Wait-list for surgeries, diagnostic procedures grows to 110,000, Doctors Manitoba estimates
Delays, cancellations due to pandemic leading to prolonged pain, even death
Manitoba doctors estimate the backlog in surgical and diagnostic procedures caused by the COVID-19 pandemic has grown to more than 110,000, and say that will lead to prolonged pain, worsening health conditions and even death.
"This backlog is staggering and it is growing larger every day," Dr. Kristjan Thompson, president of Doctors Manitoba, said during a news conference Thursday.
According to a new report from the organization, which represents physicians in the province, the backlog includes more than 39,000 surgeries, 44,000 diagnostic imaging tests and 32,000 other procedures, such as mammograms and endoscopies.
As hospitals came under increasing strain from the number of COVID-19 patients needing care during successive waves of the pandemic, staff were redeployed and some medical procedures were postponed to free up capacity.
As of midnight Thursday, there were 142 Manitoba patients in intensive care units, including 122 patients in local ICUs receiving both COVID and non-COVID care, as well as 20 COVID patients receiving care in other provinces, a provincial spokesperson said in a statement.
The normal pre-pandemic ICU capacity in Manitoba was 72.
This backlog is staggering and it is growing larger every day- Dr. Kristjan Thompson, president, Doctors Manitoba
Although some progress was made clearing the backlog in February and March, after the end of the second wave, it has begun to grow again since most surgeries were postponed on May 8.
Assessing the full scale of the backlog is difficult due to insufficient public reporting, particularly for surgeries, the report says. Doctors estimate they have decreased referrals for surgery by 11 per cent during the pandemic.
"This is a potential 'hidden' backlog not captured elsewhere, which we have incorporated into our estimate," the report says.
WATCH | Dr. Kristjan Thompson calls Manitoba surgery, diagnostic procedure backlog 'staggering'
Data on diagnostic procedures is more readily available, and the impacts on diagnostics has been less than that on surgeries during the second and third waves, it says.
The data in the report comes from a variety of sources, including a Doctors Manitoba survey of physicians, which drew 1,022 responses, and an online Probe Research poll of Manitoba adults, which received 1,000 responses. Both surveys were conducted in early April, before the third wave.
Heart, cancer surgeries delayed
Among the most concerning impacts are delays of cardiac and cancer surgeries; at least two patients have died waiting for heart surgery, the report says.
The Canadian Institute of Health Information has said that during the first wave of the pandemic, cardiac surgeries decreased by 16 per cent and cancer surgeries decreased by nine per cent.
Cancer physicians reported many cases of delayed biopsies and surgeries, resulting in cancers progressing, spreading and patients needing additional treatments.
Wait times for all procedures have more than doubled on average. The worst impacts have been on neurosurgery and cardiovascular surgery, which have increased by 243 per cent and 204 per cent, respectively.
Surgery volumes have fallen an estimated 40 per cent overall, with the biggest impacts on obstetrics and gynecology (55 per cent), cardiovascular surgery (50 per cent) and head and neck surgery (50 per cent).
Impacts on women, children
The report estimates the surgery backlog for children and youth is between 3,500 and 5,000 cases, with many children waiting longer than the recommended time.
Most children's hospitals across Canada managed to clear their backlogs after the first wave of the pandemic by increasing their capacity above 100 per cent, but Manitoba's Children's Hospital has been unable to get its capacity above 60 to 80 per cent, due to a continuing nursing shortage.
In addition to decreased surgical loads for obstetricians and gynecologists, the report notes uro-gynecology surgeries have fallen between 40 and 70 per cent, and hysterecomies have dropped by 24 per cent.
Surgeries for pregnancy loss or abortion have also been delayed.
The number of mammograms performed during the pandemic fell by 20,000.
Backlog barriers
According to the Probe Research poll, 81 per cent of Manitobans say they are concerned about having a medical test or surgery delayed due to the pandemic; 12 per cent reported having a diagnostic test cancelled, and six per cent had a surgery cancelled.
The major barriers to addressing the surgery backlog identified in the report include insufficient nursing staff and a lack of operating room time and recovery space.
"This will be a massive task," requiring as much effort as the pandemic itself, Thompson said.
The report makes three recommendations to the province to address the backlog:
- Commit to a fixed date to bring the health system back up to speed.
- Create a surgery and diagnostic recovery task force.
- Provide monthly reports on the progress, including the size of the backlog.
Nearly all of the physicians surveyed say they are able to pick up more cases to help address the backlog.
The report cites British Columbia as an example to follow. Health officials in that province launched a plan in May 2020 to address the backlog from the first wave of the pandemic, which estimated it would take between 17 and 24 months.
By March 2021, the province reported 95 per cent of the backlog had been cleared, according to Doctors Manitoba.
Reducing backlog is shared goal, province says
Acting health minister Kelvin Goertzen thanked Doctors Manitoba for its report.
"We share the goal of reducing the backlog of surgeries … as quickly and effectively as possible," he said in a statement emailed to CBC News.
The government has contracted with organizations such as CancerCare Manitoba to perform 11,000 additional surgical procedures, and budgeted "at least" $50 million this fiscal year to reduce surgery wait times, Goertzen said.
The government plans to share more detail in coming weeks on how the "common goal" of dealing with surgical backlog will happen, Goertzen said.
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With files from Jillian Coubrough