Manitoba performed 1,900 fewer surgeries per month during COVID's 1st 3 waves: report

During the first 16 months of the COVID-19 pandemic, Manitoba performed approximately 1,900 fewer surgeries per month than in 2019.

April 2020 saw the largest decrease in surgeries in the province, with about a 68 per cent decrease in total surgeries compared with the previous year. This includes about 36 per cent fewer cardiac surgeries, 26 per cent fewer cancer surgeries and 82 per cent fewer high-volume surgeries such as hip and knee replacements.

The numbers are outlined in a report released Thursday by the Canadian Institute for Health Information (CIHI). The report explores the impact the pandemic has had on health-care systems during the first three waves of the pandemic, from March 2020 to June 2021.

Tracy Johnson, the director of health system analytics for CIHI, told CBC News the mounting surgery backlog is an "ongoing challenge that all provinces are facing right now and are trying to solve." 

The mounting backlog for elective surgeries in Manitoba has prompted some citizens to fly outside of the country to have surgery.

"The challenge will be enough physicians and anaesthetists and nurses who can help with that catch up over time," Johnson said. "It's a challenge with an aging workforce whose been working kind of 18 months flat to find the resources and free them up in order to cover off this backlog."

This isn't merely a Manitoba problem.

The number of Canadians who have had surgical procedures put on hold during this period is as many as 560,000. That's an average of about 35,000 per month.

The numbers do not depict actual surgery cancellations, but rather an estimation of the surgeries that haven't been performed.

Despite fewer surgical procedures taking place across the country, early analysis from CIHI shows that quality of care was maintained during the first two waves of the pandemic.

This included a shift to primary care conducted virtually, whether by phone or online, and increased access to care.

Across five provinces where data is available, between 27 per cent and 57 per cent of physician services were provided virtually.

"The health-care systems across the country have continually adapted their response to COVID-19 to find a balance between caring for COVID patients and caring for patients with other health issues," Johnson said.

In April 2020, 56 per cent of family physician consults and visits in Manitoba were provided virtually. That number dipped to as low as 27 per cent in August 2020, but averaged 39.4 per cent from November 2020 to March 2021.

The increase in virtual medical visits directly coincided with fewer Canadians visiting emergency departments.

Visits to emergency departments were 22 per cent below pre-pandemic levels, with less urgent and non-urgent visits decreasing the most, by approximately 28 per cent.

Children and youth had the largest decrease in emergency department visits.

Children age 0 to four decreased by an average of about 50 per cent per month compared with the pre-pandemic period, while those age five to 19 decreased by an average of 38 per cent per month.

The decrease in emergency departments did, however, result in fewer urgent visits from patients with respiratory ailments.

According to CIHI, this contributed to fewer visits for conditions such as bronchiolitis in young children, influenza, pneumonia, asthma and chronic obstructive pulmonary disease.

With colds and influenza virtually non-existent in Canada last winter, Johnson says there is a "major concern" that we could see "twin pandemics" with the return of colds and influenza.

"Omicron and the opening up of things, and people starting to do things inside as opposed to outside, we're starting to see those COVID numbers rise again," Johnson said. "So what we mean by twin pandemics is we could have a surge in patients seeking care and needing care in hospitals for both the flu and COVID-19."

This includes in long-term care centres where Manitoba had only 0.2 deaths per 100,000 during the first wave (March 1, 2020 to Aug. 31, 2020) of the pandemic, but saw that number skyrocket to a Canadian-high 32.7 during the second wave (Sept. 1, 2020 to Feb. 28, 2021).

In the third wave (March 1 to Aug. 15, 2021), that number dropped to 0.9, but was still second-highest in the country behind Quebec (1.6).

Johnson said the reason for the drop in Manitoba was in large part due to the vaccine uptake of the province's elderly population beginning in December 2020.

As the pandemic continues to trudge on, Johnson says to expect differing provincial and regional approaches to tackling it as different areas of Canada continue to deal with COVID at different stages.