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Good morning. It’s James Keller in Calgary.

COVID-19 has wreaked havoc on Alberta’s health-care system, first in the spring when hospitals cancelled a wide range of procedures as they braced for a coming wave of infections, and then in the fall and winter when a sharp increase in infections was followed by record-breaking hospitalizations.

In both cases, hospitals cancelled significant numbers of surgeries to make way for COVID-19 patients and clear staff from elsewhere in the system to care for them. In October, 30 per cent of surgeries in Edmonton were getting cancelled, which soon increased to as much as 60 per cent. And there have been cancellations elsewhere in the province, notably Calgary.

The provincial government says a total of 4,300 surgeries were cancelled since November, but as Carrie Tait reports, the true impact was much greater. The tally of people who had surgeries cancelled does not include another group of people who have been waiting to get scheduled in the first place, only to have that delayed due to the pandemic.

That includes people like Cheryl Sword, who has been waiting for surgery to get two cysts on her ovaries removed. A consultation appointment was postponed indefinitely in March, and she’s still waiting.

The impact has also been disproportionate, with more complicated procedures that would require a hospital stay and could require time in the intensive-care unit piling up in favour of simpler procedures such as cataract surgery. Alberta Health Services did not provide a breakdown of the types of surgeries in the backlog.

And as the problem continues, people waiting for what in many cases are life-changing procedures that are nonetheless considered “non-urgent” are often left with no idea about when they will finally get their surgeries.

Michael Châtenay, a general surgeon at Grey Nuns Community Hospital in Edmonton, points to cases like Ms. Sword’s to underscore that it’s difficult to know just how many people have been affected.

“This really is the hidden pandemic,” he said. “We have no idea how many people like that there are out there.”

The work of going through the backlog continues to be complicated by Alberta’s rates of COVID-19 hospitalizations, which continue to be the highest in the country. Hospital admissions have come down since a peak in late December, but only slightly. There were 819 people in hospital, including 132 in intensive care, as of Monday.

Other provinces are also dealing with their own backlogs, with Manitoba announcing last week that it will begin increasing surgeries after its hospitalization numbers stabilized.

There have also been surgical delays in Ontario, where the province has imposed strict measures including a stay-at-home order announced yesterday to bend the curve back down and protect the health-care system. And that’s on top of backlogs created last spring, which a recent study found could take a year and a half to clear.

In B.C., where the second wave of COVID-19 has been much less severe than Alberta, Ontario and other large provinces, the province announced last week that it had completed about 90 per cent of surgeries that were cancelled last spring.

Health Minister Adrian Dix said that between May 18 – when non-urgent scheduled surgeries resumed – and Nov. 12, more than 163,000 patients had their procedures. That included 90 per cent of patients who had a surgery postponed in the early days of the pandemic.

Health authorities in B.C. called more than 111,000 patients who were on waitlists to ask if they were ready to reschedule their surgery. Meanwhile, nearly 8,000 additional hours of operating-room time was added compared with the same period last year.

That work has done little to clear the backlog that existed prior to COVID-19, though the province is adding resources with an aim to wipe out the entire waitlist within 22 months.

Back in Alberta, Cheryl Sword continues to wait. She said she recognizes that her operation is not as urgent as others, but she worries that she and those like her will get lost in the shuffle as the pandemic drags on.

“I wonder if I’ve fallen through the cracks.”

This is the weekly Western Canada newsletter written by B.C. Editor Wendy Cox and Alberta Bureau Chief James Keller. If you’re reading this on the web, or it was forwarded to you from someone else, you can sign up for it and all Globe newsletters here. This is a new project and we’ll be experimenting as we go, so let us know what you think.