Hospital services restarting for 'urgent, critical' elective surgery Horizon patients

Hospital services restarting as New Brunswick recovers from COVID-19 will be available for a select few needing elective surgeries more urgently than others, says Horizon Health Network.

Ambulatory services and diagnostic imaging can also be available for high-priority and urgent cases by appointment even if they aren't scheduled for surgery, the network clarified Wednesday.

The province announced Friday the start of the orange recovery phase. Dr. Jennifer Russell, chief medical officer of health, said this means health authorities can restart non-emergency surgeries, diagnostic procedures and health services in a "progressive" manner.

On Tuesday, Horizon announced they will only be restarting elective surgeries that are "urgent and critical." This is on top of emergency surgeries and services that have not been interrupted.

This marks only the beginning of dealing with the 15,000-patient backlog of surgery patients in Horizon alone.

Russell said the price of cancelling elective surgeries and emptying hospitals "was quite high in terms of people who needed elective surgery and had to have those postponed," but the reopening of services will still have be done in a safe way.

"We're doing it with the best evidence that we have available," she said.

Vitalite Health Network said some services will resume "a higher level of activity," such as elective surgeries, some ambulatory clinics and medical imaging services. Vitalité will begin by contacting patients whose appointments were cancelled due to COVID-19. People showing up without appointments will be turned away.

"However, we are only beginning to reschedule the most critical and urgent services for people who are very ill, such as cancer patients," the network said in a news release. 

Dr. France Desrosiers, Vitalite's vice-president of medical services, training and research, said the network is gradually increasing services to reach 40 per cent of its usual volumes while still maintaining physical distancing. Desrosiers said if all goes well, the yellow phase coming in two to four weeks will allow them to increase to 70 per cent.

"Our potential limits will lie in the resources available at this time," Desrosiers said in an emailed statement.

Geri Geldart, vice-president of clinical services at Horizon, said outpatient clinics, laboratory services and diagnostic imaging are restarting but only available by appointment.

"For these urgent cases, priority will be given to those who have experienced a significant wait time," she said in a emailed statement.

She said the network chooses which procedures to prioritized based on a provincial system used by both regional health authorities. 

Examples of high-priority surgeries could include cancer surgeries, cardiac surgeries and a number of other elective procedures, she said. 

Horizon CEO Karen McGrath said surgical patients who had scheduled appointments before the pandemic take priority and cancer surgeries continue to take precedence. She also said some patients' cases might have become more urgent since elective surgeries were cancelled, and they're taking that into account.

"In some cases, surgeries could be postponed for two weeks or three weeks with no ill effects to an individual. But once you get to six or eight weeks the priority actually changes. So we're also looking at those individuals," she said.

McGrath said Horizon has begun contacting all of those patients, including 150 people who were contacted Monday. 

"People are coming to horizon by appointment only. So if somebody does not have an appointment, they they need to wait till they hear that they have an appointment before they come," she said.

McGrath said patients will be tested for the novel coronavirus virus within two days of their procedures. 

"We're asking people once they're swab to maintain isolation in their homes till their surgery," she said.

McGrath said it could take a year to 18 months of no virus resurgence before the backlog is cleared.

"We do about 45,000 surgeries a year. So it's about one third of people are waiting," McGrath said. "Putting a time on that is extremely difficult.

"I shouldn't say if we have, when we have another resurgence of the virus — because I think everybody is suggesting that will occur — then, you know, we will have to curtail these procedures again."

Geldart said Horizon is in the process of finalizing next steps in terms of offering more services.

"Details of which will be made public at the appropriate time," she said.

The orange phase also means "allied health professionals" can begin seeing patients and clients in-person again, as they follow public health guidelines. These are:

• Audiologists
• Cardiology technologists
• Chiropractors
• Dental hygienists, technicians,  dentists and denturists
• Dieticians
• Licensed counselling therapists and psychologists
• Licensed practical nurses, nurses and nurse practitioners
• Massage therapists
• Medical laboratory technologists
• Medical radiation technologists
• Midwives
• Occupational therapists
• Opticians and optometrists
• Paramedics
• Pharmacists and pharmacy technicians
• Physicians and physician assistants
• Physiotherapists
• Podiatrists
• Respiratory therapists
• Social workers
• Speech language pathologists