B.C. halts elective surgeries to prepare for surge in critical COVID-19 cases

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Thousands of elective operations are being cancelled in British Columbia’s hospitals, and for the first time in decades, physicians in B.C. will not be limited in the number of patients they can see in a day as the province seeks to free up more acute and primary care to address the COVID-19 crisis.

B.C. Health Minister Adrian Dix announced the new measures on Monday, saying the changes will free up hundreds of hospital beds and ensure doctors are better able to respond to the expected increase in the number of British Columbians requiring urgent medical care in the coming days.

Most B.C. hospitals will undertake urgent and emergency procedures only and will postpone all non-urgent scheduled surgery, Mr. Dix said. Lions Gate Hospital in North Vancouver, which has already had a COVID-19 outbreak, will accept only emergency patients, and is preparing to open a dedicated unit to care for those with the virus.

“This will result in the cancellation – and it’ll be implemented over the next three to five days – of thousands of scheduled, elective surgeries in British Columbia, and free up hundreds and hundreds and hundreds of hospital beds,” the Health Minister told reporters during a daily briefing alongside Bonnie Henry, the provincial medical health officer.

Elective surgery covers a wide range of non-urgent procedures, such as hip and knee replacements, or breast reconstruction after a mastectomy.

As of Monday, B.C. had only six COVID-19 patients in acute care, but Dr. Henry said there will be more.

“It’s not inevitable that we are going to get major surges over the next little while,” Dr. Henry said, but added: “I think we need to be really careful and prepared. It is inevitable that we’ll see additional cases.”

She said hospitals will review operating-room capacity daily to assign priority to urgent and emergency cases.

“I’m asking everybody in British Columbia to do our part, to support each other as we get through this crisis in the next few weeks,” she said.

Medical staff who would otherwise be providing elective surgery will be reassigned to support urgent needs in the hospital and critical care. As well, the province hopes to acquire more access to beds in long-term care, so that hospitals can move out patients who are in acute care only for lack of a place in a care home.

Changes in primary care announced on Monday are intended to provide more health care in the community.

British Columbians will be allowed to refill prescriptions at their pharmacy rather than going back to their doctor to authorize refills.

In addition, B.C. has suspended the limit on the number of patients that physicians can see each day, and has approved a wider range of “virtual care” fees so doctors can consult with patients by telephone. Since the 1990s, B.C.'s Medical Services Plan has capped the number of patient visits doctors can bill for each day. Those rules meant doctors would be be paid in full only for the first 50 patients.

Kathleen Ross, president of Doctors of BC, applauded the changes.

“Our main concern is to ensure British Columbians get the care they need without compromising the health of our patients, front-line physicians, or their staff,” she said in a statement. “To that end, we’re pleased that government has agreed to expand virtual care fees to include telephone services as well as suspend the daily volume limit. This includes consultations, office visits, and non-procedural interventions – for any health concern patients are wanting to see their doctor for.”

By contrast, the Alberta government has been in a battle with its doctors over reducing costs this year. In February, the government announced it is ending its long-standing master agreement and freezing physicians’ compensation. The opposition NDP has warned this could cause physicians to leave Alberta.

B.C. has also asked regulators of the different health colleges to begin emergency registration of health-care professionals who are non-practising, retired or from other jurisdictions and may be available.