'A deep, dark sense of foreboding' as Alberta braces for surge of COVID-19 illness and death

The year 2020 has been already been full of woe, but Dr. Joe Vipond fears the worst is yet to come in Alberta.

The number of patients in hospital with COVID-19 has tripled in the past four weeks, but December, he believes, will bring new levels of suffering, as the current surge in COVID-19 cases translates into more people sick and more people dying.

"There's a deep, dark sense of foreboding," Vipond said of the mood at the Rockyview General Hospital in Calgary, where he works as an emergency room physician.

At last count, Alberta had 13,166 active cases. That's more than any other province, including Quebec, which has twice the population, and Ontario, which has more than three times as many people as Alberta.

Health-care workers who have been tracking the trajectory of the virus are beyond alarmed at the rate of exponential growth through October and into November, Vipond said.

Many have been calling for weeks for a "circuit-breaker" lockdown — relatively short and severe — to slow the spread of the virus.

"The pandemic has begun a slow collapse of our health-care system and time is running out to reverse it," reads a letter signed by more than 300 physicians and sent to Premier Jason Kenney and other senior provincial leaders on Sunday.

"Health-care workers are a finite resource. We cannot continue providing adequate care at this pace."

More hospitalizations on horizon

Roughly 3.5 per cent of Albertans diagnosed with COVID-19 have wound up in hospital so far, Vipond noted, and roughly one per cent have ended up dying.

Do the math on the 1,546 new cases announced Monday alone, he said, and you can expect 54 more hospitalizations and another 15 deaths in several weeks' time — just from a single day's worth of viral spread.

Alberta's chief medical officer of health, Dr. Deena Hinshaw, issued a similar warning when she announced the new cases on Monday.

"We know that hospitalizations typically lag behind the rise in cases by about a week to 10 days," she said.

"So we will, absolutely, expect to see a continuing rise in hospitalizations and ICU cases over the coming two to three weeks. That's something we would expect to see independent of any measures that are introduced."

After delivering those comments, Hinshaw hurried off to meet with members of a cabinet committee to discuss what those new measures might look like. An update is expected Tuesday.

Vipond is frustrated it has taken this long for the government to consider serious countermeasures, as the trajectory of the spread has been consistent — and predictable — for some time.

"We've seen [new-case] doubling times of two weeks for at least six weeks," he said. "You can see people's tweets where they actually calculated it out. And they are bang-on."

Foreseeing death

Malgorzata Gasperowicz is one of those people. She is a developmental biologist and independent researcher who has been tracking Alberta's COVID-19 data closely.

Gasperowicz correctly predicted in October that, given the trajectory in Alberta's COVID-19 spread at the time, the province would be seeing 1,000 new cases per day by mid-November.

Even if Alberta were to be locked down overnight, she says, the province should still expect to see a surge of deaths in the coming weeks from the high number of existing infections.

Compounding the problem is the fact that many of the recent cases have come among older adults, who are typically more vulnerable.

Throughout the pandemic, the number of deaths among Albertans aged 70 and over has been roughly equal to the number of new cases per 100,000 people in this age group, with the deaths lagging about four weeks behind.

The fact this relationship is nearly one-to-one, Gasperowicz said, is a bit of a mathematical coincidence that has to do with the size of Alberta's population. But it allows for data visualization that neatly illustrates the general relationship between daily new cases and daily deaths among older adults in particular.

The animated chart below shows that relationship. The case rate among older adults is indicated by the red line and the number of deaths among this age group is indicated by the black line, which trails behind by four weeks. (The chart runs from March to November.)

New cases vs. deaths among people 70 and older

The way the red line shoots suddenly upward in the past few weeks, Gasperowicz said, is alarming. She sees no reason the lagging black line — indicating deaths — won't continue to follow.

"The more cases we have in this age group, the more deaths we will have, too," she said. "It's pretty scary."

Health minister taking situation 'very seriously'

Health Minister Tyler Shandro said Monday the government is "taking these rising numbers very seriously."

He said senior cabinet ministers would be meeting late Monday and "reviewing that data and reviewing what options are available to us, as a government."

"I am taking it very seriously. We all are, around that table," Shandro said. "We are going to be deliberating [on] the situation and we'll be listening to the advice of Dr. Deena Hinshaw."

He also warned about a looming increase in demand on Alberta's health-care system.

"As we have transmissions rise, so will hospitalizations," he said.

"And that means one less hospital bed for somebody to have their important surgery. So I hope all Albertans listen to that and understand the importance of being able to take all measures and take COVID responsibility throughout the fall and throughout the winter, as we continue to protect ourselves and our health-care workers."