Winnipeg Free Press

Winnipeg Free Press (Newspaper) - September 28, 2021, Winnipeg, Manitoba C M Y K PAGE B3 TUESDAY, SEPTEMBER 28, 2021 ● WINNIPEGFREEPRESS.COM B 3NEWS I CANADA / WORLD EDMONTON — The Alberta Medical Association says the province’s high COVID-19 numbers are behind a des- perate shortage of specialized staff to care for critical care patients. “The demand for (intensive care unit) nurses is currently so high that we need to increase the number of patients as- signed to each nurse,” the medical as- sociation said in a public letter Monday. “This reduction in staffing ratio is well below our normal standard of care. This will jeopardize the quality of ICU care that we are able to provide.” The letter was signed by members of the group’s intensive care section. Alberta’s hospitals and intensive care wards are overwhelmed by critical care patients, most of them stricken with COVID-19. The overwhelming ma- jority are either unvaccinated or par- tially vaccinated. Alberta Health Services has been briefing doctors on criteria to use should the health system collapse and they have to make on-the-spot decisions on who gets life-saving care. Last week, Dr. Paul Parks, the med- ical association’s head of emergency medicine, said the staffing shortage is affecting care in other ways. Parks said some critical care patients are not being put on available ventilators, because there aren’t enough nurses to monitor them. Kerry Williamson with Alberta Health Services said while typical ICU care is one nurse per patient, an al- ternative model, known as a hub, is be- ing used to adapt to the pandemic while ensuring care is delivered. Each hub includes one or two trained intensive care nurses and two to four registered nurses. “This model partners registered nurses from other areas with exist- ing trained ICU (nurses) to expand the availability of the critical-care nursing skill set to more patients,” Williamson said in an email. “ICU patients are never cared for by nurses alone. Whole teams work with nurses in ICU, including respiratory therapists and many others. “ In recent weeks, the province has scrambled to create more ad hoc inten- sive care beds, effectively more than doubling the normal total of 173 to ac- commodate 312 patients currently re- ceiving critical care. Staff have been reassigned, forcing mass cancellations of surgeries, includ- ing cancer procedures. Alberta has asked the federal gov- ernment for help, and the Canadian Armed Forces has said it will respond with eight more intensive care nurses and air transport to take critically ill patients to other provinces. Almost two weeks ago, Alberta re- introduced gathering restrictions and brought in proof of vaccination require- ments for entry to restaurants, bars, casinos, concerts and gyms to try to reduce spread of the virus. Daily case counts remain well over 1,000 a day for weeks and new numbers released Monday offered no respite. Alberta averaged more than 1,700 cases a day from Friday through Sun- day. There were 23 more COVID-19-re- lated deaths to bring that total to 2,645 since the pandemic began. There are more than 21,000 active cases and more than 1,000 in hospitals with COVID-19, including 265 in ICU. A growing number of doctors and infectious disease specialists are call- ing for a “firebreak” lockdown, which would include a shutdown of schools, businesses and other activities. The medical association added its voice to the lockdown call Monday. “This is an immediate problem that needs to be acted on. We are on the edge of a very dangerous cliff, one that will see physicians and other health-care workers making decisions on who does and does not receive care if case num- bers continue on this path,” president Dr. Paul Boucher said in a news release. Alberta Premier Jason Kenney, in a weekend radio interview, rejected a lockdown. He said it would make “no sense for the 80 per cent of the popu- lation that is vaccinated” and who are much less likely to transmit the disease and be hospitalized. Alberta has lagged behind other prov- inces in vaccination. Kenney and his United Conservative government have been trying to persuade more people to get their shots by offering $1-million prize draws, other gifts and, more re- cently, $100 debit cards. About 73 per cent of eligible Alber- tans, those 12 and over, are fully vac- cinated, while 82 per cent have had at least one shot. — The Canadian Press Alberta MDs raise alarm on staff shortages DEAN BENNETT TED S. WARREN / THE ASSOCIATED PRESS Track repair and rebuilding workers and machinery are seen near overturned passenger cars, Monday, near Joplin, Mont., where an Amtrak train derailed Saturday. J OPLIN, Mont. — An Amtrak train that derailed in rural Montana over the weekend was going just under the speed limit at about 75 mph (121 km/h) when it went off the track along a gradual curve, killing three people and possibly ejecting passengers, U.S. investigators said Monday. Investigators do not know the cause of the accident, but they are studying video from the train and another