Saskatchewan government emails warned of health-care collapse ahead of COVID patient transfer
Dr. Saqib Shahab’s voice caught in his throat on an October day in 2021 as he pleaded, again, for people in Saskatchewan to help stop COVID-19 from spreading out of control.
“We’ve gone so far, and we just have to go along for the next few weeks and months. And it is distressing to see what is happening in our ICUs and hospitals,” Shahab said, as he suppressed sobs.
He apologized for crying before continuing, but still struggled to stay calm.
“To see young lives lost through a vaccine-prevented disease – how can we accept this?”
Shahab is the province’s top doctor. As Saskatchewan’s chief medical health officer, it is his role to provide information and advice to the provincial government.
This outburst, on October 20, 2021, came two days after the province began transferring patients to Ontario for treatment for COVID-19.
Read more: Shaping Saskatchewan: Saqib Shahab
Saskatchewan’s own hospitals couldn’t accept any more patients. The ICUs were simply overwhelmed with people struggling to survive the deadly Delta variant.
For months, Shahab had publicly asked, wished for and begged the public to wear masks, to stay home and to get vaccinated so they and others could be safe.
It hadn’t worked. By the fall of 2021 Saskatchewan had the highest new case rates and, later, the highest death rates in the country.
And Shahab had warned the government it would happen.
Using a freedom of information request, Global News obtained internal government messages that show Shahab told provincial leaders the health-care system would be overwhelmed more than a month before patients were transferred to Ontario.
A note from Tuesday, Sept. 7, states “provincial vaccination coverage (two dose 69%) is insufficient to prevent acute care collapse in the absence of province-wide and targeted local measures to blunt the spread.”
An email from a health ministry official, sent at 8:06 a.m. on the same day, states the note “went over to the Minister’s office on the weekend and will be briefed on Tuesday.”
Health Minister Paul Merriman did not respond to multiple interview requests for this story.
In a statement, the health ministry said the measures it implemented during the fall of 2021 “were proportionate and helped reduce pressures on the acute care system.”
“Our goal has always been to put the tools needed to protect lives into the hands of the Saskatchewan people,” it said.
Dr. Alex Wong, an infectious disease physician in Regina who treats COVID-19 patients, said he has no doubt stronger public health measures would have saved lives.
“There was a lot of pain and death and suffering that probably didn’t need to happen,” he said.
During the first waves of the pandemic he repeatedly called for the Saskatchewan government to do something to try to stem the crushing number of patients he and his coworkers were scrambling to treat.
“We knew that unless we did something to kind of stem the tide, (hospitals were) just going to overflow and it was just going to be a matter of time,” he said.
When speaking to Global News, he said he didn’t want to blame political leaders — that he knows the decisions they faced were both complex and complicated.
But he said he wants to know why the government didn’t heed the advice every other province followed earlier.
Saskatchewan was the first province to remove all COVID-19 restrictions.
After July 11, 2021, there was no legal requirement to isolate if you had contracted the deadly disease.
By Aug. 11, 2021, Shahab’s briefing notes warned “transmission is increasing,” and that “exposures are happening at private homes, and superspreading events at large public gatherings such as weddings, social gatherings and nightclubs.”
On Aug. 26, 2021 the notes state the province was experiencing “exponential growth” in the virus, that the number of COVID-infected non-ICU hospitalized people grew 65 per cent in the previous two weeks and that the COVID ICU census increased 27 per cent in the previous two weeks.
The same notes state other provinces were incentivizing vaccination by signaling proof of vaccination would be required to access non-essential services and that many either kept or reinstated mask mandates.
“Caution exists by provinces to interrupt economic activity; yet high case rates, high hospitalization rates, sick employees, sick children all affect the economy,” they state.
Three weeks later, on Sept. 16, Premier Scott Moe announced the province was implementing a mask mandate the next day.
He also announced the province would require proof of vaccination or a recent negative COVID-19 test to enter public buildings, restaurants and gyms — but not retail businesses, weddings and funerals, as of Oct. 1.
Notes from Shahab’s team from that same day state that having 70 per cent vaccination coverage wouldn’t prevent acute care collapse.
The province’s original goal for reopening in July was having 70 per cent of eligible people double vaccinated.
It reached that number after July 11.
The province lifted restrictions a few points short of 70 per cent, with Merriman saying at the time it made sense to lift all restrictions at once.
The briefing notes also contain charts that show statistics and restrictions in other provinces.
On Sept. 17 Saskatchewan’s new case rate was 35.3 per 100,000 people. Alberta had the next highest, with 34.8. B.C. followed with 13.8.
The charts also show Alberta was the only other province to accept recent negative COVID tests for entry at this time, and then only for outdoor amateur sports. All other provinces only accepted proof of vaccination.
On Sept. 26, the province’s new case rate had risen to 39.65, which, the notes state, was higher than the United States’ rate of 35.89.
ICU admissions across the province had increased six per cent in the past 24 hours while total hospital admissions rose seven per cent.
