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A report published by the Canadian Institute for Health Information found surgeries decreased by about 35,000 a month during the first 16 months of the pandemic, with the largest declines during the first wave in early 2020.Nathan Denette/The Canadian Press

The number of surgeries performed at Canadian hospitals fell by more than half a million from March, 2020, to June, 2021, according to a new report that highlights the collateral damage caused by the pandemic.

The report, published on Thursday by the Canadian Institute for Health Information (CIHI), found surgeries decreased by about 35,000 a month during the first 16 months of the pandemic, with the largest declines during the first wave in early 2020. The CIHI report found the biggest decreases were in cataract removals and hip and knee replacements.

As the number of COVID-19 cases creeps up in many parts of Canada, public-health experts predict that disruptions to the health care system will continue for some time.

Tracy Johnson, director of health system analytics at CIHI, said it is unclear exactly what the pandemic’s long-term effects on health care will be.

“We are continuing to adapt to each of the waves of COVID-19 as it comes along,” she said.

David Urbach, head of surgery and lead medical executive at Women’s College Hospital in Toronto, said wait times for surgery have long been a problem in Canada. While patients have very good access to emergency procedures, people who need what’s known as elective treatments, such as the removal of uterine fibroids or hernia repair, typically wait for several months. Elective operations also include cancer surgery and treatments for other serious, possibly life-threatening medical conditions. The pandemic has made the problem worse, with waits getting much longer, a situation that should prompt a new discussion on how to make the process more efficient, Dr. Urbach said.

It’s still not clear exactly how large the surgery backlog is, and it’s unlikely the waiting list will ever see a major decline, he said. But the current system, with hospital teams each operating in their own silo, could be replaced with a larger, more co-ordinated system that could more efficiently manage available resources and wait lists, Dr. Urbach said.

The report also found that when COVID-19 hit, hospitals were able to adapt swiftly, prioritizing life-saving procedures and moving health care staff to ICUs and other areas of need.

Ms. Johnson said that having enough health care staff will be a long-term problem in Canada. The country faced challenges in health care human resources before the pandemic, but the COVID-19 crisis has hit the sector hard, with many people leaving or retiring.

The report noted that visits to emergency departments fell by 20 per cent during the first 16 months of the pandemic. The largest drop occurred among individuals with the least urgent conditions.

The CIHI data also found that people in low-income areas were more likely than those in the highest income neighbourhoods to be admitted to hospital for health problems linked to substance abuse. And young women were more likely than any other demographic to be hospitalized for self-harm during that period of the pandemic, the report shows. But the analysis includes only hospital admissions linked to substance abuse or self-harm, so it’s an incomplete picture of the true toll, the report said. Children 4 and younger were 50 per cent less likely to be taken to an emergency room from March, 2020, to June, 2021, the report found, which could be owing to concern over the spread of COVID-19 as well as a reduction in seasonal viruses that would require urgent care.

Ms. Johnson said significant work is needed to understand how the pandemic has affected mental health in Canada, saying that opioid-related deaths in particular have increased substantially.

“We’ve had an inordinate number of deaths,” she said.

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