Ontario Wait Times, Backlog from Covid-19

The past two years have been some of the most trying two years in my memory of health care. The fatigue, the burnout, the stress, the wait, the hope turned quickly into angst, impatience and bitterness. We have never experienced anything like this in our lifetimes. As we hope to turn a corner with the pandemic and restrictions ease, we are left looking forward and wondering what is next for health care within Ontario.

At the beginning of the pandemic the uneasiness came with the unknown. We knew little about the virus and assumed that we would require hospital capacity for those infected. The first step in creating capacity was to cancel elective surgeries. This meant joint replacement surgeries, cataract surgeries and some certain cancer surgeries. Our outpatient appointments went to limited appointments and diagnostic imaging was taken to almost nothing as well. According to Vogel (2020), the wait time for procedures within Canada has always been an issue and with the pandemic creating a further backlog, health care providers are recognizing the health crisis that we are facing next, an even longer wait to access health care.

When Covid-19 wave one and two hit Ontario, Public Health was encouraging people to stay home, socially distance, and to not go to the emergency department unless it was an actual medical emergency. Hospitals province wide braced for what we watched happen in Italy and New York. The fear that came with the virus in wave one and two inevitably kept a lot of citizens out of the emergency department. During wave one there were 25, 000 fewer emergency department visits in Canada (Friedman, n.d.). This had both a positive and negative effect on our health care system. On one hand the emergency department was able to triage and treat patients in a timely manner. However, on the other hand, patients that required some form of medical care were not coming to the emergency department out of fear, and therefore arriving at the hospital at a later date and presenting more ill than they should have been (Friedman, n.d.). 76% of Ontario doctors according to the OMA survey in 2021, have stated that some of their patients have experienced worse health outcomes because of the backlog related to the covid-19 pandemic.

There are multiple categories of patients who have been, and will continue to be, affected by the pandemic. Whether the patient has cancer, mental health illnesses, or their quality of life is affected because of a delay with a joint replacement surgery or a cataract repair, there are a significant amount of negative outcomes outside of the pandemic within health care. The amount of time and the pure cost of trying to get caught up will have a ripple effect on the healthcare system as a whole for some time to come. According to the Canadian Medical Association (2020), in Ontario alone, there will be a need for an additional $527.7 million dollars in order to get caught up with the following surgeries and tests because of the pandemic backlog: Coronary artery bypass graft, hip and knee replacements, cataract surgeries and MRI and CT scans. This is a large amount for an already underfunded health care system.

One positive thing that has come out of the pandemic is the utilization of virtual visits for clinic appointments and other virtual follow ups for patients in a variety of areas. Hamilton Health Sciences has created a way to decrease the surgical backlog by using a technological device that assesses patients at home and sends their vitals and bloodwork to a “command station” where the patients values are assessed by a healthcare team (Hamilton Health Sciences, 2021). This has allowed the hospital to discharge patients who are safe to do so and admit new patients for surgery. As other physicians moved to virtual clinic visits 74.5% of the physicians were satisfied with virtual visits (Mohammed et al., 2021).

Overall health care in Ontario has always struggled with wait times. The Covid-19 pandemic has accentuated the increase in wait times. We have been able to identify ways to move forward with multiple levels of technology to try and help to start alleviating some of the backlog within our healthcare system. Hopefully one day there will feel like a light at the end of the tunnel for not only our patients but also our staff.

References

Deloitte clearing the backlog - CMA. (n.d.). Retrieved March 28, 2022, from https://www.cma.ca/sites/default/files/pdf/Media-Releases/Deloitte-Clearing-the- Backlog.pdf

Friedman, D. J. (n.d.). Covid-19's impact on emergency departments. CIHI. Retrieved March 28, 2022, from https://www.cihi.ca/en/covid-19-resources/impact-of-covid-19-on-canadas- health-care-systems/emergency-departments

Mohammed, H. T., Hyseni, L., Bui, V., Gerritsen, B., Fuller, K., Sung, J., & Alarakhia, M. (2021). Exploring the use and challenges of implementing virtual visits during COVID-19 in primary care and lessons for sustained use. PloS one, 16(6), e0253665. https://doi.org/10.1371/journal.pone.0253665

Vogel, L. (2020). How can Canada improve worsening wait times? CMAJ: Canadian Medical Association Journal 192(37), E1079-E1080. https://doi.org/10.1503/cmaj.1095895

www.oma.org. (n.d.). Retrieved March 28, 2022, from https://www.oma.org/uploadedfiles/oma/media/public/prescription-for-ontario-doctors-5- point-plan-for-better-health-care.pdf