Elective surgery backlog grows even as hospitals ramp back up

Four months after the COVID-19 pandemic forced Ottawa's hospitals to shut down their operating rooms to elective surgeries, thousands of patients continue to languish on waiting lists that continue to grow longer.

"Patients are anxious about getting their procedures done, doctors are anxious, everybody in the hospitals, we're anxious, and we want to get back to ... see those patients," said Dr. Stéphane Roux, chief of staff at the Montfort Hospital. "We want to treat those patients, but we have to do it in a safe and effective way."

While The Ottawa Hospital has now ramped up to about 90 per cent of its normal caseload of elective surgeries, the Montfort is at only about half its capacity. As of Monday, the Queensway Carleton Hospital was at about 56 per cent of the non-urgent caseload it would have seen prior to the pandemic.

The region already had long waits for elective surgery before the pandemic hit, and the backlog has now increased significantly. Yet none of the hospitals in the region appears to be keeping track of just how many patients are on that backlog list.

The Queensway Carleton Hospital says COVID-19 restrictions forced the cancellation of approximately 1,800 surgeries. Those included orthopedic operations on hips, knees and shoulders, which are often vital to a patient's quality of life, but not life-threatening.

'People are suffering'

Until last week, COVID-19 had kept Dr. Raj Prihar out of his operating theatre since March 13. Prihar is now trying to prioritize his patients, some of whom are in desperate need.

"Over the last three months, their joint disease has deteriorated to the point where they're barely mobile because it's so painful, or they now need to use a walker or a wheelchair," he said. "I mean these poor people are suffering, and because everything just got shut down."

Both the Ottawa and Queensway Carleton hospitals have now extended their surgical hours each day, and are now performing surgeries on the weekends.

Prihar, who is also the hospital's interim chief of staff, said there are still a number of factors preventing hospitals from ramping back up to 100 per cent.

Staffing is one problem, considering it's summer and 25 full-time staff members are now working at the city's west-end COVID-19 testing facility.

As well, staff from all of Ottawa's hospitals were helping out in various long-term care facilities across the region this spring.

Meanwhile, the hospitals have been affected by a global shortage of drugs, especially anesthetic medications. And they all must also abide by restrictions imposed by Ontario Health.

While those who've long been waiting are finally getting calls to prepare for their surgeries, new patients continue to be added to the lists.

"It's a prioritization of cases where the most sick patients, the ones with the most urgent needs, will get seen right away," said Roux. "We're trying to ramp up as fast as we can. Obviously, the rate of increase is not necessarily linear because of all the challenges that we face."

A regional approach

There are also some region-wide solutions being discussed among hospitals inside and outside the city.

"For example, we're working with some patients where it might not be the hospital where you thought you might get your surgery, but if it works out for you and your care team, maybe that care could be provided in another hospital in the region," said Dr. Virginia Roth, chief of staff at The Ottawa Hospital.

Prihar's goal at the Queensway Carleton is to soon ramp up to 75 or 80 per cent of the hospital's pre-COVID-19 surgeries, but he says it's going to depend on what's happening in the community.

"What happens with procuring personal protective equipment and drugs, and safely distancing everyone when they come into hospital to prevent an outbreak."