Ontario doctors welcome decision to resume non-urgent surgeries as 'the right first step'

A decision by the Ontario Ministry of Health to resume some surgeries paused due to a surge in Omicron cases, starting next Monday, is being welcomed by doctors in the province.

Dr. Fayez Quereshy, a surgical oncologist at the University Health Network, said many patients are now in line to have their procedures done.

"It's the right first step in opening up capacity," Quereshy told CBC News on Friday.

"Obviously, we'd love to have an opportunity to deliver more care in the hospital setting for patients who have been waiting for so many weeks... but opening up some capacity for things like cancer screenings certainly is a meaningful first step for my patients as well."

Non-urgent surgeries were put on hold in early January to preserve hospital capacity, affecting an estimated 8,000 to 10,000 procedures a week.

On Thursday Alexandra Hilkene, a spokesperson for Health Minister Christine Elliott, said some operations and procedures will resume in stages starting next week as the province is set to lift restrictions on businesses that were ordered to close.

'A delicate place in the pandemic'

Quereshy said that's a welcome move.

"Obviously, we'd like to see more capacity opening up to be able to provide cancer surgeries, cardiac surgeries and all of the other scheduled care that's been deferred. But recognizing that we're in a delicate place in the pandemic history [it's] important to balance, obviously some of that resource, as well as the capacity for our COVID patients." 

Hilkene said the first stage of the resumption will include pediatrics, diagnostic services, cancer screenings, some ambulatory clinics, private hospitals and independent health facilities.

But she noted this doesn't mean all hospitals will immediately resume the surgical and procedural activities permitted.

Quereshy said in previous waves when the entire system was slowed down, including access to primary and secondary care, many ended up being diagnosed at a later stage in their diseases.

What we're planning for is a bit of a stage ramp up while we see a receding of some of the COVID numbers, and in that way, try to get as many cases done as possible.- Dr. Fayez Quereshy, UHN surgical oncologist

That's meant when the system opens back up, "the kinds of patients that we see are ones with more advanced malignancies requiring higher intensity of care, people coming to the emergency department rather than through scheduled routes, and that's all been very challenging." 

Opening up capacity for screening will allow earlier detection of diseases and allow preventative care, he said, so that when the time comes for the system to open fully, it won't be as overwhelmed as it had been in previous waves.

Meanwhile, Quereshy said, if given the green light, they would be able to "bring back surgeries in a matter of a few weeks."

He said the real limitation would be capacity and staffing while COVID hospitalizations remain high.

Bulk of surgeries unlikely to begin until second phase

Dr. Chris Simpson, executive vice president of medical at Ontario Health, said the bulk of surgeries and procedures like hips and knees probably won't get going until phase two of the resumption.

He said the second phase will be triggered when health officials have a bit more reassurance that the COVID hospitalizations are coming down and the ICU numbers are stable.

On Friday the province reported a drop in hospitalizations of COVID-19 patients but a slight increase for patients in intensive care.

The Ministry of Health said that as of yesterday, there were 3,535 people with COVID-19 in hospitals. That's down from 3,645 the day before and 4,114 at the same time last week.

Meanwhile, there were 607 patients with COVID-19 who required intensive care, up from 599 the day before and 590 the same time last week.

Roughly 82 per cent of the people with COVID-19 in ICUs were admitted for reasons directly related to the virus.  

"I think what most people are thinking in their mind about surgeries and procedures, we're not quite at that stage yet," Simpson told CBC News. 

Hospitalizations appear to be peaking: OHA

On Friday the Ontario Hospital Association said metrics indicate COVID-related critical illness ICU admissions and COVID-related hospitalizations are peaking.

Simpson said this is good to see, adding ICU numbers tend to fall about a week after hospitalizations.

"So, the wheels do seem to be in motion for a denouement of wave five but I think, you know, a few more days of that continuing trend would increase our confidence."

Simpson said there were some surgeries that continued throughout the pandemic such as many heart surgeries and cancer surgeries.

"So, the high-priority surgeries in the cardiac world and in the cancer world, they never slowed down during the pandemic. And it's now the non-time sensitive care that we'll want to catch up on," Simpson added.