Addressing surgical backlog could take two years or more: Dix

By Shannon Waters May 8, 2020

Working through the backlog of cancelled surgeries could take B.C. hospitals two years, according to the health ministry, and that’s if everything goes well. 
The first year of the catch-up effort is expected to cost $250 million and will require hundreds of additional health-care staff — including 400 surgical nurses and hard-to-find anesthetists.
“We should remind ourselves that 30,000 British Columbians have been suffering, not just by not seeing their friends … they’ve been living in pain,” Premier John Horgan said yesterday. “Today we will start the process of relieving that pain for people who have been suffering because of the lack of elective surgeries.”
The aim is to resume non-urgent surgeries by May 18 and to have all operating rooms running at full capacity by mid-June. 
Health Minister Adrian Dix said hospitals will also extend operating hours and do surgeries on weekends, as well as add new operating rooms in the summer.

Asked whether the province over-prepared for a medical disaster that never materialized, Dix defended the government’s decision to clear hospital beds at the expense of performing often long-awaited surgeries.
“Back in March, there was a very different discussion about COVID-19 — we saw images every day on television of what had gone on in Italy,” he said. Italy’s surge provided the basis for the province’s worst-case modelling scenarios.
Since mid-March, when scheduled surgeries were cancelled across the province, 14,000 procedures have been postponed and another 16,000 went unscheduled, according to the health ministry. During that time, 24,000 surgeries that would normally have been added to waitlists were not referred. About 17,300 urgent and emergency surgeries — mostly cancer and cardiac procedures — have taken place since mid-March.
People whose surgeries were cancelled are being contacted by their doctor about rescheduling. Patients who would like to defer their procedures may be able to do so with input from their surgeon and will be placed back into the surgical queue “according to their need,” according to provincial health officer Dr. Bonnie Henry
The province is also planning to contract private clinics to perform as many same-day procedures — such as eye surgeries — as possible and hopes to have them working by the end of May.
Surgical plan ‘ambitious’ and ‘extremely vulnerable’ to ‘a whole range of challenges’
Even if all goes well, the province’s plan faces a number of challenges. Screening surgical patients for COVID-19 — two to three days before a scheduled procedure and then again on the day of the operation — has reduced surgical productivity by about 30 per cent.
Hospitals will also need to hire a massive number of staff to keep operating rooms running.
“It’s our hope to hire all the graduating nurses [in B.C.] this year and to significantly increase training so that nurses who are existing in the system can upgrade skills,” Dix said. 
B.C. will also need more medical office assistants, cleaning staff and surgeons as well as anesthetists, who have historically been “challenging” to recruit, according to the health minister.

Based on emergency surgeries performed so far during the pandemic, the health ministry is currently operating under the assumption that most surgical patients will not have COVID-19. 
But a resurgence of the coronavirus in the fall could seriously delay the proposed timeline to address the backlog. 
To remain ready for a possible future surge, about half of the 19 major hospitals that have stopped surgeries to focus on treating COVID-19 patients will maintain bed capacity for coronavirus patients while the other half will shift back to performing surgeries.
Dix pledged that the province will be open and transparent about the success of its efforts to clear the backlog. Monthly progress reports are set to be published beginning in July.