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Surgery at a hospital in the Waterloo region under the threat of Omicron

 


Angela Williams, 45, was diagnosed with a borderline type II Chiari malformation. She was scheduled to undergo her first surgery in March 2020 to treat her worsening symptoms, but instead faces cancellations, referrals to other doctors, and a waiting list. (Angie Williams / Facebook)

Angela Williams, a resident of Kitchener, was diagnosed with Chiari malformation at the end of 2019, a rare brain condition that puts irregular pressure on her brain and parts of the spinal cord.

She was scheduled to undergo surgery on March 13, 2020 to deal with neck pain, dizziness, migraines and prevent her condition from getting worse.

Despite the provisional surgery day and multiple visits to the ER, surgery never came.

“It was scary,” Williams said. Since then, he has met several different doctors, specialists and surgeons across the Waterloo region within the last two years. “I didn’t hear anything from the surgeon. I didn’t hear anything from the doctor. I didn’t hear anything.”

Almost two years later, Williams is still waiting for his first surgery without seeing the date. Except now, she sometimes suffocates with her vomit, wakes up, often loses sight in both eyes, and is constantly fighting some kind of pain.

“I’m just at a loss and sitting here,” Williams said. She says she can’t work because of her condition. “I hope the phone doesn’t come.”

Accumulation of surgery in hospital

Williams is one of 11,000 people waiting for surgery in the Waterloo region. Hospital officials estimate that it will take more than a year to clear.

Over the past two years, hospitals have been forced to suspend two elective surgeries based on the existing backlog of surgery that existed before the pandemic began.

Lee Faircrow, director of St. Mary’s General Hospital and regional leader against COVID-19, said regional hospitals have delayed access to other services such as MRI scans and other diagnostic tests. He states that he is beginning to be affected by the restrictions.

“People are getting sick, partly because access to early pandemic care is restricted, not only in hospitals but also in primary care,” Faircrow said.

“We are now seeing people moving forward with some more advanced presentations of their condition.”

Lee Fairclough is the president of St. Mary’s General Hospital in Kitchener. (St. Mary’s General Hospital)

About 80% of the area is vaccinated against COVID-19. This helped hospitals increase selective surgery by more than 110% to get back on track, but Faircliffe says Omicron variants pose a threat to those short-term plans.

“We also recognize that we need to reduce some of our non-urgent urgent procedural work again to be ready for January, and we are planning to do so now,” she said. Told.

According to Fairclough, regional hospitals will help people receive a third dose of the COVID-19 vaccine, in addition to preparing resources for the expected influx of hospitalizations for Omicron cases. I am trying to enhance the service.

How to work on the backlog

Flaircough states that hip and knee surgery is in high demand, with ophthalmic cases accounting for more than 50% of St. Mary’s untreated surgery.

To address more than 7,000 untreated surgeries, St. Mary’s partnered with offsite provider TLC Vision earlier this year to perform eye surgery at 130% capacity.

According to communications manager Cheryl Evans, the Grand River Hospital, which has 2,000 people behind surgery, operates in six operating rooms, with seven in late January and preferably eight by the end of March. is. Prior to COVID, hospitals performed about 10,000 surgeries each year.

Cheryl Evans, Communications Manager at Grand River Hospital, said the hospital will continue to take advantage of new care opportunities, allocating existing beds according to Omicron and being ready to reopen beds as needed. increase. The hospital has already grown thin, and on December 18, it was reported that less than 10 beds were available to COVID-19 patients alone. (CBC)

According to Communication Manager Stephan Beckhoff, Cambridge Memorial Hospital also has about 2,000 surgeries on the waiting list and is partnering with Tri-City Colonoscopy Clinic to assist with the endoscopy procedure.

“We are looking for a similar partnership for other procedures,” he said, adding that there were some “promising” discussions, but nothing formal yet.

Hospitals in the Waterloo region, along with hospitals in Ottawa, Kingston and Windsor, all work with community partners to free up operating room capacity in new settings, according to an email from the Ministry of Health. You are performing the procedure.

Despite community care and private partnerships, and the triage process of surgery depending on the need and pain management, people can still go through the rift, Fairclough said.

“In reality, I think the backlog and latency are increasing. You can see the same effect every time a big wave occurs.”

Reflection of state-wide issues

The backlog in this area may seem staggering, but it’s just a drop in a bucket of Ontario hospitals.

In November, Report Commissioned by the Canadian Medical Association, it will cost at least $ 1.3 billion to return surgical waiting times to pre-pandemic levels.

But in May Financial Accountability (FAO) found Assuming the hospital is operating beyond capacity, it would cost $ 1.3 billion alone to clear the backlog of increasing surgery and diagnostic procedures, and another 3.5 years to clear the backlog of surgery. increase.

The state has allocated $ 610 million (less than half) of its budget to work on the surgical backlog. Some of this has already been used in hospitals in the Waterloo region to train more nurses and fund surgery.

However, the ministry said FAO’s report did not reflect “the actual current requirements of patients awaiting surgery and diagnostic imaging procedures.”

“Current data show that the total number of surgical patients waiting in Ontario is currently not higher than before the pandemic, but as patients proceed with upstream screening, referrals, and diagnostic evaluations, More surgical patients could be on the waiting list in a few months. ” Email from the ministry.

Ontario officials say few people meet their doctor or get medical attention during a pandemic. At a technical briefing in July, the Ministry of Health stated that between March 2020 and March 2021, 76% of all patients underwent surgery. (Evan Mitsui / CBC)

The same email also showed that the hospital received $ 6.2 million in one-time surgery assistance funds to operate at night and on weekends to catch up with the surgery. The ministry said the Cambridge Memorial Hospital had completed 92%, the Grand River Hospital had completed 86%, and St. Mary’s General Hospital had led to complete 84% of the funding allocation in 2020-21.

Between 2020 and 2022, the ministry said hospitals in the Waterloo region received a cumulative $ 2.6 million to support uptime for additional MRI and CT scans.

“Waterloo hospitals are also eligible for additional surgical recovery assistance from 2021 to 22 based on the level of surgical activity achieved,” the email said.

Preparing another wave

According to Fairclough, hospital and nursing home community partners, pharmacists and clinics are working together to prepare for the next wave, but they can’t do it themselves.

“My main message to the community is to continue to work very hard to strike the right balance between these two choices and decisions,” Fairclough said. “”[If you] I haven’t obtained the first dose yet. In the unvaccinated population, this variant is expected to move very quickly, so get the first dose. “

In her experience, Williams believes that limited burnout medical staff, combined with bureaucratic oversight, puts her at the bottom of the surgery waiting list.

But not only is she dissatisfied with waiting for surgery, she is also angry with people who are not trying to control the spread of the virus.

“My frustration lies with the unvaccinated people,” Williams said. “People who don’t wear masks, people who still think it’s a joke, people like,’Oh, well, anything doesn’t affect me. I’m not sick.’

“The more people who are treated this way without vaccination, the longer the waiting time for those waiting for surgery.”

Sources

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2/ https://www.cbc.ca/news/canada/kitchener-waterloo/waterloo-region-surgeries-at-hospitals-omicron-covid-1.6293878

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