Canadian international forward Adriana Leon will miss the rest of the FA Women’s Super League season after undergoing surgery to repair a fractured foot.
The English league runs through May 9. There was no immediate word on whether her recovery will stretch into the Tokyo Olympics, whose soccer competition is scheduled for July 21 through Aug. 7.
In a release Tuesday, West Ham said the surgery happened last Friday.
In 18 appearances this season, Leon has picked up one goal and five assists.
She joined West Ham United in January 2019 following a five-year stretch in the National Women’s Soccer League where she was last with the Seattle Reign, who decided not to retain her rights following the 2018 season.
In between that time, she made the move to Swiss Nationalliga A team FC Zurich Frauen in 2016, where she spent four months before returning to the U.S. to play for the Boston Breakers of the NWSL.
The King City, Ont. native attended Notre Dame University for her first two years on the Divison 1 level before transferring to the University of Florida for one year.
The 28-year-old has won 66 caps for Canada with 19 goals and four assists.
Sky Blue FC says Canadian goalkeeper Kailen Sheridan has undergone successful surgery on her right quad.
The NWSL club said there is no timetable for Sheridan’s return.
The 25-year-old from Whitby, Ont., was injured Feb. 18 in Canada’s first game at the SheBelieves Cup in Orlando. She was helped off the pitch in the 10th minute of the 1-0 loss to the U.S., going down in pain after a seemingly innocuous pass to a teammate.
“Surgery went really well and I am excited to start my recovery process,” Sheridan said in a statement Tuesday. “I will be pushing myself to come back stronger and better than ever.”
The Olympic football tournament is scheduled for July 21 to Aug. 7 in Tokyo. Canada Soccer said it had no information on Sheridan’s possible return to action.
Veteran Stephanie Labbe, who has 72 caps, started the rest of the SheBelieves Cup, with the uncapped Rylee Foster as her backup. Erin McLeod, a 38-year-old who has 118 caps, had to leave camp early with a dislocated finger.
WATCH | Sheridan leaves SheBelieves Cup game with injury:
Early in the match against the United States, Canada’s goalkeeper Kailen Sheridan plays the ball then goes down in pain. She would have to be replaced by Stephanie Labbé. 1:19
Also Tuesday, the Chicago Red Stars said Canadian defender Bianca St-Georges had successful arthroscopic surgery to repair a “lower knee injury” suffered in camp with Canada prior to the SheBelieves Cup.
The NWSL team said the surgery happened Feb. 24. The 23-year-old from Quebec is expected to return to action before the May 15 start of the regular season.
Tiger Woods was seriously injured Tuesday when his SUV rolled over and ended up on its side in suburban Los Angeles, authorities said. The golf superstar had to be extricated, and his agent said he was undergoing leg surgery.
Woods was alone in the SUV when it crashed shortly before 7:15 a.m. PT, the Los Angeles County Sheriff’s Department said in a statement. No other cars were involved.
The cause of the wreck wasn’t clear. The two-lane road curves through upscale suburbs, and the northbound side that Woods was driving on descends steeply enough that signs warn trucks to use lower gears. The speed limit is 45 mph, a little over 70 km/h.
At a news conference Tuesday, the police chief and fire chief of Los Angeles County said there’s no immediate evidence that Woods was impaired in the crash, but didn’t answer follow-up questions about how they know or about how fast he was driving. Weather was not a factor in the crash, they said.
Sheriff Alex Villanueva and Fire Chief Daryl Osby also say Woods was conscious and able to communicate when authorities arrived to pry him from the car.
WATCH | Woods suffers leg injuries in car crash:
Golfer sustained multiple leg injuries after rollover accident in Los Angeles area and is undergoing surgery, his agent said. 1:11
Images showed the SUV on its side, with its front end heavily damaged, just off the side of a road near a hillside. An ambulance took the 45-year-old Woods to a hospital, authorities said.
“Tiger Woods was in a single-car accident this morning in California where he suffered multiple leg injuries,” said his manager, Mark Steinberg. “He is currently in surgery and we thank you for your privacy and support.”
Barbara Ferraro, a councilwoman in the community of Rancho Palos Verdes, said the road where Woods crashed is not winding like other stretches but it’s steep and not far from a gravel runaway truck lane that was ahead before the next traffic light.
“It’s easy to pick up speed,” Ferraro said. “Even if you’re not speeding, unless you’re actually putting on the brakes, you’ll pick up speed.”
