Waterloo region hospital surgeries threatened by Omicron
Kitchener resident Angela Williams was diagnosed with chiari malformation, a rare brain disease that puts irregular pressure on parts of her brain and spinal cord, in late 2019.
She was due to undergo surgery on March 13, 2020 to treat her neck pain, dizziness and migraines, and to prevent her condition from getting worse.
Despite tentative surgery dates and multiple emergency room visits, surgery never took place.
“It was scary,” said Williams, who has since seen several different doctors, specialists and surgeons beyond the Waterloo region over the past two years. “I didn’t hear anything from the surgeon. I didn’t hear anything from the doctor. I didn’t hear anything.”
Almost two years later, Williams is still awaiting the initial surgery with no date in sight. Except now she sometimes wakes up choking on her own vomit, frequently loses sight in both eyes, and is constantly struggling with some kind of pain.
“I’m just sitting here at a loss,” said Williams, who says she is unable to work due to her condition. “I hope and pray for the phone call that never comes.”
An accumulation of surgeries in hospitals
Williams is one of 11,000 people waiting for surgery in the Waterloo region. Hospital officials estimated it would take more than a year to clear.
In the past two years, hospitals have been forced to stop elective surgeries twice, building on an existing backlog of surgeries that in some cases existed before the start of the pandemic.
Lee Fairclough, president of St. Mary’s General Hospital and regional leader against COVID-19, said hospitals in the area are starting to see the effects of delayed or limited access to other services, such as MRI and other diagnostic tests.
“People are arriving sicker and sicker – in part because of limited access to care at the start of the pandemic, both in hospitals but also with primary care,” Fairclough said.
“We are now seeing people come forward with more advanced presentations of some of their conditions.”
About 80% of the region is fully vaccinated against COVID-19. While this has helped hospitals increase elective surgeries to over 110% to get back on track, Fairclough says the Omicron variant poses a threat to these short-lived plans.
“We also realize that in order to respond in January, we will probably have to scale back some of our non-urgent and emerging procedural work again. For now, we will plan that,” she said.
Fairclough says regional hospitals are looking to increase services to help people get their third dose of the COVID-19 vaccine, in addition to preparing resources for the influx of admissions they are waiting for due to the Omicron cases.
How to tackle the backlog
Flaircough says the demand for hip and knee surgeries is high, with ophthalmology cases accounting for more than 50 percent of surgeries awaiting St. Mary’s.
To address a backlog of more than 7,000 surgeries, St. Mary’s partnered with offsite provider TLC Vision earlier this year to perform ophthalmic procedures at 130% capacity.
Grand River Hospital, over 2,000 surgeries, has been operating in six operating rooms and will drop to seven at the end of January and hopefully eight at the end of March, according to communications manager Cheryl Evans. Before COVID, the hospital would perform nearly 10,000 surgeries each year.
Cambridge Memorial Hospital, which also has about 2,000 surgeries on its waiting list, has a partnership with the Tri-City Colonoscopy Clinic to help with endoscopy procedures, according to communications director Stephan Beckhoff.
“We are also exploring similar partnerships for other proceedings,” he said, adding that although there have been “promising” talks, nothing has yet been formalized.
According to an email from the Department of Health, hospitals in the Waterloo region as well as hospitals in Ottawa, Kingston and Windsor are all working with community partners to deliver low-risk interventions in new settings to unlock the disease. capacity of operating rooms in hospitals.
Despite community care and private partnerships, as well as the process of triage of surgeries based on need and pain management, people can still fall through the cracks, Fairclough said.
“I think the reality is that the backlog and the wait times are increasing, and with every big wave we’re going to see the same effect.”
A reflection of a province-wide problem
The backlog may seem huge for the region, but it is just a drop in the bucket for Ontario hospitals.
In November, a report commissioned by the Canadian Medical Association said it would take at least $ 1.3 billion to bring wait times for surgeries back to pre-pandemic levels.
However, in May, the Financial Accountability Office (FAO) found it will cost $ 1.3 billion alone to clear the growing backlog of surgeries and diagnostic procedures and an additional 3.5 years to clear the backlog of surgeries, assuming hospitals are operating above their standards. capacity.
The province has allocated $ 610 million – less than half – in the budget, to tackle surgical backlogs. Part of this has already been used by Waterloo regional hospitals to train more nurses and fund surgeries.
But the ministry said the FAO report does not reflect “the actual current demands of patients awaiting surgeries and diagnostic imaging procedures.”
“Current data shows that the total number of surgical patients waiting in Ontario is currently no higher than before the pandemic, although as patients proceed with early screening, referrals and diagnostic evaluations,” more of them could be on surgical waiting lists in the coming months, ”an email from the ministry said.
The same email also showed that hospitals received $ 6.2 million in one-time surgical support funding to operate evenings and weekends to make up for surgeries. The ministry said this led to Cambridge Memorial Hospital completing 92%, Grand River Hospital 86% and St. Mary’s General Hospital 84% of their allocation volume funded in 2020-21.
Between 2020 and 2022, the ministry said hospitals in the Waterloo region have received a cumulative amount of $ 2.6 million to support overtime MRI and CT scans.
“Waterloo hospitals will also be eligible for additional supports for surgical recovery in 2021-2022 depending on the level of surgical activity they perform,” the email said.
Prepare for another wave
Fairclough says that while hospitals and community partners in nursing homes, pharmacists and clinics are working together to prepare for another wave, they can’t do it on their own.
“My main message to the community is that we will continue to work very hard to find the right balance between these two choices and decisions,” said Fairclough. “[If you] have not yet received your first dose, please take your first dose as I believe this variant will move very quickly in the unvaccinated population.
Based on her experience, Williams believes it’s the limited and exhausted medical staff, combined with the bureaucratic oversight, that puts her at the bottom of waiting lists for surgery.
But as frustrated as she is with waiting for surgery, she is also upset by people who are not making an effort to curb the spread of the virus.
“My frustration is with people not getting the shot,” Williams said. “People who don’t wear masks, people who always think it’s a joke, people who think, ‘Oh, well, whatever, that doesn’t affect me. I am not sick. “
“The more people there are who don’t get the vaccine and treat it like this, the longer the wait for people who are waiting for surgery.”