loco- motive that went over the same track a little over an hour earlier, National Transportation Safety Board Vice Chairman Bruce Landsberg said. The derailed train also had a black box that records everything happening in the train, he said. “We have experts that are studying the camera footage frame by frame to make sure that we see exactly what the engineer saw — or maybe didn’t see,” Landsberg said. The train derailed before a switch in the line, where one set of tracks turned into two, on a stretch of track that had been inspected just two days before, he said. The westbound Empire Builder was travelling from Chicago to Seattle when it left the tracks Saturday after- noon near Joplin, a town of about 200. The train, carrying 141 passengers and 16 crew members, had two locomotives and 10 cars, eight of which derailed, with some tipping onto their sides. When asked about wooden ties that were seen along the side of the tracks, and whether there was recent mainten- ance on that section, Landsberg did not answer directly. “That will be one of the questions that we look at,” he said. “Maintenance will be a really big concern for us. We don’t know, at this point, exactly what happened, whether it was a track issue, whether it was a mechanical issue with the train. So all of these things are open.” He said a preliminary report on the derailment is expected within 30 days. Dale Fossen, one of several Joplin residents who went to the scene to help, said the train tracks ended up mangled. “You could see the tracks looked like a pretzel, they were really twisted bad,” Fossen said. Investigators will look at “every- thing,” including the switch, wheels, axles and suspension systems, as well as the track geometry and condition, including any cracks, said Steven Dit- meyer, a rail consultant and former senior official at the Federal Railroad Administration. He said a switch like the one in Joplin would be controlled by the BNSF Railway control center in Fort Worth, Texas. Sometimes rail lines can become de- formed by heat, creating buckles in the tracks known as sun kinks, Ditmeyer said. That was the cause of a derailment in northern Montana in August 1988, when an Empire Builder train veered off the tracks about 274 kilometres east in the tiny town of Saco. The NTSB concluded that an inspec- tion failed to catch a problem in the track, and officials did not warn trains to slow down on that stretch. The crew saw the track had shifted, but the train was going full speed and could not stop before derailing. Temperatures were above 30 C on Saturday near Joplin, according to the National Weather Service. Russ Quimby, a former rail-accident investigator for the NTSB, said heat is the most likely explanation. He is con- vinced because the locomotives in front did not derail, but eight lighter coach cars behind them did. “This has all the earmarks of a track buckle also,” Quimby said. “Sometimes a locomotive, which is heavier, will make it through” a buckled track, “but the cars following won’t. You saw that in this accident,” he said. A malfunction of the switch seems less likely, Quimby said, because the switch would have been inspected when the track was checked last week. Another possibility was a defect in the rail, said railroad safety expert David Clarke, director of the Center for Transportation Research at the Univer- sity of Tennessee. He noted that regu- lar testing does not always catch such problems. Speed was not a likely factor because trains on that line have systems that prevent excessive speeds and colli- sions, which appear to have worked in this case, Clarke said. “Did the switch play some role? It might have been that the front of the train hit the switch and it started fish- tailing and that flipped the back part of the train,” Clarke said. The derailment was about 241 kilo- metres northeast of the capital of Helena and about 48 kilometres from the Canadian border. The tracks cut through vast, golden brown wheat fields that were recently harvested and roughly parallel to U.S. Highway 2. Allan Zarembski, director of the Uni- versity of Delaware’s Railway Engin- eering and Safety Program, said he did not want to speculate but suspected the derailment stemmed from an issue with the track, train equipment or both. Railways have “virtually eliminated” major derailments by human error af- ter the implementation of a nationwide system called positive train control, which is designed to stop trains before an accident, Zarembski said. — The Associated Press Amtrak train that derailed was going just under speed limit Incident in rural Montana killed three people AMY BETH HANSON, MARTHA BELLISLE AND DAVID KOENIG A federal judge said Monday that John Hinckley Jr., who tried to assassinate president Ronald Reagan four decades ago, can be freed from all remaining restrictions next year if he continues to follow those rules and remains men- tally stable. U.S. District Court Judge Paul L. Friedman in Washington said during a 90-minute court hearing that he’ll issue his ruling on the plan this week. Since Hinckley