The COVID-19 outbreaks at Foothills Medical Centre, the largest hospital outbreak in terms of sheer numbers to hit Alberta since the start of the pandemic, are taking a devastating toll on heart patients and prompting at least one doctor in southern Alberta to keep less-urgent heart patients closer to home.
According to Alberta Health Services, as of Monday afternoon, six of the eight deaths are connected to outbreaks on cardiac wards at the Foothills hospital and 34 of the 42 infected patients have been on impacted cardiac units.
All five of the visitors who have tested positive are connected with patients on cardiac wards.
As of Monday afternoon a total of 80 patients, staff and visitors had tested positive for COVID-19, and seven units were battling outbreaks, including two cardiac care wards and a cardiac intensive care unit.
Because Foothills hospital has one of just three cardiac catheterization labs in Alberta (the other two are in Edmonton) many heart patients from southern and central Alberta often need to be sent there for diagnostic procedures and specialized treatment.
For years, doctors in both Lethbridge and Red Deer have been calling for their own cardiac catheterization labs so they don't have to send patients to Calgary or Edmonton for potentially life-saving treatment.
And doctors outside of Calgary are now weighing the risks of sending patients who are not in urgent need of care.
Lethbridge cardiologist Dr. Sheila Klassen said a seriously ill patient she helped care for had be sent to Foothills hospital, just before the outbreak was discovered.
"That transfer was medically necessary.," she said. "He required advanced care in Calgary but unfortunately he ended up in the middle of the Foothills outbreak. Sadly that was something that we didn't want to see."
According to Klassen, the man ended up on one of the cardiac wards with an outbreak. He tested positive for COVID-19 and later died of cardiac arrest.
"I don't know whether the cardiac arrest was due to COVID-19 or due to his underlying cardiac disease in absence of COVID-19," she said. "But I am concerned he was a very vulnerable patient in terms of COVID-19 infection. So I"m concerned that COVID-19 may have caused the cardiac arrest."
It's an ongoing worry for doctors and patients in southern Alberta as the pandemic drags on.
There are are only 47 confirmed cases in all of the south zone, while staff inside the walls of Foothills hospital are battling an outbreak that is nearly double that number.
"Throughout the course of COVID-19 over the last few months and certainly during the recent outbreak … there are many patients who are reluctant to travel up to Calgary because of fear of infection and them knowing that they are in a more vulnerable… population in terms of consequences from COVID-19," Klassen said.
When cases aren't urgent, Klassen is finding ways to keep her patients close to home.
"I lean toward a more conservative approach in terms of medical management and local testing just to avoid inter-hospital transfers recently because of COVID-19," she said.
But there are bigger implications to the Foothills hospital outbreaks, according to Klassen.
The outbreaks have underscored the need for services, including cardiac catheterization labs, in Lethbridge and Red Deer.
"The fact that we're deferring these procedures because of location and distance from a [catheterization] lab and because of COVID-19 cases that differ between locations, I think it speaks to again the inequity in access to care for Albertans living in certain areas of the province versus others."
John Church, a health policy expert in the department of political science at the University of Alberta, said the disparity between the healthcare services available in urban and rural Alberta is an ongoing issue and a problem that is very expensive to fix.
"The stress that the system is currently under [due to the pandemic] is highlighting some of these flaws in our system," said Church.
"There is a problem in the province with the distribution of healthcare resources, in particular the south of the province … and the Calgary zone in particular gets way more resources than other parts of the province."
Church said it's a budgetary issue for AHS which decided long ago that certain expensive services — including cardiac catheterization — would be centralized.
"And it's not an ideal situation from the point of view of the patient at all."