The crash happened on the border of Rolling Hills Estates and Rancho Palos Verdes, two upscale communities about 32 kilometres south of downtown Los Angeles.
There was a second crash when a vehicle that had apparently stopped to help Woods got hit, said Christopher Thomas, a spokesman for the Los Angeles County Fire Department. That wreck was very minor, and no one was hurt.
WATCH | ‘Probably the best player ever’:
Lorne Rubenstein, who co-authored “The 1997 Masters: My Story” with Tiger Woods, reflects on the golfer and the man. 12:32
Woods was in Los Angeles over the weekend as the tournament host of the Genesis Invitational at Riviera Country Club, where he presented the trophy on Sunday. He was to spend Monday and Tuesday filming with Discovery-owned GOLFTV, with whom he has an endorsement. A tweet Monday showed Woods in a cart smiling with comedian David Spade.
According to Golf Digest, also owned by Discovery, the TV shoot was on-course lessons for celebrities, such as Spade and Dwyane Wade, at Rolling Hills Country Club.
5th back surgery in December
Woods, a 15-time major champion who shares with Sam Snead the PGA Tour record of 82 career victories, has been recovering from Dec. 23 surgery on his lower back. It was his fifth back surgery and first since his lower spine was fused in April 2017, allowing him to stage a remarkable comeback that culminated with his fifth Masters title in 2019.
He has carried the sport since his record-setting Masters victory in 1997 when he was 21, winning at the most prolific rate in modern PGA Tour history. He is singularly responsible for TV ratings spiking, which has led to enormous increases in prize money during his career. Even at 45, he remains the biggest draw in the sport.
The SUV he was driving Tuesday had tournament logos on the side door, indicating it was a courtesy car for players at the Genesis Invitational. Tournament director Mike Antolini did not immediately respond to a text message, though it is not unusual for players to keep courtesy cars a few days after the event.
Woods feared he would never play again until the 2017 fusion surgery. He returned to win the Tour Championship to close out the 2018 season and won the Masters in April 2019 for the fifth time.
He last played Dec. 20 in the PNC Championship in Orlando, Fla., an unofficial event where players are paired with parents or children. He played with his son, Charlie, who is now 12. Woods also has a 13-year-old daughter.
During the Sunday telecast on CBS from the golf tournament, Woods was asked about playing the Masters on April 8-11 and said, “God, I hope so.” He said he feeling a little stiff and had one more test to see if he was ready for more activities.
He was not sure when he would play again.
Athletes including Mike Tyson and Magic Johnson offered hopes Woods would make a quick recovery.
“I’m sick to my stomach,” Justin Thomas, the No. 3 golf player in the world, said from the Workday Championship in Bradenton, Fla. “It hurts to see one of my closest friends get in an accident. Man, I just hope he’s all right.”
This is the third time Woods has been involved in a car investigation. The most notorious was the early morning after Thanksgiving in 2009, when his SUV ran over a fire hydrant and hit a tree. That was the start of shocking revelations that he had been cheating on his wife with multiple women. Woods lost major corporate sponsorships, went to a rehabilitation clinic in Mississippi and did not return to golf for five months.
In May 2017, Florida police found him asleep behind the wheel of a car parked awkwardly on the side of the road. He was arrested on a DUI charge and said later he had an unexpected reaction to prescription medicine for his back pain. Woods later pleaded guilty to reckless driving and checked into a clinic to get help with prescription medication and a sleep disorder.
Woods has not won since the Zozo Championship in Japan in fall 2019, and he has reduced his playing schedule in recent years because of injuries. The surgery Tuesday would be his 10th. He has had four previous surgeries on his left knee, including a major reconstruction after he won the 2008 U.S. Open, and the five surgeries on his back.
Rose Foy was already worried that her son-in-law was having quadruple bypass surgery.
The 48-year-old husband of Foy’s daughter has long suffered from health problems, including a stroke five years ago and a heart attack earlier this fall.
After his five-hour, open-heart procedure on Nov. 10, Foy’s concerns grew: scans showed her son-in-law had a popped internal stitch. Then, on his fourth day recovering at Toronto General Hospital, he was discharged.
Staff told her daughter the hospital was getting ready for an influx of COVID-19 patients, Foy said.
“I can’t believe I had to drive him home so soon,” she recalled, adding that at every bump on the highway ride to her son-in-law’s Oakville, Ont., home, he would cry out in pain.
