Over half a million fewer surgeries were performed across Canada during the first 16 months of the COVID-19 pandemic compared to previous years, a new report suggests.
The report from the Canadian Institute for Health Information (CIHI) drives home the profound strain the pandemic has had on every province and territory’s health-care system, which will continue to be challenged even after COVID-19’s impact fades.
“We don’t know where the health-care system is going to land as it works to build back better,” said Tracy Johnson, director of health system analytics at CIHI.
“Addressing this surgical backlog will certainly be one of the many challenges the system faces as it continues to adapt to the pandemic.”
About 560,000 fewer surgeries were performed between March 2020 and June 2021 compared to the previous 16-month period through 2019, according to health data compiled and analyzed by CIHI for the report.
Most of that decline occurred during the first wave of the pandemic in March and April 2020, when Johnson says the health-care system — along with every other sector of the country and the world — was struggling to figure out how to respond to COVID-19.
“When you look at the rest of the time period, from last summer through to this summer, what you can see is systems adapting to this new information,” she said.
“They figured out how to triage, figured out how to turn the tables and how literally to turn things back on. And you can see the different provinces were able to ramp up their surgeries faster or slower, depending on what their system was like.”
Surgical patients still waiting for care after pandemic delays
Ontario, for example, saw a 76 per cent decline in surgeries in April 2020 compared to a year before, the sharpest drop of any province or territory in that hard-hit month.
That might explain why it took Ontario an extra two months to recover that lost ground: while all other jurisdictions were able to return to relatively normal levels by June compared to 2019, it wasn’t until September that the country’s most populous province climbed to within five per cent of 2019 levels.
The impact of the second and third waves, which hit certain provinces and territories at different times, is also reflected in the data. For example, Manitoba’s health-care system had a hard November and December last year, with surgeries being cut by about one-third compared to 2019, while other provinces stayed relatively steady.
Not all types of surgeries were impacted to the same degree, either. The report found cardiac and cancer surgeries, while also experiencing a dip of about one-third in April and May 2020, largely remained at previous levels.
Other procedures like knee, back and eye surgeries dropped by as much as 87 per cent over that same period before rebounding.
The report found less people were visiting the hospital in general as doctors and other health-care workers adapted to providing virtual care to patients as a way to reduce strain on the system. On average, CIHI found there were 9,300 fewer hospital visits per day nationwide compared to 2019.
Across five provinces that was able to provide data — Ontario, British Columbia, Alberta, Saskatchewan and Manitoba — virtual care visits by either phone or online climbed between 27 and 57 per cent on average, with B.C. seeing the most virtual visits overall.
Johnson says solutions like that will play a big role in how the system responds to the backlog and other challenges brought up by the pandemic — though it may still not be enough.
“There will still be a need for overtime, holiday work, weekend work, evenings,” she said. “The big challenge is finding people who want to work that long and who can help us get through that backlog.”
The report notes that the full impacts of the delayed or cancelled surgeries on patients and health-care workers has yet to be fully seen — for example, how many patients may have experienced debilitating health issues or even death as a result of missing their procedures.
Manitoba doctors warn healthcare system straining under increasing COVID-19 numbers
Johnson says CIHI is hopeful the data provided will help the health-care system learn from the past waves of the pandemic and prepare itself for future waves, while also recovering from the backlog and other impacts.
Surgery backlogs across the country have led to dire warnings from provincial health experts, forcing governments to make hard choices.
Doctors Manitoba, which represents more than 4,000 physicians, estimated earlier this week that the backlog of surgeries and tests has grown to a record 152,000 cases. The Manitoba government said Wednesday some patients may need to be shipped to other provinces to help ease the strain.
Modelling has suggested that Saskatchewan’s health-care care system won’t return to sustainable levels until mid-January.
Rising COVID-19 cases in some parts of the country, meanwhile — along with fears of the new Omicron variant — have led other provinces like Ontario to warn this week that surgeries may be reduced again to make room for an anticipated surge in patients.
–With files from the Canadian Press
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