moved to Williams- burg, Virginia, from a Washington hos- pital in 2016, court-imposed restrictions have required doctors and therapists to oversee his psychiatric medication and therapy. Hinckley has been barred from having a gun. And he can’t con- tact Reagan’s children, other victims or their families, or actress Jodie Foster, who he was obsessed with at the time of the 1981 shooting. Friedman said Hinckley, now 66, has displayed no symptoms of active men- tal illness, no violent behaviour and no interest in weapons since 1983. “If he hadn’t tried to kill the presi- dent, he would have been uncondition- ally released a long, long, long time ago,” the judge said. “But everybody is comfortable now after all of the studies, all of the analysis and all of the inter- views and all of the experience with Mr. Hinckley.” Friedman said the plan is to release Hinckley from all court supervision in June. A 2020 violence risk assessment conducted on behalf of Washington’s Department of Behavioral Health con- cluded that Hinckley would not pose a danger if he’s unconditionally released. The U.S. government had previously opposed ending restrictions. But it re- cently retained an independent expert to examine Hinckley and took a dif- ferent position Monday, with attorneys saying they would agree to uncondition- al release if Hinckley follows the rules and shows mental stability for the next nine months. Kacie Weston, an attorney for the U.S. government, said it wants to make sure Hinckley can adapt to living on his own for the first time in 40 years. He recently moved out of his mother’s house, which sits along a golf course in a gated community in Williamsburg. She died in July. Attorneys did not say where Hinckley is currently living. “Mr. Hinckley does have a history of turning inward, and toward isolation,” Weston said. Another concern is the impending re- tirement of one of Hinckley’s therapists and the looming end to a therapy group, which has provided much support and social interaction. Weston said Hinck- ley will likely face challenges finding a similar group in the future. “All we have to do is wait a few more months and see,” Weston said. “And we’ll have actual hard data. We’ll have information in real time to see how Mr. Hinckley adapts.” The Ronald Reagan Presidential Foundation and Institute said in a state- ment that it was “saddened” by the court’s plan. “Contrary to the judge’s decision, we believe John Hinckley is still a threat to others and we strongly oppose his re- lease,” the foundation said. “Our hope is that the Justice Department will file a motion with the court leading to a re- versal of this decision.” Hinckley was 25 when he shot and wounded the 40th U.S. president out- side a Washington hotel. The shoot- ing paralyzed Reagan press secretary James Brady, who died in 2014. It also injured Secret Service agent Timothy McCarthy and Washington police offi- cer Thomas Delahanty. Hinckley did not attend Monday’s hearing. But Barry Levine, his attor- ney, said Hinckley wanted to express his “heartfelt” apologies and “profound regret” to the people he shot and their families as well as to Foster and the American people. “Perhaps it is too much to ask for for- giveness,” Levine said. “But we hope they have an understanding that the acts that caused him to do this terrible thing (were caused by) mental illness.” Hinckley was suffering from acute psychosis. When jurors found him not guilty by reason of insanity, they said he needed treatment and not a lifetime in confinement. Such an acquittal meant that Hinck- ley could not be blamed or punished for what he did, legal experts have said. Hinckley was ordered to live at St. Elizabeths Hospital in Washington. In the 2000s, Hinckley began making visits to his parents’ home in Williams- burg. A 2016 court order granted him permission to live with his mom full time after experts said his mental ill- ness had been in remission for decades. Friedman, the judge, has loosened some of Hinckley’s restrictions over the years. For instance, Hinckley was granted the right to publicly display his artwork and allowed to move out of his mother’s house. But he’s still barred from travelling to places where he knows there will be someone protected by the Secret Service. Hinckley must give three days’ notice if he wants to travel more than 120 kilo- metres from home. He also has to turn over passwords for computers, phones and online accounts such as email. In recent years, Hinckley has sold items from a booth at an antique mall that he’s found at estate sales, flea mar- kets and consignment shops. He’s also shared his music on YouTube. “I would hope that people will see this as a victory for mental health,” Le- vine, Hinckley’s attorney, said Monday. “That is the real message in this case — that people who have been ravaged by mental disease, with good support and access to treatment, can actually be- come productive members of society.” — The Associated Press Man who shot Reagan to be freed from oversight BEN FINLEY B_03_Sep-28-21_FP_01.indd B3 9/27/21 10:06 PM ;