The family’s experience comes as Ontario hospitals are increasingly facing a juggling act.
That’s leaving patients and their families coping with a range of concerns, from fears over another shutdown of elective procedures, to ongoing booking delays, to what Foy sees as a hasty discharge for a loved one who did make it into a hospital.
The family was initially told her son-in-law would be in intensive care for two to three days, Foy explained, plus another four to five days in a cardiac unit.
“He had serious surgery. He needed to be in that hospital for at least a few days more,” she said. “You can’t just discharge people because of COVID.”
A visibly frustrated Premier Doug Ford said an announcement is coming Friday concerning Ontario COVID-19 hot spots. Health experts can only do so much and if people don’t listen to their advice, Ford said he won’t hesitate to issue lockdowns in order to protect the public. 3:08
‘Stress on the system’
According to a spokesperson for Toronto General, “discharge planning” at the hospital remains the same, timing can vary and no patient is sent home without a physician signing off.
But it’s clear that, more broadly, some Ontario hospitals and intensive care units are increasingly under strain.
“We’re trying to do more than normal and still make room for COVID,” said Dr. Niall Ferguson, head of critical care medicine for the University Health Network and Mount Sinai Hospital in Toronto.
His hospital is trying to ramp up surgery to a level even slightly more than average to make up for several months of cancelled surgeries this spring, he explained.
The ongoing demands, plus that backlog, means beds are full, and it’s all “putting stress on the system,” Ferguson said.
Across Ontario, at least 135 patients with COVID-19 are currently in intensive care, according to the latest-available census from Critical Care Services Ontario.
That snapshot, as of end of day Tuesday, is just 15 patients away from a provincial threshold of 150 COVID-19 patients in critical care beds that could require hospitals to start cancelling other procedures to manage the load.
“I think hospitals are doing everything possible to move patients forward and through the system fast,” said Dr. Brooks Fallis, a medical director and critical care physician at a hospital in Peel region.
But he warned the prospect of more cancellations is a real concern with COVID-19 cases spiking.
“Inevitably, resources have to be diverted to COVID,” he said. “And that will inevitably mean that other things can’t get done, such as elective surgeries.”
Surgery delays, reschedulings
Some patients and families say even now, months into the pandemic, delays and rescheduling continue.
On Wednesday, Toronto resident Rochelle Roberts finally had surgery to remove non-cancerous tumours in her uterus after waiting months for a procedure date.
She was diagnosed by ultrasound back on March 16 — the same day much of the country started shutting down — and recalls watching the news conferences from her hospital waiting room.
At her first consultation, Roberts learned no elective procedures were being done. When she followed up in August, the administrative assistant for her surgeon “gently explained” the hospital had no idea if she’d get a slot this year.
At last, near the end of October, she got a November surgery date, but even that moment felt uncertain for the 44-year-old.
“The [COVID-19] numbers started going up, which made me anxious,” she said.
In Bowmanville, the Le Fevre family is still waiting for a crucial procedure for their 11-month-old, Charlie.
After delivering her son last December, Jade Le Fevre learned one of his hands had some webbed skin, a condition known as syndactyly. Several of his fingers are fused together and won’t grow at a normal rate unless they’re surgically separated.
The family was booked for an initial consultation with Toronto’s Hospital for Sick Children in June, which got bumped until October.
“We were told COVID aside, if the world was well, we’d have been booked for December,” Le Fevre said.
But there’s still no word when Charlie will get in for the first of two procedures, even though the family was told not to wait much longer than a year after his birth.
“The longer these fingers stay attached, the longer the chance they won’t grow at all.… Just typing would be very difficult, or holding a pen,” Le Fevre said.
Dr. Simon Kelley, associate chief of surgery at the children’s hospital, said a ripple effect of the pandemic has been a rapid increase in the number of children waiting for surgeries.
Roughly 4,800 families are currently wait-listed for a spot even though the hospital is operating close to pre-pandemic levels, he told CBC News on Tuesday.
Hundreds of millions in provincial investment to support additional surgeries is a step in the right direction, but the ongoing delays threaten to increase the risks for children currently waiting, Kelley said.
Lockdown looms as hospitals ‘hitting capacity’
As the tension grows for both patients and health-care workers, Premier Doug Ford warned on Wednesday that a lockdown may be on the horizon for regions facing high COVID-19 case counts.
