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TSN Senior Correspondent

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The president of the Canadian Medical Association (CMA) says Alberta Health Services (AHS) should immediately reduce capacity limits for both indoor and outdoor professional sports teams, and if the provincial government refuses, that teams should commit to the rollbacks themselves.

Dr. Katharine Smart, whose CMA represents more than 75,000 physicians across the country, said that Alberta Health Services, the provincial body that oversees health care in the province, has been negligent in its response to COVID-19.

“The health care system in Alberta has collapsed,” Dr. Smart said in an interview with TSN on Thursday. “We wouldn't be in this situation if we had had stronger public health measures in Alberta. Physicians have been saying that now for weeks but that didn't happen... Right now we need groups like sports organizations to step up and be leaders.”

TSN reported on Wednesday that more than a dozen critical care and infectious disease specialists were upset that National Hockey League teams in Alberta planned to start their seasons playing games in arenas at 100 per cent capacity, as permitted by the provincial government.

Rogers Place in Edmonton is an 18,347-seat arena and the Scotiabank Saddledome in Calgary can hold 19,289 fans. The Calgary Flames are scheduled to host the Edmonton Oilers on Sunday in the teams’ first pre-season game.

“I don’t think it is acceptable [to play before full capacity] at all right now until the health care system has stabilized,” Dr. Smart said. “All elective surgeries are cancelled. It’s life and limb only. ICU capacity is almost entirely full. Alberta is literally just a few people away from starting to triage critical care, which means some people will be denied critical care and some people will be removed from critical care. Alberta is now looking at airlifting [ICU patients] out of the province. That's why you're hearing so much concern about gathering upwards of 20,000 people in an enclosed space.”

Tom MacMillan, a spokesman for the AHS, wrote in an email on Thursday that the provincial ministry would not respond to Dr. Smart’s criticism.

“We will continue to monitor the situation closely and recommend any change in our approach if and as needed,” MacMillan wrote.

Determining how to respond to Dr. Smart’s request is complex for teams that already have lost millions of dollars during the pandemic. One NHL team president told TSN on Friday that cutting back to 50 per cent arena capacity from 100 per cent would probably cost even small-market teams close to $1 million per game and could lead to employee layoffs.

Spokesmen for the Oilers, Flames and Stampeders did not respond to requests for a response to Dr. Smart’s plea.

The Elks play in the 56,302-seat Commonwealth Stadium and spokesman Evan Daum said the team will review its protocols before its next home game on Oct. 15 against Winnipeg.

“We understand the significant strain COVID-19 has put on our healthcare system and the important leadership role we play in terms of bringing our community together safely,” Daum wrote in an email to TSN. “As our next home game on October 15th approaches, we will continue to evaluate our current plans and adjust them as needed to best mitigate risk.”

Dr. Joe Vipond, an emergency room doctor who practices at the Foothills Medical Centre in Calgary, warns the province may be heading towards the kind of crisis the world watched unfold last spring in the northern Italian region of Lombardy, where there were so many COVID-19 deaths that the military had to be called in to take coffins stacked in warehouses to crematories.

“We are heading for disaster,” Dr. Vipond said in an interview on Friday. “Our government told people in July that Covid was over and there’s still a lag. Many people still believe that. We're going to pay the price”

AHS president Dr. Verna Yiu said Thursday at a press conference that Alberta over the previous five days had admitted at least 23 new ICU patients each day. "We can only keep pace in ICU because patients are passing away," Dr. Yiu said.

In Ontario, which has more than triple Alberta’s population but fewer than one-third as many active COVID-19 cases, the Ontario government announced today that the Toronto Maple Leafs, Ottawa Senators and Toronto Raptors will be allowed to play at 50 per cent capacity to begin the pre-season.

Ontario’s CFL teams and the Toronto Blue Jays will be permitted to fill their stadiums to 75 per cent capacity. Those limits may increase or decrease as the province navigates through the fall and winter.

“Being outside is indeed much safer, but when we are talking about people spending prolonged periods next to one another unmasked, there is still risk,” Dr. Ilan Schwartz, an infectious disease specialist in Edmonton, wrote in a text message to TSN on Thursday. “Overall, I think the risk [of spreading COVID-19 in an outdoor setting] is low but given just how desperately strained our healthcare system is right now, I think limiting capacity would be prudent.”

Dr. Smart agreed with Dr. Schwartz and three other infectious disease specialists contacted by TSN on Thursday that the risks of contracting COVID-19 at an outdoor event are lower than they are in an indoor hockey rink.

“Outdoor is a little bit better because you don't have the same ventilation issues that you have in an indoor arena, but you still have the issues of people being crowded close together,” Dr. Smart said. “Maintaining social distancing at this point is still important.”

Dr. Smart said it may only be days before Alberta hospitals, jammed with patients, are unable to provide treatment for the critically ill.

“We're going to start losing friends and neighbours, and it's not only going to be from COVID-19. It's going to be from things like car accidents, heart attacks, and cancer,” she said. “People need to reflect on that when they're making these decisions about issues like arena and stadium capacities.”

While doctors say Alberta is days away from running out of ICU beds for its sickest patients, the province’s sports teams say they are following the standards set by the province in filling their venues and that they have numerous protocols to safeguard fans.

While the Stampeders and Flames require fans to be fully vaccinated to attend games, the Elks will allow unvaccinated fans to attend games if they have negative COVID-19 tests that are up to 72 hours old. The Oilers will allow unvaccinated fans with negative COVID-19 tests that are up to 48 hours old.

The two football teams do not require fans to wear masks in their seats, while the hockey teams say they’ll require mask wearing from seated fans when they are not eating or drinking.

Recent medical studies show that while vaccinated people can contract COVID-19, the unvaccinated are 29 times as likely to end up hospitalized with the virus as a vaccinated person.

Nevertheless, Dr. Smart said both the vaccinated and unvaccinated alike (COVID-19 vaccines have not been approved for children under 12) who attend a sports event can still catch the virus and pass it along to the elderly or others at risk.

"The risk tolerance would be different if the system wasn't collapsing," she said.

As of Sept. 18, 61.9 per cent of people in Alberta were fully vaccinated, Health Canada reported today, compared to 73.2 per cent in Quebec, 71.2 per cent in B.C., and 69.9 per cent in Ontario.

Dr. Smart said she hopes both Alberta Health Services and the teams hear her appeal.

“The responsible approach is limiting fans so that they can be appropriately socially distanced in the arena, making sure people are vaccinated, and having indoor masking,” she said. “We have to keep people appropriately distanced and that's not possible when you have a fully packed arena.”