Ontario Operates Hospitals at 115% Capacity to Clear Pandemic Surgery Backlog

The Ontario government says it wants to boost the operating capacity of the province’s hospitals system to up to 115 percent of pre-COVID-19 levels to address a backlog of surgeries and procedures delayed by the pandemic.

At a media briefing Wednesday, officials said the province will commit $324 million to — among other things — help hospitals perform up to 67,000 more surgeries and offer 135,000 more hours for diagnostic imaging than would have otherwise been possible.

That represents a roughly 10 percent increase in capacity for the highest-volume surgeries in the province, including orthopedic and ophthalmologic procedures.

Part of the effort also includes more surgeries on evenings and weekends, officials said.

Twice during the pandemic, Ontario’s chief medical officer of health ordered hospitals to stop non-urgent and non-emergency care to make room for COVID-19 patients. At the peak of the third wave, 900 people with COVID-19 were admitted to intensive care, representing nearly half of all ICU capacity in Ontario.

Despite the directives, however, about 99.3 percent of all emergency and urgent surgeries and procedures were completed in the province between March 1, 2020, and March 1, 2021, officials said.

It’s expected that capacity for non-urgent and non-emergency procedures will reach roughly 100 percent of its pre-pandemic level by the fall. Then the province will aim to begin ramping up capacity further over the following months, eventually reaching between 110 and 115 percent by spring 2022.

But some experts are questioning whether there will be enough staff to make that happen.

“It’s finding those people to work after hours, to support the surgeries,” said Tracy Johnson, director of health system analytics at the Canadian Institute for Health Information.

“It’s not only the time and space to do it — it’s the people.”

Dr. Carol-Anne Moulton, deputy surgeon and chief at Toronto General Hospital, agrees.

“Obviously money and resources are one thing, but human resources is another thing,” she said.

Moulton added that her hospital is trying to find a balance between prioritizing both the mental health of workers — including time off — and tackling the backlog.

“We’ve had health professionals working almost around the clock … for the past 16 months,” she said. 

The province says exactly how individual hospitals will be impacted will depend on where they are, as COVID-19 had regional effects on the healthcare system.

Somewhat counter-intuitively, officials said, the pandemic did not result in significantly longer surgical and diagnostic wait times because demand also fell. Fewer people saw their family doctors or sought out care in emergency departments.

Officials expect it will take several months for the true number of backlogged procedures to reveal itself, as people increasingly begin seeing their doctors again or seeking care for ailments they may have put off during the pandemic.

“As we continue to safely and gradually lift public health directions, we expect more and more Ontarians to seek the care they need,” Minister of Health Christine Elliott told reporters Wednesday.

Health Minister Elliott says the province has seen a significant increase in virtual care throughout the pandemic, but that it will be crucial to reintroduce people to in-person tests, procedures and scans.

“We know some people will come forward that still haven’t been diagnosed yet, but that’s why we are increasing capacity,” Health Minister Elliott said.

Exactly how long it will take to clear the backlog caused by the pandemic, Health Minister Elliott says, is unclear.

A breakdown of the $324-million includes:

  • $216 million to help hospitals extend operating room hours.
  • $35 million to increase diagnostic imaging, particularly MRIs and CT scans.
  • $18 million to improve the centralized surgical waitlist management system.
  • $24 million to help independent and private facilities to expand capacity to offer some procedures, such as cataract surgery.

One of the remaining unanswered questions is how the new plan would be impacted by another surge in COVID-19 cases.

While Ontario Health CEO Matthew Anderson said the province has prepared for small peaks in infections, it’s unclear how priorities within the healthcare system could change if the province saw a fourth wave of the virus.

“Right now COVID is at a manageable level,” he said Wednesday. “We hope that it will stay that way.”


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