An image of the 2019 Novel Coronavirus (2019-nCoV), from the U.S. Centers for Disease Control and Prevention.

Pandemic versus politics

Alberta health-care workers have been voicing their concerns
about provincial budget cuts and the COVID-19 outbreak
By Rudy Howell

This week, in what NDP leader Rachel Notley has called an “abusive process,” the UCP government rushed to pass its $57 billion 2020-21 provincial budget, before the legislature has to shut down as a social distancing precaution against the spread of COVID-19.

Since the World Health Organization declared the outbreak a pandemic March 11, the UCP has been scrambling to tackle the ongoing crisis, partly by amending its February budget by adding an additional $500 million for testing, public health surveillance and patient care.

“I’m now responsible for a lot more with less pay,” says Alyssa Akins, 22, a nurse who works at Valleyview Health Centre, “especially during a pandemic where the pressure on our hospitals is at an all-time high.”

This implies a major complication of the government’s November announcement that it would slash between 3,900 and 4,900 front-line health-care positions – including 500 nurses – over the next three years in an effort to balance the provincial budget by 2022.

“It’s frustrating and disheartening,” Akins says of the situation. “I recently graduated, so it’s been next to impossible to get a job.”

A review of Alberta Health Services (AHS) conducted by independent contractors Ernst and Young found that the province could save nearly $2 billion annually by reducing benefits for nurses, cutting the pay of some doctors, and outsourcing more health and support services to the private sector.

However, in November, no one was predicting the outbreak of a global pandemic. Tuesday, Premier Jason Kenney declared a state of public health emergency in an effort to combat the growing spread of COVID-19. According to CTV News, as of March 24, there were 301 confirmed and presumptive cases in Alberta, with 18 in hospital and seven in intensive care, and two dead. Across Canada, there were more than 2,648 cases and 28 deaths.

There have been 18 confirmed deaths in Canada, including one in Alberta, since the virus entered the country on Jan. 25.

Akins says that overworked staff and limited supplies are her biggest concerns.

“If this spreads to a high amount of people that need hospitalization, it’s going to be rough.”

Now, Alberta doctors are urging the government to do more to “flatten the curve” in the province. Hundreds of physicians are requesting that the UCP not only put upcoming contract changes on hold but also take further steps to help prevent COVID-19 from overwhelming the provincial health-care system.

A letter written by Lana Myroniuk, a family doctor in Edmonton, on behalf of 558 other Alberta physicians was sent to Premier Jason Kenney, provincial Health Minister Tyler Shandro, and other members of the Alberta legislature Sunday night.

“When the exponential rise in cases comes in the next few days, the cuts will limit our ability to continue working on the front lines,” the letter read. “This will push patients to seek care in ERs, which will be simply unable to accommodate them.”

She wrote that physicians are doing what they can to stop the community spread of COVID-19, but can’t continue without government intervention.

So far, the UCP has taken several steps in that direction, but Myroniuk has said they weren’t enough.

On March 12, the province activated a billing code known as 03.01AD, which Shandro said was used during the H1N1 response in 2009. The code allows physicians to charge $20 per call when giving COVID-19 advice over the phone. This helps ensure patients who may be carrying the virus do not spread it to others by visiting clinics.

The health minister also assured AHS employees that there will not going be any layoffs “during” the COVID-19 response and that there would likely be staffing increases to deal with the outbreak.

While both the phone-call billing code and pledging not to lay off staff are a good start, Myroniuk has said more needs to be done.

In her letter, she called on the province to …

    1. Reverse the cuts to physician fees and table negotiations for a later date, when the province is not in crisis.
    2. Remove the weekly cap for 03.05JR (telephone calls to patients). This will promote social distancing and
      enable telephone care even if the patient and/or physician are not required to self-isolate.
    3. Increase the fee for 03.01AD to align with those of other provinces.
    4. Reassure Albertans that everyone who must self-isolate, physicians included, will receive financial support
      from the government. Otherwise, infected individuals will continue to go to work and further spread the virus.

“I ask you to pause your political agenda and let us help Albertans,” she wrote. “If the proposed cuts are enacted, this will be a disaster beyond imagination.”

    • For live updates regarding COVID-19, visit the Alberta government website.
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