Surgery cancellations starting again as Omicron wave puts strain on Alberta hospitals

As the Omicron-fuelled fifth wave of COVID drags on, Alberta's hospitals are once more feeling the strain. Hospitalizations have hit new highs and, like previous waves, surgeries are once again being postponed — causing uncertainty for doctors and patients alike.

"We field as health-care practitioners, we see all the phone calls from our patients and, unfortunately, we don't have answers," said Dr. Shahzeer Karmali, an Edmonton surgeon and section head of general surgery with the Alberta Medical Association.

"It's dramatic, and I couldn't imagine the mental anguish for somebody to know within, you know, even a week to know their surgery's cancelled."

Alberta Health Services (AHS) says surgery volume was reduced this week to about 90 per cent, with surgeries cancelled on a "case-by-case basis, site by site." Urgent and emergency surgeries, including urgent and emergency cancer and pediatric surgeries, have not been affected.

"To those Albertans who have had surgeries or procedures postponed, I'm so sorry," said Dr. Verna Yiu, the president of Alberta Health Services, on Thursday. 

"I understand how difficult it has been for you and your loved ones, but this has been necessary to allow us to create an increase in hospital capacity. It is also necessary due to the impacts of staff illness."

She said that hospitals in Edmonton and Calgary started postponing surgeries on Wednesday. For now, the number of postponements isn't as large as during previous waves, but numbers are likely to increase in the weeks to come, Yiu said.

Adding to the cancelled surgeries is the fact that the hospital system hasn't been able to function at full capacity in the time between waves of COVID.

"We have a care deficit that we're going to have to recover from," Dr. Peter Jamieson, medical director at the Foothills Medical Centre in Calgary, told Alberta at Noon on Friday. "It's not just surgeries, it's endoscopy, it's psychological treatment … it's a whole range of things."

Karmali said there will be challenges for curable diseases and easy procedures that become more difficult, with longer hospital stays and a higher chance of complications, when they are delayed.

And he's concerned about the mental health of patients who have called him this week, unsure if their surgery will proceed.

"They don't know where to go, what to do."

Compromises in care

Dr. Paul Parks is an emergency room doctor in Medicine Hat and head of the emergency medicine section with the Alberta Medical Association. He says the strain COVID is putting on hospitals and staff is being felt in wait times and triage.

"In the big emerg departments, it might be eight to 10 hours to wait … to see a physician, and, unfortunately, we have days where there'll be multiple patients with chest pain and the triage will have difficulty deciding which gets to see the doctor next and which has to wait."

He says more staff than ever are absent because they are isolating or are sick with COVID, leaving remaining workers to make difficult decisions.

"We're having to choose which patients can go up to the next bed on the floor, or where do they go — do they go in the hallways? What kind of compromises do we make in their care?"  

To avoid these decisions, Karmali says he wants to see capacity built earlier, before it's needed, by setting up field hospitals and ensuring there are enough health-care providers to meet demand, or by implementing public health restrictions earlier.

"Using the idea that we can cancel procedures as an option to build capacity, that is just the wrong way to do it. And, unfortunately, this has been seen as the option [in all the waves of COVID]," said Karmali.

"Proactive thinking is what is lacking."