COVID-19 phone lines and virtual clinics aim to relieve burden on Alberta ERs

Primary care networks around the province are working to take pressure off Alberta's stretched emergency rooms and urgent care centres as Alberta's fifth COVID wave continues.

Many have set up their own virtual clinics or COVID-19 phone lines, and there are plans to set up stand-alone COVID clinics if they're needed.

Alberta Health Minister Jason Copping pointed to these initiatives on Jan. 20 as some of the measures being taken to address the strain on the province's acute-care system during the Omicron-driven wave.

The pressure on hospitals has played out differently during this wave with ERs and inpatient wards bearing the brunt of the high transmission rates and record hospitalizations. Family doctors' offices around the province are also seeing high demand.

Dr. Christine Luelo, a Calgary family physician, said the sheer number of people who are sick with COVID — and need medical advice — has skyrocketed with Omicron.

"What's really shifted gears for Omicron is the vast volumes [and] the wonderful benefit of vaccines so that many more patients are minimally symptomatic. But given the past history of the other waves with ICU admissions and such, people are still really just scared. They don't want to make the wrong decision and then realize, 'Oh my gosh, I've waited until it's too late,'" said Luelo, who is also the medical director for the South Calgary Primary Care Network.

"With this latest surge, there's a lot more of a role for primary care in doing that coaching and calming.… Before, I would be talking to one member of a family who is isolating. Now I'm talking to a mom or a dad and everyone in the house is sick, and they all got sick at different times. So there's a new kind of flavour to the counselling we're having to do around isolation and quarantine."

Earlier this month, the South Calgary Primary Care Network, which includes 261 doctors caring for 265,000 patients, launched its dedicated COVID-19 phone line staffed by nurses. It runs from 8 a.m. to 5 p.m. weekdays. Social workers are also available.

Mini Health Link for south Calgary

"It's essentially a mini 811 for south Calgary.… [Patients] can call directly or their doctors can refer them. And they can be followed by a nurse," said the PCN's executive director, Melina Dharma-Wardene.

"They can ask questions about clinical management. They can ask questions about symptoms they're having. The nurse can check in with them at time periods that work for them. And it allows them to recover at home."

The idea is to give people one-to-one health advice and to divert non-urgent patients from overwhelmed emergency rooms and urgent care centres. She said it's also in place to relieve long wait times at Health Link.

With most Albertans no longer eligible for PCR tests, and a scarcity of rapid antigen tests, Dharma-Wardene said they're encouraging people to assume they should be isolating even if their symptoms are mild.

"It reduces the burden on the system from an acute-care perspective, and it also gives them information. And that's essentially what we're finding people need with Omicron. They're looking for a source of information as to what they should do. And our nurses can help them with that."

Similar supports around the province

Many of Alberta's 40 PCNs have similar services in place. People who need in-person care are either sent back to their family doctor or to other in-person clinics.

"Care with [the patient's] family doctor is the safest care that they can get.… But we recognize that not all patients do have family doctors, and those family doctors' offices may be closed because of COVID," said Dr. Ernst Greyvenstein, the physician lead for Calgary zone PCNs and the co-chair for the Primary Care Network COVID response team.

Because patient needs vary around the province, each primary care network in Alberta has a slightly different version of COVID supports, Greyvenstein said.

For example, the North Zone PCNs have worked together to set up a centralized virtual COVID-19 hub, including a toll-free hotline and a web intake form that connects patients with triage nurses.

"If we find — and only if we find — that that capacity is overburdened, then we will start looking at a COVID clinic that would provide a supplementary service," said Greyvenstein.

Alberta Health Services said it is working with PCNs to set up COVID-19 specific clinics around the province.

They'll be designed for people with milder illness or suspected cases — and will be opened if demand gets high enough, the health authority said.

According to Greyvenstein, space is being carved out in the Red Deer Regional Hospital for a stand-alone COVID-19 clinic, should it be needed. Plans are underway in other zones as well.

Alberta's PCN team also created a self-navigation tool to help people understand when they are safe to recover at home and when they may need to seek medical care.