As hospitals in large swaths of Canada gear up to provide elective operations again, at least one province is predicting it could be as long as two years before the backlog caused by the novel coronavirus pandemic is cleared.
British Columbia says it will cost $250-million this year and take 17 to 24 months to complete the 30,000 procedures that were postponed to make way for a wave of COVID-19 patients that so far has not swamped the province’s hospitals.
B.C. will resume offering non-emergency operations on May 18, Health Minister Adrian Dix said Thursday, as he explained how his government intends to use the coronavirus crisis as an opportunity to overhaul the province’s strained surgical system, including by scheduling procedures on the weekend.
The Ontario government also released a “framework” for restarting elective procedures on Thursday, but it did not set a date, saying instead that hospitals with the most empty beds and fewest COVID-19 patients in their communities would likely go first.
Cancelling non-emergency operations, “has weighed heavily on all of us,” Ontario Premier Doug Ford said. "I want more than anything to get these surgeries and procedures back on track as soon as possible.”
Provincial governments across the country halted scheduled procedures such as hip and knee replacements and cataract operations in the middle of March, as they prepared for an anticipated surge of COVID-19 patients.
For the vast majority of Canadian hospitals, that surge never came, thanks to shutdowns and physical distancing efforts that kept the novel virus in check.
The exception has been the hard-hit Montreal, where crowding in hospitals contributed to Quebec Premier François Legault’s announcement Thursday that he would delay the reopening of that city’s schools and businesses until May 25 at the earliest.
Quebec has not released plans to resume elective operations.
In other jurisdictions, such as Alberta, some operating rooms are already humming again. The province resumed elective day procedures on Monday, with an emphasis on treating urgent patients first and those who had been in the queue the longest.
In B.C., hospitals will begin rebooking elective procedures next week.
Health officials in the province say it will take at least 17 months to clear the backlog of operations that were delayed by COVID-19 – if everything goes according to plan – but that still leaves a backlog of more than 90,000 patients who were wait-listed for surgery before the pandemic.
Mr. Dix said the province will offer permanent, full-time jobs to all existing, reinstated and graduating nurses this year. It will also need to recruit more surgeons, anesthetists and other health care professionals to meet the targets. As well, the province will tap private clinics to maximize the number of day operations that can be completed outside of hospitals.
By mid-June, the province expects all its operating rooms to be running at full capacity again.
B.C. public health officials declared this week that the province has successfully flattened the curve, but warned the restart plan for operations could be thrown off if hospitals are overwhelmed by a second wave of COVID-19 cases.
“All of this is dependent on avoiding resurgence of COVID-19,” said Provincial Health Officer Bonnie Henry.
In Ontario, elective procedures won’t begin again until Chief Medical Officer of Health David Williams lifts the directive that halted them nearly two months ago.
After that, hospitals will be allowed to restart their scheduled surgery programs only if they satisfy a readiness checklist that includes having 15 per cent of their acute-care capacity available to handle a spike in COVID-19 cases, and having 30 days worth of personal-protective equipment available.
“It will be really dependent on what these feasibility assessments show,” said Chris Simpson, chair of the provincial committee that drafted the framework for resuming non-emergency operations. “There may be places that are in a perfect position to go, where there’s essentially no COVID in the community.”
Dr. Simpson, a cardiologist and vice-dean of Queen’s University’s medical school, said in an interview that places such as his hometown of Kingston – which has just one patient with an active COVID-19 infection right now – would likely resume scheduled procedures sooner than regions grappling with serious outbreaks, such as the Greater Toronto Area.
Nearly 53,000 hospital procedures had been cancelled or avoided in Ontario as of the third week of April, the province’s fiscal watchdog revealed in a recent report.
Among the patients caught up in the pandemic-related delay is Dory Kashin, a 33-year-old Toronto event planner and breast-cancer survivor.
Ms. Kashin, a new mother to a six-month-old girl, underwent a double mastectomy and breast reconstruction four years ago. Since then, she has suffered chronic infections related to her textured implants. She was hoping to have them replaced in April. Now she has no idea when she’ll be able to get the surgery.
“It’s a little upsetting,” Ms. Kashin said. “It’s something that I just want to be over. It’s four years later – I just wanted everything to be wrapped up by now.”
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