddenly change someone's life. Should they go to ICU? Will they survive in ICU? Can the person's goal of care be changed? Can the family come in?" he said.
Jena, who has worked in a supportive role for a handful of shifts on the COVID-19 unit, said he was struck by the pure dedication of his colleagues.
He was also struck by how sick the patients are when they arrive on the unit.
"The last time I probably listened to the lungs is a long time back.… But I absolutely was shocked to know how bad the lungs were damaged, how sick people looked. And the fear in people's eyes. You could see the fear when they came in."
Sheer volume of deaths
Cecilia Incze has seen that fear, too.
As a pediatric intensive care nurse, she was recently redeployed from Alberta Children's Hospital to care for critically ill adults at Calgary's Foothills Hospital.
"The tragic part is seeing the sad stories of how poorly [these patients] recover and how long their stays are in the ICU and [the] volume and numbers of tools and machines and medications that are required to help," she said.
"It's seeing mothers fathers, grandpas, grandparents brothers and sisters who are struggling to recover."
And then there is the sheer volume of deaths.
"It's the continuous, repetitive exposure to seeing individuals pass away — and how quickly it happens. Sometimes you're fighting for someone for two to three weeks until you decide … to take them off the ventilators and seeing if they make it or not. It's hard to repetitively see people die," she said.
It is unclear how many health-care workers have been redeployed in Alberta during the fourth wave.
Alberta Health Services said that number is not tracked centrally since decisions are made at a local level and can change on a daily basis.
"When there is an urgent need for additional staff, staff previously trained are considered first for redeployment," spokesperson James Wood said in a statement emailed to CBC News. He said redeployed staff are provided with orientation and training before they start working in a new environment.
A question of trust
On Ian Hennes's first day in the Medicine Hat intensive care unit, staff were in the process of converting the recovery room — which he often worked in — into an overflow ICU.
Prior to his redeployment in September, the operating room nurse hadn't worked in intensive care since he was a student, nearly 20 years earlier.
"It's a day I'll remember," he said.
"Going patient after patient down the hall from ICU to this new ICU — filling it up with very ill people [who were] all on ventilators.… And then you come back for more patients, and they're already bringing down more patients from the COVID unit to ICU and filling that up as we're emptying it. "
Hennes, who is embracing his redeployment as a time to learn new skills, said staff from all over the hospital — including physical therapists, respiratory therapists and lab staff — are working to save these patients.
Prior to the fourth wave, the ICU would have had one nurse for every patient.
Now, according to Hennes, one ICU nurse cares for several patients with the help of redeployed RNs, who assist with tasks such as preparing, mixing and administering a complex combination of intravenous drugs needed to stabilize ventilated patients.
"They couldn't take care of four or five ventilated patients who need a variety treatments. It's just not possible. So that's where we are be able to be in an assisting role and try to support them so that they don't feel a overwhelmed."
He wants Albertans to know what it's like behind the ICU doors.
"There's a lot of sorrow," he said. "From my few weeks there, more patients have left from passing away than getting better and leaving."
The vast majority of those patients are unvaccinated. And Hennes hopes people will get immunized, follow the rules and start to trust the medical system.
"When people can't breathe and the ambulance comes, they trust the health-care system. They come to us and they want everything that can be done to help them at that point," he said.
"So let's skip that step and be a little bit preventative and trust science and trust the medical community with their recommendations."