N.S. surgery capacity has rebounded from COVID-19, but backlog remains

Nova Scotia Health has rebooked the bulk of the surgeries that were cancelled this spring because of COVID-19, but the extent of the upset the pandemic has caused to surgical services is unclear.

By the start of August — about three months after the health authority slowly restarted elective surgeries — 56 per cent of cancelled operations were complete.

Another eight per cent were rebooked and operating rooms were back to 97 per cent of last year's volume capacity.

Dr. Greg Hirsch, senior medical director for perioperative services at the health authority, said the whole backlog — which at its peak counted 3,212 surgeries — could be cleared in another month or two at the current pace.

"But the hit is probably bigger than that," Hirsch said. "People also stopped getting processed through family docs and through specialist visits."

Thousands more surgeries would have been booked during the first few months of COVID-19 when the health care system slowed down services. That backlog, which can't be quantified, will take much longer to clear.

Patient processing is still lagging about 25 per cent behind pre-pandemic levels, partly because of physical distancing guidelines that force clinicians to work more slowly. Hirsch said it causes him some concern about what's coming.

"We're anticipating … a flood of patients coming through, but they haven't quite arrived yet."

Better equipped for a second wave

Another thing that could be coming is a second wave of COVID-19, but Hirsch said the health system is better equipped to handle it now than it was the first time around.

The health authority recently introduced a different system for data management, which Hirsch said has made it easier for health-care leaders to monitor bed capacity across the province in real time and understand how prepared the system is for a surge.

Hirsch said that information was unavailable at the start of the first wave of COVID-19, "so we just put the brakes on and said, 'OK, let's create about 50 per cent capacity to deal with it.'"

With the improvements that have been made in the past several months, Hirsch said surgeries can continue operating close to capacity even under the threat of a second wave.

"The cut almost certainly won't go as deep in terms of a loss of surgery. We slowed down [and] we lost like 70 per cent of our surgical volume over the COVID period. And now we're back up to where we were before and we won't fall as far behind the next wave."

The long-term care backlog

But COVID-19 contingency plans aren't the only thing affecting bed capacity in Nova Scotia hospitals right now.

There are around 350 beds occupied by people who are ready to be transferred to long-term care homes and cannot be for a lack of space in those facilities.

That figure is up by more than 50 per cent over the same time last year, in large part because long-term care homes have reduced occupancy and restricted intake during the pandemic.

Hirsch has said previously, and reiterated again this month, that the long-term care backlog is a major impediment to catching up on surgical wait-lists. The health authority said in a recent bulletin that it's a central challenge for the reintroduction of all health services.

Health Minister Randy Delorey acknowledges the issue. He told reporters last week it's one of the reasons his department is looking for help from the private sector to increase long-term care capacity.

In May, the province struck a deal with Shannex to use 23 vacant beds at one of their private homes in Bedford and the province is now gauging interest for more similar partnerships.