SUNDRE – The COVID-19 pandemic might be over, but the crisis in Alberta’s health-care system “is alive and well,” a local physician said.
Dr. Michelle Warren, who alongside husband Dr. Rob Warren owns and operates the Moose & Squirrel Medical Clinic in Sundre, spoke with the Albertan on Saturday, June 17 about Alberta Health Services’ decision to drop masking requirements in health-care facilities throughout the province.
The World Health Organization downgraded the COVID-19 pandemic earlier in May and declared the virus no longer represented a global health emergency, but nevertheless urged nations to remain vigilant and not let down their guard.
“I think what everybody’s recognized is that the COVID virus is well entrenched into society nowadays,” said Warren, adding it’s become endemic, or in other words, ever-present.
“That’s a distinction that we need to be aware of,” she said.
However, Warren also asserted that equally important of recognition is the fact that measures such as masking, hand washing, maintaining distance or even ideally staying home when feeling ill is “just a smart thing to do no matter what you’re sick with so you’re not spreading the illness to anybody else. In a way, it’s common sense.”
Asked for her thoughts on AHS’s decision to drop last week the masking requirement in health-care centres such as clinics, hospitals, and continuing care facilities and whether she agreed with that course of action, Warren said that to her understanding, the provincial authority responsible for administering the delivery of health care has opted to “leave it up to the patients, the families and the staff as to whether or not they wish to continue to mask.”
However, while no longer having mandates in general public places like malls and movie theatres may be reasonable, health-care facilities provide a service specifically for people who fall ill and thus by default are vectors for the potential spread of diseases not only among patients but also staff.
“There are some situations where – masking mandates aside – you would continue to mask. That would be because the patient is in a tenuous situation and very prone to infection. So, masking will always happen in those situations,” said Warren.
“The biggest concern that I’ve seen is that many patients in health-care facilities – whether it’s the medical clinic or the hospital – aren’t necessarily forthcoming about whether or not they’re ill,” she elaborated.
“A lot of people – because they need to – are going to work when they’re sick. And so, the viruses are spreading,” she added.
Warren, who is also the immediate past president of Alberta Medical Association for 2022-23, said her concerns are twofold.
First off, the physician said that from a personal perspective of preferring not to be ill, especially recognizing the potential long-term impacts of a virus like COVID, she does not herself want to fall sick.
“But the other part is we are so short staffed in health-care facilities nowadays – whether it’s nurses, lab, X-ray, physicians – (that) it doesn’t take many to become ill before all of a sudden you are looking at closures,” she said, adding that a local effort led by the Sundre Hospital Futures Committee, which had originally started as a physician recruitment and retention group, has over the past few years “bent over backwards to prevent” such situations.
But when physicians become sick, they don’t come to work to avoid infecting not only colleagues and staff at the hospital or clinic, but patients as well, she said.
“And the problem is, as the number of physicians has dropped in the community, the number of locums available to cover has dropped across Alberta, and we’re starting to see more and more episodes where we potentially can’t cover (shifts),” she said. “And so my concern moving forward is, short of coming to work ill, we are I think at risk of seeing closures in our own community.”
The physician also confessed a certain lack of clarity in term of what’s expected of doctors in her position who run a practice and in whose absence upwards of 100 patients a day can be affected.
“If I’m unwell, is the expectation that I still come to work? Or is the expectation that no, you should be home. And if so, then what’s the game plan? Because I think we have to have one,” she said.
So the physician reserves a level of concern regarding the potential unintended consequences of AHS’s decision.
“Having lived through the past few years (and) knowing that patients aren’t always forthcoming about whether they’re ill or not when they come in, I think having masking strongly encouraged makes sense,” she said. “Especially if you’re around those that are at risk, whether they’re pregnant patients or newborns, or people with chronic illnesses.”
She also encourages empathy for those who must for medical reasons continue to mask to protect themselves, which includes health-care staff.
“I would like to see respect for those that continue to mask and understanding that they’re continuing to mask not out of fear, but actually out of service to the community so that they can continue to be present to work and to provide care for those others that are out there,” she said.
Over at their clinic, masking will be strongly encouraged but no longer mandatory for patients with the exception of those who are experiencing respiratory symptoms such as cough, cold, fever or runny nose.
“You can do your part to reduce this risk by voluntarily wearing a mask during your time in clinic. Our staff has also been asked to continue to wear a mask while providing care,” reads part of a statement posted on the clinic’s social media.
When the Moose & Squirrel Medical Clinic was built some 10 years ago, the Warrens installed air purifiers that go through HEPA viral filters in all of the exam rooms in recognition that patients who come in sick can potentially transmit a bug to staff.
“We wanted to try and mitigate that as much as possible,” she said, adding they nevertheless will also continue to “strongly recommend” that patients – whether they have symptoms or not – as well as staff, continue masking.
“If the patients elect not to mask, they also acknowledge the providers’ decision to how they want to see that patient. So, it works both ways,” she added.
Warren expressed gratitude to those people in the community who have been so understanding over the past few years of the issues faced, whether coming into clinics in adherence with health measures or having to learn how to do virtual care or waiting to be seen in the emergency room.
“We understand that it’s not fun when you have to come in and wait to be seen and care models are changing,” she said. “But we appreciate you working with us, and understand that we’re doing our best to be there for you and will continue to do so.”
Health-care crisis “alive and well”
Responding to a question about her thoughts on Premier Danielle Smith’s claim in late February that AHS is no longer in crisis, Warren said she could speak to the local situation in Sundre.
“We’ve lost over 50 per cent of our physicians and we’ve had zero new physicians come in the past three years since 2020,” she said. “And that is not because we aren’t actively trying to recruit.”
Warren said she could also speak to physicians in Central Zone, some of whom are making plans to move to B.C. Additionally, many physicians are also changing how they plan to work over the coming years, or whether they even intend to continue working at this point, she said.
“And we’re not training those replacements because we can’t,” she said. “We’ve only got so many seats at medical schools, but we need to have physicians in the field to train the learners. When we lose the teachers, who’s going to teach the new crop?”
Warren disagreed with the premier’s assessment.
“The health-care crisis is very much alive and has not been solved. We’ve made steps towards increasing enrolments in medical schools for nurses. But we haven’t dealt with the immediate crisis, which is how do we retain the physicians we currently have because we’re still losing them,” she said.
“The reality is that the health-care crisis in Alberta is alive and well. And that’s been acknowledged by anybody who’s actually working out there on the front lines.”