Saskatchewan’s rate of new cases remained higher than the United State’s for weeks, the briefing notes show.
On Oct. 3, 2021, the province had the highest death rate in the country -which was 33 per cent higher than the next highest provinces.
“August to November 2021 in Saskatchewan, Saskatchewan was fighting for its life against COVID-19,” University of Saskatchewan epidemiologist Nazeem Muhajarine said.
Global News shared some of the emails with Muhajarine and Wong ahead of publication.
Muhajarine said he wasn’t surprised to see the Sept. 7, 2021 note warning acute care could collapse, saying any public health professional would have concluded the same thing.
“Unfortunately, I was not surprised that nothing was done,” he said.
“That message (of the coming influx of patients) that was very clear (and) went unheeded.”
Like Wong, Muhajarine told Global News he thinks the province needs to understand why the government chose the policies it did, saying “I think people in Saskatchewan need to see this, to reckon with it along with the politicians.”
On Oct. 7, Moe and Merriman handed over control of the province’s pandemic response to the Provincial Emergency Operations Centre (PEOC).
A press release stated deputy health minister Max Hendricks, Saskatchewan Health Authority (SHA) CEO Scott Livingstone and Public Safety Agency president Marlo Pritchard were now in charge.
The PEOC started hosting regular COVID-19 updates, with Pritchard and Shahab answering most questions from reporters.
Livingstone resigned from the SHA in December 2021. Global News reached out to him for an interview but never received a response.
Global News asked for an interview with the current CEO Andrew Will.
In a statement, the SHA’s chief of emergency operations during the pandemic, Derek Miller, said the SHA “provided information to inform the Government of Saskatchewan’s decisions about public health measures required to protect Saskatchewan residents.”
Global News asked the SPSA for an interview with Pritchard.
The public safety agency directed all questions to the health ministry.
When Global News pushed back, a spokesperson said Pritchard was out of the office for the week and again said questions about decisions and operations should be directed to the health ministry.
Global News never received a response from Saskatchewan government officials regarding interviews with Hendricks and Merriman, other than an email from a government spokesperson saying they were checking on the request.
Briefing notes from Oct. 13, 2021 cite the recent 12-per cent increase in non-ICU patients and the 19-per cent increase of the number of patients in the province’s ICUs in the previous two weeks.
“If SK continues at this rate, we will need to transfer ICU patients out of province in the next few weeks,” the memo reads.
It took only days.
The transfers began on Oct. 18, 2021.
Two days later, Shahab cried during a PEOC briefing.
The Canadian Armed Forces deployed 15 members, including six critical care nurses, to help the struggling province’s healthcare workers.
A report from the Canadian Press shows Merriman’s request to Ottawa for help surprised the CAF and federal health minister because Saskatchewan had previously turned down support.
In total, 27 people were flown to Ontario for intensive care treatment.
It was only near the end of October that the pressure started to break.
According to the documents, the total number of non-ICU patients decreased 19 per cent while the new case rate had dropped to 19.9 / 100,000 — though that was still the highest among provinces east of the Maritimes.
Looking back, Wong and Muhajarine told Global News the province should have kept the proof of vaccination policy in place longer because it prompted more people to get the jab.
Nov. 1, 2021 briefing notes for the PEOC state the province “has the lowest immunization of all provinces (tied with AB), the highest daily case rate, and the least restrictions.”
Since March 1, 2021 the notes read, there has been 385 deaths, which “makes up 47.5 per cent of all deaths since the start of the pandemic.”
“24 per cent of deaths since March were in the fully vaccinated.”
Wong and Muhajarine both said it’s impossible to know exactly how many deaths could have been prevented if more people got vaccinated — only that it would have been more.
They said the provincial government’s decisions need to be examined but the public and the politicians who made those decisions in order to prepare for the next health crisis.
Muhajarine suggested the role of the chief medical health officer should be reformed so its holder is more accountable to the public instead of political leaders.
Both Wong and Muhajarine also both said the province will be dealing with the effects of COVID-19 for a long time.
“COVID-19 is not just an acute disease. It is also turning out to be a chronic disease,” Muhajarine said, referring to long COVID.
Wong said his response to grief hasn’t been the same.
“I don’t feel death and suffering and pain the way I did before. I don’t feel it as acutely,” he said.
“Because we saw so much repetitive trauma, so much unnecessary death, and not just in the hospitals, but even with my own (patients) living with HIV and addictions and so forth, like countless overdose deaths… I’m not sure whether or not it’s ever going to be the same for me.”
His suggestion for how to handle another health crisis: listen to the experts.
“Listen to our public health physicians, listen to Dr. Shahab, listen to (SHA interim senior medical health officer) Dr. Cory Neudorf, the rest of the (medical health officers), who were basically just giving us a very clear pathway of what needed to be done.
Global News asked the health ministry for an interview with Dr. Shahab.
A spokesperson said he was away until the end of the month but would work on securing an interview with him upon his return.
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