Delayed surgeries have ‘huge impact’ on patients as hospitals scramble to keep up with COVID-19

·4 min read

In January, Victoria Hurst was deemed legally blind and told to get an urgent cataract surgery.

But days before the April procedure, Ontario ordered hospitals to postpone non-life-saving surgeries to prepare ICUs for the COVID-19 surge.

Now, the 69-year-old Stoney Creek resident is in the lurch learning how to live with a new disability.

“I don’t know how to make a cup of tea without burning myself,” she said.

Victoria had been dealing with problems in both eyes for years. Last July, her right eye was removed. In October, she was diagnosed with lymphoma in her left eye. At the time, doctors said a cataract in that eye wasn’t an immediate problem.

But in just two months, her eye got worse. A doctor told her there was damage to an optic nerve, but couldn’t say what caused it — chemotherapy or a different, hidden problem — without surgery. The procedure would also potentially help her recover partial vision.

Victoria’s surgery was scheduled for April 13 at North York General Hospital’s Cataract High Volume Centre. But on April 8, Ontario Health, a provincial agency, sent a memo instructing hospitals to “ramp down” all elective and non-urgent procedures effective April 12.

Elective surgeries are necessary procedures that affect a patient’s quality of life, though they do not need to be performed immediately. Emergency procedures are ones considered life-threatening and must to be completed within hours or days.

North York General Hospital confirmed in an email that all cataract surgeries were postponed due to the province’s direction.

The hospital, which declined to provide a name with the statement, noted it’s preparing “to ramp up postponed surgeries as quickly as possible ... as soon as we are able.”

The directive means patients like Victoria are left suspended as hospitals scramble to keep up with ICU demand. As of April 19, Ontario had an estimated cumulative backlog of 257,536 surgeries due to the pandemic.

“Clearing the surgical backlog will be an enormous challenge,” said Adalsteinn (Steini) Brown, dean of the Dalla Lana School of Public Health at the University of Toronto, during provincial projections April 29.

The Ontario COVID-19 Science Advisory Table said ICUs are continuing to fill up, with occupancy in critical care expected to “remain above the level necessary to restart surgeries for some time.”

Victoria had to move in with her son, Ryan, and his wife, Aeisha. A lack of supports during COVID-19 make it hard for her mother-in-law to adapt, Aeisha says. Both Victoria and Aeisha say Victoria’s greatest loss is her independence.

“She couldn’t take care of the home,” Aeisha said. “The system totally failed her.”

At Hamilton Health Sciences, 715 out of 1,842 non-urgent procedures scheduled between April 12 and 30 were delayed, according to spokesperson Wendy Stewart.

St. Joseph’s Healthcare Hamilton also had to “drastically reduce” surgeries, said chief of surgery Dr. Anthony Adili. He said roughly 500 to 550 procedures are added to the hospital’s backlog each week.

Endoscopies and minor procedures — such as for carpal tunnel syndrome or skin cancer — are running at 25 per cent capacity, Adili said. Bigger surgeries at the Charlton and King Street campuses are down to 40 per cent. That includes joint replacements, plastic reconstruction surgery and hernia repairs, among other procedures.

Adili estimated that it would take “a good eight to 10 months” for St. Joe’s to catch up.

“It has a huge impact on patients,” he said. The orthopedic surgeon said some of his patients have had to cut down their shifts or stop working entirely as a result of the delays. Some use canes and walkers for support.

“Their joint pain is so severe that they can’t function at work,” he said. “They’re pretty significant procedures.”

And cataract patients like Victoria are left with limited to no vision until hospitals return to normal operations.

The doctor noted that the delays would likely affect some patients’ conditions, and perhaps make their surgeries more complicated and impact their outcomes or recovery.

“But it’s a balancing act,” Adili said. “It’s a constant struggle for us to say who gets access.”

At the same time, he doesn’t believe the delays will cause patients to reach a point where they can no longer be treated.

He encourages people to follow public health measures and get vaccinated as soon as possible to avoid more pressure on already overwhelmed hospitals.

“If we can minimize the spread, it’ll allow us to catch up.”

At the same time, he encourages those who need medical care to get it, emphasizing that hospitals are safe.

Maria Iqbal, Local Journalism Initiative Reporter, The Hamilton Spectator

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