Alberta’s plan to restart non-urgent medical care on Monday expected to face delays as regulators prepare

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Alberta has cleared the way for a range of non-essential medical treatment to begin on Monday, but regulators and providers in the province say it could be weeks before some routine procedures such as dental check-ups resume.

The provincial government outlined its plan last week to begin reopening sectors of the economy in several phases beginning this month. The province’s regulated health professions, which include dentists, optometrists, physiotherapists, social workers and many others, were cleared to resume non-essential procedures beginning this week, but only if their regulatory colleges issued guidelines to mitigate the risk of COVID-19 transmission first.

Some colleges, such as the bodies that regulate physiotherapists and optometrists, have already issued those guidelines and some of those services are expected to resume Monday or soon after. Others, including the colleges for occupational therapists and dietitians, are encouraging members to provide virtual care whenever possible even after the formal restrictions are lifted. And providers such as dentists and speech language pathologists won’t start seeing patients again until their colleges issue their own guidelines.

Several providers said that even when they are cleared to see patients, the timing will depend on whether they can secure personal protective equipment such as masks, which are in short supply across Canada and around the world.

The Alberta Dental Association and College said its members can resume urgent procedures, such as treatment for severe pain, dental trauma, sleep apnea, complications from surgery and denture adjustment on Monday. But it expects non-essential procedures such as routine check-ups to wait until at least May 14, which is the earliest that businesses such as retailers and hair salons will also be permitted to open.

Mo Korayem, an orthodontist in Airdrie, just north of Calgary, said he’s skeptical that his clinic will be able to resume treating patients by May 14. He said he’s already working on preparing the clinic by rewriting procedures to further mitigate the risk of transmission and by installing plexiglass barriers at the front desk, but obtaining masks and N95 respirators, which will be mandatory for procedures such as drilling that can generate aerosols that increase the risk of transmitting COVID-19, has been difficult.

“The PPE is a huge issue," said Dr. Korayem, who said his suppliers are sold out. “We can’t reopen until we can get PPE, and we can’t get PPE until they do.”

The Alberta government has said it has enough PPE and has set up a system to distribute PPE to health care providers outside the provincial health system. Dr. Korayem said he put in a request more than a week ago but has yet to hear any update.

Dr. Korayem said he would have preferred more time to prepare instead of scrambling now to stock up on supplies and prepare his clinic to open.

The province’s Chief Medical Officer of Health, Deena Hinshaw, said the Monday timeline was simply the earliest date, and patients will likely see a “staggered” opening of health care services that will take some time. She said the province would provide guidance to colleges about what their guidelines should contain.

“We do rely on the colleges, who know how their individual members, what the practice of that particular profession entails," she said.

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Tammy Chu, a dentist in Grande Prairie, about 450 kilometres northwest of Edmonton, said she’s confident her clinic will be able to operate safely while protecting staff and patients, though she also said the N95 respirator supply could be an issue.

She acknowledged there’s an inherent risk to resuming treating patients, but she said there’s also a risk in waiting longer.

“As much as I know that we are in a high-risk profession, I don’t want to see the mess that I will have to come back to,” she said. “It might not be an emergency, but you might see it differently if your filling is now a root canal.”

The college for physiotherapists has told its members they can start booking appointments on Monday as long as they follow a newly released set of guidelines, including the use of PPE, patient screening, increased cleaning and hygiene and arranging clinics to maintain physical distancing when possible.

Suzanna Wong, a physiotherapist who works out of a clinic in Sherwood Park, near Edmonton, said she expects to resume her work in two or three weeks as she waits for masks and face shields.

She said the pandemic restrictions will likely have a lasting impact on her profession.

“We’re going to have to change how we’re doing things in clinics,” she said. “I know a lot of traditional physio clinics can become very busy or there is shared gym equipment. We’re going to have to change our regular practice going forward. ”

The Alberta College of Optometrists has told its members they can resume routine eye exams as of Monday, providing they use PPE and follow other infection-control guidelines.

The registrar of the Alberta College of Speech-Language Pathologists, Michael Neth, said in an e-mail that guidelines for that profession would be available in the coming days, but the timing for when treatment would resume will depend on the availability of PPE and sanitizing supplies.

The Alberta College of Occupational Therapists said its members can see patients starting on Monday, if they follow new guidelines, but is encouraging virtual visits whenever possible.

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