Up to 60% of Edmonton-area surgeries to be delayed in COVID-19 response

As rising COVID-19 cases put pressure on Alberta's health-care system, the province plans to postpone many surgical procedures in the Edmonton area.

Dr. Deena Hinshaw, Alberta's chief medical officer of health, said on Tuesday that up to 60 per cent of non-urgent scheduled surgeries that require a hospital stay will be postponed in the Edmonton zone, as a new measure to respond to increased COVID-19 hospitalizations in the area.

Diagnostic imaging and other clinical support services will be reduced by as much as 40 per cent, and ambulatory visits and procedures by as much as 70 per cent, according to Alberta Health Services.

"These will help ensure there is space to care for the critically ill patients who require care, both now and in the coming weeks," Hinshaw said on Tuesday.

Alberta Health Services confirmed on Wednesday that surgeries will be limited to cases that require emergent treatment in less than three days. Surgery will still be performed for major and minor trauma, and urgent cancer, cardiac and vascular cases.

AHS had already postponed approximately 30 per cent of non-urgent scheduled surgeries in the Edmonton zone in late October.

As of Wednesday, there were 375 COVID-19 patients in Edmonton zone hospitals, with 71 in ICU.

"COVID-19 has stretched our system capacity with mounting demands in isolation requirements, outbreaks, contact tracing and most recently, increased hospitalizations and the need for additional critical care capacity," AHS spokesperson Kerry Williamson said in an emailed statement on Wednesday.

"To respond to these challenges, we are implementing additional surge capacity measures in Edmonton zone. These are proactive measures to ensure we are able to provide care to those who most need it."

AHS is also converting some hospital units to assist with pandemic response as needed. As of Dec. 14, the geriatric psychiatry unit at the Glenrose Rehabilitation Hospital, including 22 beds, will be temporarily repurposed for recovering non-COVID hospital patients who are not ready to be discharged.

Williamson said Glenrose patients who would be using this unit and aren't ready to be discharged will be transferred to Villa Caritas, a Covenant Health facility, to continue their treatment.

AHS was making progress on a backlog of around 25,000 surgeries after an initial shutdown due to COVID-19 in March. Surgical activity resumed in May, and by the end of September, AHS had increased surgeries to around 88 per cent of the pre-COVID-19 volume, Williamson said.

Repurposing hospital staff and units for COVID-19 response is an unfortunate reality Alberta faces right now, said Sandra Azocar, executive director of Friends of Medicare.

But Azocar said a lack of hospital beds and overstretched frontline health staff represent problems are long-standing problems in Alberta and the province could have been better prepared for an emergency like COVID-19.

"What this pandemic has shone a light on is the fact that we haven't done enough to make our health care responsive for situations such as the one we're living right now," Azocar said.

"When decisions are made in the short-term interest of saving money, Albertans have learned over and over again we end up having to pay more because of a lack of long-term planning."

Azocar said a test of leadership faces the provincial government after the pandemic is over when they must address the shortfalls within Alberta's public health system. But she said she's worried that delays in surgeries could lead to more reliance on privatized care in Alberta.

Delaying surgeries can compound problems for the whole health-care system, said Michael Parker, president of the Health Sciences Association of Alberta. Each person who can't receive surgery may mean more demand for other services like physiotherapy.

Parker added that even before the COVID-19 pandemic, Alberta wasn't operating at its full capacity for providing surgeries.

"We could have alleviated a lot of this if we'd have invested properly in the system," Parker said.

Alberta could still reach a point where all elective surgeries are delayed, United Nurses of Alberta president Heather Smith said, as hospitalizations continue to rise. But Smith said the need in immediate care to protect Albertans during the pandemic trumps other concerns.

Fewer surgeries also creates uncertainty for health-care workers, Smith said, as they could be deployed to other areas or not receive as much work. This uncertainty on top of the pressures of the COVID-19 pandemic has created difficult working conditions for frontline health staff, Smith said.

"To say that it's a constant state of fear is not an exaggeration," Smith said.