Toronto

'I feel forgotten': Patients in Ontario wait for surgeries postponed due to COVID-19

The backlog of health-care services has grown "quite substantially" during the pandemic, but backlogs and wait-lists have been an issue for decades, says one Toronto doctor.

Shelley Brownlee, who's been diagnosed with cancer, has been waiting months to undergo surgery

A nurse attends to a COVID-19 positive patient in the Humber River Hospital intensive care unit on Jan. 13. The president of the Ontario Medical Association said the pandemic has created a backlog of nearly 20 million health care services, based on provincial data from March 2020 to September 2021. (Evan Mitsui/CBC)

The waiting has become excruciating for Shelley Brownlee and her partner, Jonathan Clow.

Brownlee, who's been diagnosed with a form of cancer in her abdomen, has been waiting months to undergo surgery at a hospital in Toronto. Her doctor said he had hoped to proceed with it next month but the Ontario government's pause on all non-urgent surgeries and procedures amid soaring COVID-19 cases means she'll likely have to hang on a bit longer.

"This is excruciating waiting, not having an endpoint so we know for sure she'll be able to get the surgery, and knowing that as time goes by, the options available to the surgeon when he's doing the surgery become less," said Clow, who detailed Brownlee's situation as she wasn't up for an interview.

"She's only 40 years old and she has kids and it's excruciating."

Compounding the couple's frustration is the fact that the province is allowing businesses shuttered earlier this month to reopen with capacity limits on Monday while maintaining the pause on non-urgent surgeries.

"It's infuriating, because the implication to me is that business and the economy is more important than people's lives," Clow said.

Brownlee started experiencing abdominal pain last January and decided to get checked out. After several tests, a doctor told her she didn't have cancer but needed to have an ovarian cyst removed, Clow said. When she went in for that procedure last June, Clow said the medical team realized "there was indeed cancer and it had spread throughout her abdomen."

The backlog of health-care services has grown 'quite substantially' during the pandemic, but backlogs and waitlists have been an issue for decades, said Dr. Adam Kassam, president of the Ontario Medical Association. (Evan Mitsui/CBC)

That cancer can't be treated by chemotherapy and requires surgery to "remove everything in her abdomen that she doesn't need," Clow said.

"It'll probably involve a full hysterectomy, could involve parts of her large bowel. And unfortunately, if it's growing on her small bowel, there's only so much that they can remove," he said. "The longer we wait, the more opportunity there is for this ... to seed in the small bowel, which would worsen her prognosis."

Nearly 20 million health-care services in backlog

The president of the Ontario Medical Association said the pandemic has created a backlog of nearly 20 million health-care services, based on provincial data from March 2020 to September 2021.

Dr. Adam Kassam said those services could include hip or knee replacements, cataract surgeries, colonoscopies, mammograms that screen for certain types of cancers, as well as primary, tertiary and mental health services.

"It runs the gamut across our health system and unfortunately, has been exacerbated as a result of the most recent wave of Omicron and the Directive 2 that the health-care system is currently under," Kassam said.

Toronto resident Akbar Jassani injured his knee in September while playing soccer — a sport that he said provided a form of stress relief during the pandemic — tearing his anterior cruciate ligament and meniscus.

Jassani was scheduled to have knee surgery on Jan. 17, but it's been postponed indefinitely. Now, with no surgery date in sight, he said mental fatigue has taken over.

"What's frustrating is that (there are) days where I can't walk because there's so much pain," he said.

Jassani acknowledged that small businesses are suffering, but questioned the reasoning behind reopening businesses while COVID-19 hospitalizations and ICU counts remain high.

Last week, during a press conference about Ontario's reopening plan, Health Minister Christine Elliott said that once numbers of hospital and ICU admissions start dropping, the province can start getting surgeries back on track. (Evan Mitsui/CBC)

Last week, during a press conference about Ontario's reopening plan, Health Minister Christine Elliott said the government made a "difficult decision" earlier this month to pause non-urgent surgeries in order to preserve critical care and human resource capacity at hospitals. The province placed a similar pause on non-urgent surgeries earlier in the pandemic.

"If people do have a life-threatening condition, of course they will still receive the care that they need, but we know that many people are upset and frustrated at having their surgeries pushed off yet again," Elliott said.

"We don't expect the peak of the admissions to ICU to happen until about mid-February ...  so as soon as we can see that the numbers are going down both in terms of admissions to hospital and in terms of intensive care admissions, then we'll be able to get back on track with those surgeries and procedures."

Backlog result of 'chronic underfunding,' OMA head says

Emma Saunders, 17, has been waiting months for surgery on her left hand, which she injured while horseback riding.

As time has progressed, Saunders said a joint in her hand "fused itself shut" and she was told a more "invasive" surgery was needed to mend her hand. She's now waiting for a vascularized joint transfer from her foot to her hand, but said it's been rescheduled twice in the last two months.

"It's frustrating listening to the government announce that concert venues and restaurants can open while we're still waiting," she said. "I feel forgotten by the government when listening to those announcements."

At a press conference Wednesday, NDP Leader Andrea Horwath criticized the government for pausing non-urgent surgeries and not doing more to clear the surgical backlog.

"Restart the surgeries in Ontario. Give the hospitals what they need to get the [operating rooms] fired up and get those surgeries going," she said.

To help deal with the backlog, Horwath suggested Ontario implement a centralized referral system that would assess patients on their level of need, extend availability of operating room time, and develop a strategy to retain and recruit more operating room nurses.

The Ontario Medical Association has also developed recommendations, including carrying out certain surgeries and procedures in community-based specialty clinics and providing "adequate" health-care funding from all levels of government.

Kassam said "chronic underfunding" of the health-care system under various governments had led to the backlog. For now, he said physicians have a clear message for patients.

"Please reach out to your family doctor, please reach out to your primary care provider, please reach out to the physicians that you have established relationships with to ensure that you can get the care that you need."

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