Slew of cancelled surgeries mean long-term consequences

'Really, we need the funder to be willing to go beyond or outside the box," a doctor said. "Otherwise, this will become a chronic problem.'

The Star Phoenix 5 minute read November 2, 2021

Keeley Buckley’s toddler spent more than a year on a waiting list before Saskatchewan indefinitely suspended a slew of surgical procedures as its hospitals buckled under the fourth wave of COVID-19.

No one knows when three-year-old Elijah will be able to get the cleft lip surgery and bronchoscopy his mother says would make a huge difference in his quality of life.

“It’s very stressful not knowing when his health care will become important again,” she said.

Elijah’s delayed surgery is a small part of a massive problem. Tens of thousands of procedures, put on hold by the pandemic, threaten to clog Saskatchewan’s health-care system. Leading physicians say an urgent, innovative plan to clear the backlog is needed before it’s too late.

“Really, we need the funder to be willing to go beyond or outside the box,” University of Saskatchewan provincial medicine department head Dr. Haissam Haddad said. “Otherwise, this will become a chronic problem.”

Dr. Ivar Mendez, the U of S’s provincial head of surgery, said the backlog of patients awaiting surgery has grown by between 34,000 and 35,000 since the start of the pandemic, with 800 to 1,000 being added every week. They range from people awaiting hip or knee replacements to cataract surgeries and organ donations.


People who urgently need surgery have never stopped getting it, but the delayed surgeries are not just growing in number: they are growing in urgency as those patients get sicker, Mendez said.

Haddad noted there is a saying in cardiology that “time is muscle” — every moment could mean more damage to the tissue and a harder recovery. The same now applies for the province’s health system. Every delayed procedure could mean a required reassessment; an elective surgery may become urgent or a simple problem become complicated.

“Down the road, as we delay the care of these patients, there will be more problems as patients who would have been stable get worse,” Mendez said.

Saskatchewan originally suspended non-urgent procedures in March 2020, when health leaders decided to conserve every resource they had in case the pandemic rocked Saskatchewan in the way it struck northern Italy, New York City or other hard-hit areas at the time. They eventually resumed, ebbing and flowing depending on the province’s COVID-19 caseload.

Then, in September, the Saskatchewan Health Authority announced it would once again postpone services to divert every human resource it could to the province’s overwhelmed intensive care units, which were being filled with mostly unvaccinated COVID-19 patients.

As of Monday, Saskatchewan has flown 26 of those patients to Ontario for care.

The strain has a ripple effect for the health system as a whole, according to U of S epidemiology professor Dr. Cordell Neudorf. Some severely ill COVID-19 patients are in ICU for weeks before convalescence, he noted.

“That could represent dozens and dozens of heart patients every week that we can’t be looking at.”

No one is entirely sure when such procedures will resume. Saskatchewan Health Authority CEO Scott Livingstone said the fourth wave stopped plans to restore elective procedures. He said a committee is advising the SHA on what it would take to clear the backlog.

“Everything is dependent on what we see down the road with COVID,” Livingstone said on Friday.

On top of the backlog, Haddad worries a growing number of patients will suffer long-term complications of COVID-19 infection. He said there is also evidence some patients are putting off seeking emergency care, which he stressed they should not do.

Mendez and Haddad said a bold, data-based plan is needed — something that will likely require more recruiting, training and extra money from government. Mendez said that would be a “parallel” approach using every option.

“We need to expand the hours of surgeries. We may need to work on the weekends and after hours. It is really important all our efforts are now very geared to take care of the backlog,” he said.

Haddad said they recognize staff are tired, but believe health-care teams are dedicated to helping patients.

“If we don’t have a scientific plan supported by evidence and commitment … you may lose the trust of people,” Haddad said.

Buckley said it has been stressful waiting for Elijah’s surgery. She is frustrated with people who chose not to be vaccinated, who are much more likely to fall ill, but also with the government for its manoeuvring in the fourth wave.

Premier Scott Moe apologized to people whose health services were interrupted last month. Buckley said she’s not sure if she accepts that.

“I think that the policy-makers that made public health orders should definitely have taken what the health experts were saying into account, and I don’t think they did.”

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