Smoke plumes over Stanton Territorial Hospital, after a state of emergency was declared, in Yellowknife on Aug. 15.PAT KANE/Reuters
The Northwest Territories does not have the capacity in Yellowknife to reabsorb all of the health care patients who evacuated from the region last month, and some will have to stay in facilities in Alberta and British Columbia until fires threatening other parts of the North subside further.
Claudia Kraft, the medical director for the Northwest Territories Health and Social Services Authority (NTHSSA), said there is not enough room in Yellowknife for patients from Hay River and Fort Smith to return to the northern capital.
Hospital patients, people in assisted-living centres and long-term care residents from those communities were evacuated from their local facilities to Yellowknife, only to be forced to move again when the capital was evacuated starting Aug. 16. Hay River and Fort Smith are still under evacuation orders, while the restriction on Yellowknife was lifted Wednesday.
Patients who originated from facilities in the capital will be able to return, Dr. Kraft said. She said repatriation will be slower – and more comfortable – than the evacuation flights, when the most complex patients were airlifted on a C-17 to British Columbia.
N.W.T. has expertise in transporting patients, given so many of its communities are accessible only by plane. It is assembling a transportation plan for hospital patients and long-term care residents, but not everyone will return at once.
“I don’t think that would be good care for our patients and it would probably overwhelm our staff,” Dr. Kraft said in an interview Thursday.
The return will likely be comprised of a “gradual series” of medevacs, charter flights and scheduled flights, depending on “who is ready to come home from where and who we can effectively and safely look after,” she added.
Dozens remain in Yellowknife hospital as evacuation stretches past deadline
It is difficult to predict when Hay River and Fort Smith patients will be able to return because those communities are still imperiled by fire.
“We don’t have enough capacity elsewhere in the N.W.T. system to absorb all of those folks,” Dr. Kraft said. “For that group of people, it certainly could be quite some time and it is really going to depend on when Fort Smith’s and Hay River’s long-term care facilities will be able to stand back up.”
Flames were 500 metres west of Hay River’s hospital and 3.4 kilometres away from Fort Smith on Thursday. Hay River evacuated Aug. 13 and Fort Smith emptied a day earlier.
Dr. Kraft hopes patients in Alberta and B.C. will be able to repatriate to N.W.T. facilities starting next week. Officials will weigh staffing, patient medical needs and the ability of the southern provinces to carry the extra burden.
The Stanton Territorial Hospital usually operates about 60 beds and runs at capacity, Dr. Kraft said. Given that Yellowknife, Fort Smith, Hay River and their neighbouring communities evacuated in mid-August, the number of N.W.T. residents in Alberta’s hospitals likely matches Stanton’s capacity, she noted. Further, Alberta normally cares for about 30 N.W.T. patients at any given time because the province can offer more specialized services.
Dr. Kraft said Stanton’s emergency department is essentially back to full speed.
Stanton should be capable of providing “limited” intensive care services “quite soon,” Dr. Kraft said. The facility has an operating room available for emergent and urgent surgeries.
The hospital had opened an inpatient unit of 10 beds, making it comparable to one of N.W.T.’s regional facilities, by Thursday. The mixed ward can accommodate surgical or general medical patients.
Stanton planned to open part of its psychiatric unit Thursday evening, Dr. Kraft said.
“Some capacity there is really important, particularly to have that capability for the communities that aren’t in Yellowknife,” she said. “Maintaining that service was really challenging without the capital, as were many of the services for health centres across the territory.”
Dr. Kraft also hoped Stanton’s extended care unit will soon reopen. Some endoscopy services – colonoscopies and gastroscopies – will be available next week.
The two units that require the most specialized nurses – pediatrics and labour and delivery – will take the most time to admit patients, Dr. Kraft said, reiterating that the emergency department can handle urgent situations. N.W.T. advised those who are 33 weeks pregnant and beyond not to return to Yellowknife. The government is facilitating longer stays elsewhere, she said.
N.W.T. will be able to provide IV therapy, dialysis and chemotherapy in Yellowknife next week, Dr. Kraft said. N.W.T. previously asked residents in those outpatient programs to avoid returning to the capital.
Fire did not reach Yellowknife’s boundaries and the power largely stayed on throughout the crisis, leaving the hospital and other pieces of critical infrastructure intact. Stanton’s emergency department operated at reduced capacity during the three-week evacuation, with between 30 and 50 staff members providing logistical and clinical support.
About 800 people work at Stanton and in Yellowknife’s outpatient facilities, such as primary care clinics, while NTHSSA has about 1,500 employees across the territory, according to Dr. Kraft.
Health care professionals and other support staff started returning to the capital ahead of the general population this week. About 200 NTHSSA employees from Stanton and outpatient facilities were in Yellowknife by Wednesday, Dr. Kraft said.