Western provinces driving Canada's 4th COVID-19 wave as physicians warn cases 'out of control'

Canada's western provinces are largely driving the country's fourth wave of COVID-19 cases, and physicians are now raising the alarm — saying lax and late public health measures helped spark a rise in serious infections that's already putting pressure on hospitals and impacting patient care.

In British Columbia, Alberta and Saskatchewan, infection rates are high above the country's average and far beyond every province to the east, including Ontario, whose population is larger than all three westernmost provinces combined.

The rate of cases in the last seven days in B.C. was 93 per 100,000 people as of Aug. 30, federal data shows, with Alberta's rate at 159 and Saskatchewan's at 135 — with no province to the east hitting more than 43.

In terms of raw case growth, Alberta currently has the most new infections in the country, with more than 7,000 cases reported in one week.

The province is now in the early stages of postponing surgeries and transferring patients to help boost capacity, but it has yet to reinstate major public health measures or bring in a vaccine mandate to curb case growth as the fast-spreading delta variant surges across much of the country.

"Things are going very poorly. They're only going to get worse," said Dr. Ilan Schwartz, an infectious diseases clinician and researcher at the University of Alberta in Edmonton.

"And the time for intervention was yesterday — or realistically, weeks ago — and if nothing is done, it's only going to continue to spiral out of control."

Active COVID-19 cases by province & territory

400-plus Albertans in hospital with COVID-19

In Alberta, it's growing clear that rising vaccination rates couldn't ward off a spike in serious infections driven by the delta variant — largely among unvaccinated residents — that are now putting pressure on the province's hospitals.

There are currently more than 400 people being treated in hospital for COVID-19, including 98 in intensive care beds. Provincial data shows that all but two of those severe ICU cases are among people who aren't fully vaccinated.

"We're going to see the exact same thing we saw in the winter of last year, which is hospitals are filling up, ICUs are filling up, and it's going to lead to a number of consequences," Schwartz said.

On Sunday, Alberta Health Services transferred six patients out of one Grande Prairie hospital to neighbouring facilities due to an increase in COVID-19 patients requiring acute care.

Just two days earlier, the health authority announced it was taking steps to boost acute and ICU capacity in the province's hospital system — which would mean postponing some non-urgent surgeries and procedures.

Dr. Aisha Mirza, who works in the emergency department at Grey Nuns Community Hospital in Edmonton, recently told CBC's As It Happens that her facility is among those already feeling the impact of rising infection rates among mostly unvaccinated Albertans.

"People are in the waiting room way too long. That's not normal. I'm showing up to a shift and hearing that there are five nurses short," she said.

"Now, I don't know if that's because they're sick, they're leaving the province, they're leaving acute care in general or they're just burned out. But we're short — and now we don't have beds to use for those patients that are in the waiting room."

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Sask. hospitals on cusp of 'getting crushed'

Alberta officials said in mid-August that due to higher-than-expected hospitalizations, the province would be hitting pause on its polarizing decision to lift further public health measures.

But at this point, there's no provincial mask mandate in place, and Schwartz said there are "no signs" the province plans to implement one or put in place other restrictions, such as a vaccine passport, to try to curb case growth.

"Albertans have really been left on their own and also left in the dark," he said.

"I think those who aren't at the hospitals, in the ICUs, seeing this in front of their eyes are going to be surprised — and they're going to think this is something that happened really suddenly, but of course that's not the case. This is happening in painful slow motion."

It's a similar situation in Saskatchewan, said Regina-based infectious diseases specialist Dr. Alexander Wong, where public health measures remain lifted while cases are spiking — with more than 110 people now in hospital for COVID-19 across the province.

"We're literally on the cusp of our hospitals and ICUs getting crushed," he warned.

As of Monday morning, ICUs at hospitals in three Saskatchewan cities were full, which could be because of rising COVID-19 cases, said Dr. Jeffrey Betcher, critical care lead with the Saskatchewan Health Authority.

Local hospitals simply don't have the space or staff to juggle both a surge of serious COVID-19 infections and everyone else who needs care, Wong said.

"It's a perfect storm now. Everyone is burned out, tired, we can't find staff.... It's not like it was last March, when all the elective stuff stopped."

B.C. bringing in mask mandate, vaccine passport

A combination of measures is required to beat back this delta-driven wave, Wong said, including boosting vaccination rates, wearing masks, physical distancing and avoiding large gatherings.

Physicians in Saskatchewan are calling for the return of public health measures and the creation of vaccine passports to access certain businesses — but so far, the province is holding off.

On Monday, Premier Scott Moe called the notion of a government-mandated vaccine passport "heavy handed," instead saying he backs businesses launching their own programs.

Meanwhile, in B.C., where there are more active cases reported than in either Ontario or Quebec, officials are taking major steps toward tighter restrictions.

The province is bringing back a mask mandate in public places and at events, and it's implementing a strict vaccine passport program that will prove the holder's immunization status.

"Neither of those things are going to be immediately effective," said Dr. Srinivas Murthy, an infectious diseases specialist and clinical associate professor in pediatrics at the University of British Columbia in Vancouver.

"I think we have some challenges with the timing of our interventions, like letting loose of the mask mandates earlier in the summer, then reinstituting them."

So is it all too little, too late? That's the fear now — that any measures taken at this point, as cases are surging across Western Canada, won't prevent many of the serious infections expected in the weeks ahead.

Even B.C. officials themselves acknowledged during a Tuesday modelling presentation that the more likely scenario is a plateauing of cases and hospitalizations in that province, or even a slight increase, rather than a dramatic drop in reported infections.

B.C.'s provincial health officer, Dr. Bonnie Henry, and Health Minister Adrian Dix also said that in order to bring down case counts and hospitalizations before October, the vaccination rate will need to increase by an average of seven per cent across all age groups.

"We're kind of getting to the desperation phase," Wong said. "It hasn't come remotely close to when it's going to be at its very worst."