What happens to N.W.T. patients if Alberta hospitals are overwhelmed? 

On Oct. 28, doctors from the Edmonton Zone Medical Staff Association wrote an open letter warning the local health-care system was at a "tipping point," citing record-high COVID-19 case counts and hospitalization rates. 

That was almost a week before Alberta's chief medical officer of health announced that 2,268 cases had been logged in the previous four days, and said the province was at a "critical juncture." 

The situation in Alberta is still not as dire as it is in Manitoba, where hundreds of doctors have warned that the health-care system is strained. 

Manitoba's rising caseload prompted a warning from the Nunavut government on Oct. 31 that scheduled medical travel for people in the Kivalliq region, who rely on Manitoba medical services, could be affected. The health department said staff would review all scheduled travel and notify individual patients about possible cancellations. 

Though the number of cases is higher in Alberta, it has more than three times the population of Manitoba, fewer COVID-19 cases per capita, and more health care available generally.  

People in the territories rely heavily on Alberta for health care. 

In addition to scheduled medical appointments, data from the Canadian Institute for Health Information shows that in 2019-20, N.W.T. residents were admitted to hospital overnight in Alberta's Edmonton zone 955 times. The previous year, that number was 1,004. Both numbers are a tally of "acute inpatient hospitalizations," or hospital stays that were not scheduled ahead of time, and can include patients who were admitted more than once.

In addition, N.W.T. patients received 522 day surgeries in Alberta's Edmonton zone in 2019-20, and 721 the previous year. 

Urgent services a priority

The N.W.T. Health and Social Services Authority (NTHSSA) has a longstanding agreement with Alberta in which N.W.T. residents are considered equal to Alberta residents in terms of access to services. 

"[Alberta Health Services] has confirmed that this relationship will continue to be honoured as we move through the evolving pandemic situation," authority spokesperson David Maguire said in an email. 

Maguire also said the authority has been closely monitoring the situation as cases have "escalated in recent weeks." 

"The NTHSSA remains in close contact with counterparts in Alberta, as recently as last Friday [Oct. 30], and to date they have not advised of cancellations or reductions in booking of elective appointments or procedures or access to emergency care services," Maguire said. 

Virtual care is already being used whenever possible, he added. 

"Urgent critical services will always be a priority," said the N.W.T.'s Chief Public Health Officer Dr. Kami Kandola in response to a question about out-of-territory care during a weekly COVID-19 briefing with reporters Wednesday. 

In a call-in show on CBC's The Trailbreaker Thursday morning, territorial medical director Dr. Sarah Cook noted that not all doctors of clinics in Alberta know about the special relationship with the N.W.T., and that some northern patients have received calls about cancelled appointments, and been told they're being cancelled partly because they live outside of the province. 

"If that happens it's really important that you contact your health care provider here in the N.W.T. so that we can navigate that for you," Cook said. "It is really important for everyone in the N.W.T. to understand that we do have a formal relationship with Alberta." 

Planning for the worst

The N.W.T.'s COVID-19 pandemic response plan operates on the explicit assumption that "the ability for Alberta to accept patients for transfer may be limited." 

The plan envisions preparing to activate "external resources," such as field hospital supports, once about half of the 24 COVID-19 inpatient beds at Stanton Territorial Hospital are full. 

Throughout the plan, it emphasizes efforts to "flatten the curve" to prevent the widespread illness. 

Dr. Deena Hinshaw, Alberta's chief medical officer of health, has also offered assurances that health services will remain available and accessible. 

"While COVID[-19] has consumed much of our attention in our lives, we must not forget that babies are still being born, accidents are still occurring, and Albertans continue to experience a wide range of urgent health needs," Hinshaw said Tuesday.

"Our top priority is protecting the health system to ensure that COVID-19 does not threaten our ability to provide the essential care that Albertans require for all their health issues."