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Clearing surgery backlog will take at least 17 months and cost millions, province says

Tens of thousands of surgeries and screenings cancelled to make hospital beds available for the pandemic will start to be rescheduled mid-month, as the province kicks off a $250-million plan to clear the backlog.
Premier John Horgan is joined by Provincial Health Officer Dr. Bonnie Henry and Health Minister Adrian Dix as they discuss reopening the province's economy in phases in response to the COVID-19 pandemic during a press conference in the rotunda at Legislature in Victoria, B.C., on Wednesday May 6, 2020. THE CANADIAN PRESS/Chad Hipolito

Tens of thousands of surgeries and screenings cancelled to make hospital beds available for the pandemic will start to be rescheduled mid-month, as the province kicks off a $250-million plan to clear the backlog.

“British Columbians have been suffering, not just by not seeing their friends, not just by not going out to enjoy the splendour of British Columbia, but they’ve been living in pain,” Premier John Horgan said Thursday.

“Today we will start the process of releasing that pain for people who have been suffering because of the lack of elective surgeries.”

The first year of the plan will cost an estimated $250 million. About 75 per cent of the cost will be for labour, as more surgeons — especially anesthetists — and nurses, as well as cleaners and office assistants, are hired. The goal is to recruit about 400 nurses, which includes hiring graduating nurses and offering full-time hours to part-time nurses.

Hours will be expanded, with surgeries and procedures done seven days a week, and there will be extended weekday hours to 6 p.m. New and unused spaces will be opened, and private clinics will be used for publicly funded day surgeries, such as cataract surgery.

B.C. Health Minister Adrian Dix said shutting down non-urgent elective surgeries is an easier task than re-starting them.

He defended the decision, announced March 16, to cancel elective non-urgent surgeries to make beds available for a surge in COVID-19 patients that never emerged.

“Was it worth it?” asked Dix. “You bet it was.”

On Wednesday, there were 74 COVID-19 patients in hospital in the province, including 19 in critical care. At its peak, about 149 were hospitalized. Meanwhile, B.C. hospitals were operating this week at about 64 per cent of total capacity, and 48 per cent of critical-care capacity, Dix said.

Hospitals that usually slow down in summer, as nurses and doctors go on vacation and the number of surgeries is reduced, will now operate at full capacity to clear the backlog.

Dix said he’s optimistic doctors and nurses will agree to continue working from June through August.

“I think we’re going to have enormous buy-in from everyone in the system,” said Dix. “This is what they do. This is their life’s work.”

The government estimates it will take 17 to 24 months to clear the backlog of 30,298 patients whose elective surgeries were cancelled or weren’t scheduled because of COVID-19 restrictions.

They joined those who were already waiting, bringing the total waitlist to 93,000.

An additional 24,000 patients would have typically been added to the waitlist during that March 16 to May 3 period but weren’t because physicians’ offices were working at essential-service levels, the Health Ministry said.

After eliminating the backlog, the ministry hopes to continue to reduce wait times, Dix said, noting gains made in recent years to reduce waitlists have been lost.

Safety measures in place during the pandemic have reduced surgical productivity by 30 per cent, and the plan now is to try to minimize that while keeping patients safe.

On Thursday, calls started going out to everyone who has had a surgery or a screening test postponed to ensure they want to proceed. The calls are expected to continue over the next 10 days. Patients will have the option to wait if they are uncomfortable with going to hospital or day-surgery clinics during the pandemic.

Priority will go to the most urgent cases — cancer and cardiac patients, for instance — and those waiting twice the time of the recommended clinical benchmarks for waiting for particular procedures.

“In our processes, there is no gaming of the stats” to clear the backlog, said Dix. “We need to do all kinds of the surgeries, day surgeries, of course, but also the more serious surgeries.”

Patients will be screened for COVID-19 three days prior and on the day of surgery.

The province aims to restart surgeries by May 18, ramping up capacity over four weeks to near pre-COVID levels. By May 31, all private contracted facilities are expected to be working at maximum available capacity.

The recruitment and training of new staff will begin in June.

By June 15, all available operating rooms are expected to be running at full capacity. The extension of weekday hours and adding Saturdays and Sundays to the schedule will unfold through June until Oct. 15.

There were more deaths in B.C. than usual in March, and while most were related to COVID-19 and some can be attributed to the overdose crisis, B.C. provincial health officer Dr. Bonnie Henry said she suspects some could be the unintended consequences of COVID-19 measures, including people who waited too long to go to a hospital emergency department. Health officials plan to investigate.

“The first order of business is to say to those who made a significant sacrifice by having their surgeries cancelled that they’re at the top of the priority list for us going forward,” said Horgan. “We were mindful that these were not just numbers on spreadsheets; these were human beings, people, in many cases, who had been waiting a long, long time.”

While elective surgeries were cancelled, 17,308 urgent surgeries were completed in B.C. from March 16 through May 3, including 3,437 on Vancouver Island.

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