How Long Will You Be Waiting for Your Elective Surgery?

Canadians deal with medical wait times even with no pandemics.  In the past few weeks, all the healthcare resources were directed towards treating Covid-19 patients, rightfully so, and an estimated 100,000 patients had their elective surgeries cancelled or postponed. People are patiently waiting in pain to find out when they will be seen by a specialist or when their new surgery is going to take place.

Last week brought in some positive news. Some provinces are starting to call cancelled patients to evaluate and possibly reschedule. According to this article, BC is to restart its elective surgeries on May 18th. They estimate that it will take them up until June 15th to come back to the same capacity as they were pre-COVID-19. The province cancelled 30,000 elective surgeries. It may take up to 2 years to catch up, with maximizing their operating room capacity and extending surgeries to happen on weekends.

Ontario Ministry of Health released directives to help hospitals and regional centres plan for a gradual resumption of cancelled surgeries. Although no date was given, each hospital has a responsibility to evaluate its resources and adhere to the released framework. The emphasis was given to the word gradual. As a requirement, 15 % of acute care should be reserved (or made available on a moments notice). According to the document the surgeries are only to resume if the hospital has had a stable number of COVID-19 cases and has:

• available space and this space was evaluated in the context of physical distancing, so no care in the hallways
• supplies of PPE, medications, swabs and reagents are available
• health human resources are available and are not affecting urgent and emergent care

Alberta resumed their elective surgeries on May 4^th and is expecting to have 26,000 to 30,000 urgent and non-urgent surgeries performed over the next six weeks. New Brunswick started rescheduling priority elective surgeries on May 11. Manitoba and Prince Edward Island are following suit, but no certain dates have been announced.

Many news reports stated the difficulties of reopening and all the challenges that may arise with its safe implementation. In this article, the issues of asymptomatic COVID cases, the availability of PPEs, anaesthetic drugs and ventilators are raised. Everyone scheduled for surgery will have to get a negative COVID-19 test within a certain time frame prior to the surgery. So that is an additional burden on the testing centres.

All the above is promising, and one can hope that the wait will not take years. While you are waiting to hear back from your doctor’s office, there are some things you can do.

• Reach out to your physiotherapist or chiropractor to ask them what exercises you can do at home. If your condition changed, be sure to mention all the details.
• If your condition worsens dramatically, contact your doctor to tell them the new information. Most family doctors are able to do a phone consultation or a virtual appointment.
• Consider your private options for the future. By getting a medical records review done with Health Vantis you are not obligated to proceed. However, should you decide that your post-COVID wait time is too long, you will be ready.

Private Surgery After Covid-19

With medical wait times most likely increasing for elective surgeries due to Covid-19, some of you may be searching for information about your potential private options. We wanted to give an update on what is being done or considered being done at the private surgical facilities we work within Canada and the US.

As you already know, some of the southern United States are lifting the COVID-19 restrictions. Depending on the state, some are allowing elective surgeries to take place. Certain provisions and requirements must be met. Those are mandated by the state’s Department of Public Health.

Each facility we work with is accredited not only by the state (which is a requirement) but by another accrediting body in the US. We reached out to two of them, AAAASF (American Association for Accreditation of Ambulatory Surgery Facilities) and AAAHC (Accreditation Association for Ambulatory Healthcare) to ask what they have in place.

AAACH advised that they have a number of resources available to their members on their website, but that they defer to a state department of public health for further guidance on reopening as those will differ from state to state.

AAAASF offered a similar answer and added that they conduct onsite resurvey and that they ask all facilities in their resurvey year reopening to submit policies and procedures to ensure that all infection control and patient safety requirements are in place.

Health Vantis is keeping an eye on the states governments announcements and their public health departments directives. So far, we see that there are several things that are being mandated by each opening state, such as pre-op COVID testing requirement: negative Covid-19 test results within 48h or 7 days, depending on the state. Some require staff and doctors continuous testing as well.  Another one is sufficient supplies of PPE to be stocked at a facility and enhanced cleaning protocols.

We are also keeping in touch with all the facilities we work with so that we get pertinent information on their developments. It is not clear yet how soon we will be able to send someone for medical travel.