Manitobans face longer waits for surgeries, procedures after 3rd COVID-19 wave

Manitoba's backlog for surgeries and procedures has grown by nearly 20,000 since the COVID-19 pandemic's third wave peaked earlier this summer, a report from Doctors Manitoba says.

In its latest update, released on Thursday, the organization estimates the total backlog now sits at almost 130,000 procedures.

"We had hoped that we would see more progress as the third wave ended and COVID-19 case counts decreased," said Dr. Kristjan Thompson, president of Doctors Manitoba.

"Instead the backlog has grown, and we are now bracing for further disruptions as Manitoba is in the midst of its fourth wave."

Doctors Manitoba estimates combine data on scheduled procedures from provincial agencies, as well as reporting on surgical volume changes from the Canadian Institute for Health Information and estimates from physicians and surgeons of decreases in volumes, representing a potential "hidden" backlog not captured elsewhere, the report says.

Although the wait-list for diagnostic imaging procedures decreased from 44,000 to 41,000 as the province eliminated the backlog of CT scans, the wait-list for surgeries increased 33 per cent, from 39,000 to 52,000, the doctors' organization estimates.

For all three publicly reported priority procedures — hip and knee replacements, cataract surgeries and cardiac surgeries — the backlog has increased, the report says.

The number of cardiac surgeries performed decreased 12 per cent, while the backlog increased from 163 in April to 204.

Cataract surgery volumes fell 20 per cent, pushing the backlog from 3,273 to 4,889.

The number of hip and knee replacements done dropped 56 per cent, increasing the backlog from 6,001 to 8,128.

The longer waits are leading to worsening health outcomes, delayed diagnoses and potentially unnecessary deaths, Thompson said.

Rebecca Ellis has been waiting nine months for a hysterectomy for her adenomyosis, a condition in which the tissue lining her uterus grows into her uterine muscle.

"I am in and out of the ER and urgent care in pain. I'm in pain 24/7," she said.

Her doctors have told her the delay is due to the COVID-19 pandemic.

"The wait times are ridiculous," she said.

While some progress was made on the backlog of these procedures between the second and third wave, "the disruption during the third wave erased that progress and added [to] the backlog," the report said.

The wait-list for other procedures, such as endoscopies, mammograms and allergy tests, increased from 32,000 to 35,000.

Limited progress

In June, Doctors Manitoba estimated the backlog had reached more than 110,000 procedures. At that time, the organization made recommendations to the provincial government, including committing to a fixed date to bring the health-care system back up to speed, creating a surgery and diagnostic recovery task force and providing monthly reports on the size of the backlog.

Progress on those recommendations has been slow, Doctors Manitoba said in the report.

No date has been set for when the province intends to eliminate the backlog, and no additional reports on the backlog have been released. 

"We need transparent monthly reporting so that we not only understand the scope of the problem today, but so that we can see how progress is being made and know if our interventions are actually having the desired effect," Thompson said.

"We are releasing our own estimates today, and that's not good enough." 

While preliminary steps have been taken to create an advisory group, they have never met, and it's unclear whether a task force will be established with authority to take steps to address the backlog, the report says.

In a scrum with reporters Thursday afternoon, Health Minister Audrey Gordon said a "steering committee" had been struck to help develop a strategy to deal with the backlog.

The province had contracted with other service providers, such as the Pan Am Clinic, to perform hand and foot procedures, and the Western Surgery Centre, to perform procedures such as cataract, pediatric dental and plastic surgery.

The province committed $50 million at the end of March to help chip away at the backlogs. Gordon said Thursday that $13.7 million of that has been spent so far.

She said $8.1 million of that has been spent to address "backlogs in endoscopy, cataracts, paediatric general surgery, dental and ENT [ear, nose and throat], outpatient spine procedures, and adult ENT and general surgery."

"Our government made great strides in reducing surgical wait times in Manitoba prior to COVID-19, and we will continue working with our partners across the health care system – including Doctors Manitoba – to do it again as we recover from this global pandemic together," Gordon said in a statement.

'Missed opportunity'

Compared to other provinces, Manitoba did not suffer as severe a disruption to its surgical volumes during the first wave of the pandemic, dropping 45 per cent compared to the national average of 55 per cent.

During the second wave, however, other jurisdictions took steps to shore up their health-care system capacity, leading to a national average surgery decrease of four per cent, while Manitoba's surgical volumed dropped 29 per cent.

"We were quite fortunate in Manitoba, in that we didn't have as severe a first wave, and so I think a lot of the things that other jurisdictions were doing, we didn't have to do," Thompson said.

While provinces such as British Columbia have managed to eliminate their backlogs, Manitoba's grew between the third and fourth waves.

"I think it's a missed opportunity," Thompson said.

Many problems in the health-care system, such as shortages of nurses and technologists, preceded the pandemic. During the pandemic, staff have been diverted from other areas of the health-care system help overloaded intensive care units.

"On a good day, if there was not pandemic, our health system is stretched pretty thin," Thompson said.

"With a pandemic, I think it's really shown quite clearly how stretched thin we are."

Changes in government leadership in Manitoba over the summer, including the resignations of Brian Pallister as premier and Heather Stefanson as health minister, may have contributed to the lack of progress, Thompson said.

"But every single person we spoke to … committed to addressing this backlog and truly demonstrated a deep understanding of how severe this was. And so I know that we're on the same page, but we need to start seeing action."