TORONTO — Ontario hospitals were given the green light Wednesday to gradually resume non-urgent surgeries as COVID-19 infections decline across the province.
The chief medical officer of health said he was rescinding an emergency order issued April 20 that made hospitals temporarily stop the procedures during an onslaught of cases.
Dr. David Williams said daily COVID-19 rates, hospitalizations and intensive care admissions appear to be trending downward, giving some hospitals the capacity to restart non-urgent surgeries.
"While these numbers remain high and we continue to see demand for health services related to COVID-19, we are beginning to see available capacity among community and hospital partners in some areas of the province," he said in a memo.
"It is therefore important to make use of this available capacity to limit the long-term impacts on patients awaiting non-urgent care."
Ontario's hospitals came under intense pressure during the third wave. In addition to postponing non-urgent procedures, hospitals also transferred patients between facilities and staff were redeployed to handle a surge in cases. Some medical staff flew in from other provinces to help.
The province has seen case numbers and hospitalizations decline in recent weeks as public health measures, including a stay-at-home order, remain in place and vaccination rates rise.
Ontario reported 1,588 new cases of COVID-19 on Wednesday and 19 more deaths linked to the virus.
The Ministry of Health said there were 1,401 people hospitalized with the novel coronavirus -- with 735 in intensive care and 539 on a ventilator.
"As we gradually and cautiously resume non-urgent and non-emergent care, we will continue to closely monitor COVID-19 cases, hospitalizations and critical care capacity and will respond rapidly should we see a worsening of the situation," Williams said.
A spokeswoman for Health Minister Christine Elliott said the resumption of non-urgent procedures won't be immediate.
"This is dependent on hospital capacity and does not mean that surgeries or procedures will resume at this time, and the resumption will not be uniform across the province," Alex Hilkene said in a statement.
Solicitor General Sylvia Jones said rescinding the order is a good sign, but urged people to continue to follow public health measures.
"We're by no means out of the woods yet," she said. "It also gives us some hope, and the ability for people who have some of those scheduled surgeries that they can start resuming some of those activities."
Last week, Ontario's fiscal watchdog said it will take the province approximately three and a half years to clear the surgical backlog from the COVID-19 pandemic.
The Financial Accountability Office projected that the backlog of cancelled surgeries will reach 419,200 procedures by the end of September.
The FAO estimated it will cost the province $1.3 billion to clear the backlog, and noted the government allocated $610 million in its latest budget to address the issue.
The watchdog said its projections on clearing the backlog assumed hospitals will be able to operate at 11 per cent above pre-pandemic volumes in the coming years.
The president of the Ontario Hospital Association said while the worst of the capacity crunch of the third wave appears to be over, hospitals are still not operating anywhere near normal.
"We shouldn't be under any illusion that the situation doesn't continue to be very serious," Anthony Dale said, adding that the OHA agrees that it is time to begin to resume some surgeries and procedures.
He said part of that will mean learning difficult lessons from the pandemic and treating the system in a more integrated fashion to help eliminate the surgical backlog.
Dale said that could mean asking patients to travel to neighbouring hospitals or even further away to access some surgeries.
"Patient-centred care by its nature requires the health-care system to try to minimize travel for for patients," he said.
"But what is clearly evident with the sheer size of this backlog is that we'll have to entertain all sorts of solutions and approaches that we wouldn't have normally done before in order to tackle this as quickly as possible."
NDP Leader Andrea Horwath said the government needs to introduce a plan to address the backlog that includes investment in the hospital sector.
"They should have a plan right now, not in post-pandemic, they should have had a plan, after the first wave," she said. "But to think that they still are not prepared to spend the necessary money to clear that backlog ... is completely unacceptable."
Green party Leader Mike Schreiner said the government cannot allow the surgical backlog to persist for over three years, as predicted by the FAO.
"I'm calling on the government to make the financial investments in our health-care system, to ensure our hospitals have the capacity to close the backlog and catch up."
Meanwhile, Ontario's COVID-19 Science Advisory Table issued a new report Wednesday saying the province has seen a nearly 13 per cent increase in the number of deaths during 2020 compared to average death rates seen in the three years prior.
It said "excess deaths" include infection from COVID-19 as well as causes that are likely related to the pandemic, but not due to the virus itself. The group arrived at the findings using cremation figures.
This report by The Canadian Press was first published May 19, 2021.
Shawn Jeffords, The Canadian Press