Massive backlog of cancelled surgeries, appointments at Eastern Health

The massive backlog of cancelled appointments, surgeries and procedures due to the COVID-19 pandemic has taken a toll on the health-care system — and patients.

In a statement to CBC News, Eastern health said 11,500 in-person specialist appointments have been cancelled between March 16 and April 30. Some high-priority services are resuming, according to the healthy authority.

So far, just over 2,800 of those appointments have been conducted virtually or over the phone, leaving about 8,700 appointments to be rescheduled.

Mark Squires, one of the people behind the staggering statistics, had an appointment to see a specialist as well as to have day surgery in late March. The procedure was cancelled.

"I'm wondering when I'm going to get my surgery. It may not be until next year," he said.

Squires said he understands the cancellations, but said the situation is tough. "Mobility was really, really tough, and I couldn't get around," he said.

He said the wait to see a specialist can be long, at the best of times.

"Now with the added issues that COVID-19 brings, I have no idea where we are in the backlog of appointments," he said.

Squires said this situation is minor, in comparison to some — who need to see doctors and get surgeries urgently.

Eastern Health said appointments across many specialty areas have been affected, including oncology, dermatology, endocrinology, gastrointestinal conditions, infectious diseases, nephrology, neurology, pulmonary function, respirology, rheumatology, genetics, internal medicine, thrombosis, endoscopy, electroencephalogram, electromyography and diabetes education clinics.

Thousands of surgeries

The number of surgeries in the six-week period between March 16 and April 29 was down 78 per cent from the same time frame in 2019.

Andrea Squires — no relation to Mark Squires — was supposed to have bladder surgery on April 29. But she got a call in early April saying it was cancelled. 

"It's basically ruining my life. I can't go out anywhere, my anxiety level is high," she told CBC News on Thursday.

Squires said she was finally told only this week that her surgeon needed approval for operating-room time in order to do the procedure — and she isn't currently on the list, which is already 15 patients long.

She said the uncertainty is added stress on top of a condition that impacts her daily.

"I can't go for a walk, and I got to use the bathroom.… I don't know when I have to use the bathroom," she said.

"But sometimes I just use the bathroom, I don't even know I'm doing it. And that's no life to live."

Dr. Larry Alteen, vice-president of medical services at Eastern Health, told CBC News that's about 4,000 fewer procedures done in that time period.

Alteen said Eastern Health is trying to reach a level of normalcy in its services. He said the focus is on removing urgent patients from the wait list first, and emergency procedures are being handled as they would be under normal circumstances.

The plan until June 8 is to increase surgery, medical imaging — diagnostic imaging, radiology and CT scans — as well as endoscopy and some cardiac services. June 8 is the tentative date when the province will move to Alert Level 3 of its reopening plan. From there, Alteen said, services will see another increase, keeping in the mind the need to have a proper supply of personal protective equipment as well as available hospital beds in the event of another flare-up of COVID-19.

"It is extremely challenging," he said. 

Eastern Health said there has also been a significant reduction in elective surgeries, which are not being scheduled due to the pandemic.

"Our care teams review and prioritize patient lists on a regular basis to identify and to complete critical and emergent appointments and surgeries while we continue to put plans in place as we manage through COVID-19," said Eastern Health's statement.

On May 7, Health Minister John Haggie said about 5,500 surgeries were outstanding due to COVID-19 and each regional health authority is developing a plan to address the backlog.

Haggie said surgeries that put a smaller demand on in-patient beds and minimize face-to-face interaction will be considered first. 

"The other piece is around do we have [personal protective equipment] to manage COVID surgeries?" said Haggie.

Imaging and other procedures

In the same six-week period between March 16 and April 29, Eastern Health said there's been a 72 per cent decrease in medical imaging, an 87 per cent decrease in endoscopy and a 52 per cent decrease in cardiac diagnostic procedures, compared with 2019.

"In medical imaging, which includes the broad aspect of everything from basic, plain film X-ray to MRI and PET scans, we're down about 72 per cent, which is about 37,000 images," said Alteen.

"Endoscopy, it's about 2,100 procedures not done and cardiac surgeries it's about 47 less cases compared to the same time frame last year."

 Eastern Health said in its statement, "Patients will continue to be prioritized based on urgency, as deemed by their physician. The areas that will wait the longest will be those deemed less urgent."

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