“The hospitals around, especially, Brampton and northern Etobicoke and other areas in Toronto are hitting capacity,” Ford said. “We need to be responsible.”
Foy hopes officials remember their responsibility to all patients, whether or not they have COVID.
But while she maintains her son-in-law was discharged too soon, she also appreciates that he had a crucial surgery this year while others are still waiting for elective procedures.
“He couldn’t have survived much longer,” Foy said.
Diego Maradona was released from a Buenos Aires hospital on Wednesday, just over a week after undergoing brain surgery, and will continue his recovery in a private home.
Footage broadcast by local TV stations showed the former World Cup winner leaving the Olivos clinic in an ambulance. Maradona’s doctor, Leopoldo Luque, told journalists that he had authorized the release.
His lawyer, Matias Morla, said the 60-year-old Argentine will continue to receive treatment for alcohol dependency. He is expected to stay in a house near his older daughters.
The 1986 World Cup champion last week had an emergency operation for a subdural hematoma, which us an accumulation of blood between a membrane and his brain.
Maradona’s personal doctor, neurologist Leopoldo Luque, said Tuesday that even small amounts of alcohol consumption could have negative effects in combination with the medication Maradona needs for his recovery.
The former Boca Juniors, Barcelona and Napoli star has had addiction problems in the past.
Maradona was initially admitted to another clinic in La Plata with signs of depression, anemia and dehydration, before being moved to Olivos when the subdural hematoma was discovered.
Dr. Luque said an accident likely caused the subdural hematoma but that Maradona did not recall any falls or mishaps.
Maradona felt ill Oct. 30 while coaching first-division team Gimnasia y Esgrima. He had left before the end of the first half, raising questions about his health.
Ongoing surgical and diagnostic backlogs will only worsen without immediate government help to address a strained health-care system, says the Canadian Medical Association, which found average wait-times increased by one-to-two months for the most common procedures in the first wave.
The CMA said Monday it would take $ 1.3 billion in additional funds to tackle delays sidelined from January to June because they were deemed non-essential during the pandemic.
A study ordered by the organization looked at the six most commonly delayed procedures:
CT and MRI scans.
Hip and knee replacements.
Coronary artery bypass grafts.
The procedures all plummeted in April, when almost no cataract or knee replacements took place.
Although procedures gradually began to rebound in June, the report found more than 270,000 people had their MRI scans — which can detect serious disease or injury — delayed by a national average of nearly eight months, more than seven weeks longer than before the pandemic. Those waiting for knee replacement surgeries had to wait an average of 14 months, about two months longer than before the pandemic.
“The impact on wait times is just going to be the worst-ever in our system,” CMA president Dr. Ann Collins said as she called on the federal and provincial governments to develop a plan to restore backlogs to pre-pandemic levels in one year.
“It’s going to have serious consequences the longer this pandemic goes on.”
Almost half of the delayed procedures were CT scans, while about a third were MRI scans, which are often used to diagnose potential cancers, follow-up on cancer treatment and screen for breast cancer as well as diagnose joint pain.
WATCH | Managing the surgery backlog from COVID-19:
By the time the COVID-19 pandemic is finally over, Canadian doctors could face another health care crisis due to a massive backlog of surgeries and procedures that will strain an already stretched system. 2:04
The rise in CT scan backlogs varied wildly across the country, from a 14 per cent increase in Alberta to a 75 per cent increase in Ontario.
Ontario also saw the biggest delays in MRI scans and still had the most ground to cover in June when many parts of the country began resuming health services.
Nationally, the backlog included 249,088 CT scans with a 3.5 month-long wait, which was 33 days longer than before the pandemic.
While Collins said she believes every effort has been made to triage patients, it’s very possible that an “unfortunate unintended consequence” could be untold numbers of missed cancers, diseases and declining health that would eventually demand more complex care than if they had been caught earlier.
Critical procedures to walk and work
Even designating some procedures like hip replacements “non-essential” is a misnomer, said Collins.
“To the patient who’s having great difficulty walking, who can no longer go up the steps in their home, that is a critical procedure,” she says, noting delayed care could also limit ability to work, increase reliance on caregivers and pain killers and strain families emotionally and financially.
All non-essential surgeries were halted early in the pandemic to limit the spread of COVID-19 and ensure hospitals had the capacity to respond to a possible surge in infections.
But any one of the delayed procedures could become urgent over time, especially as the second wave further delays care for people who may have been waiting since before the pandemic, said Collins.
And that could lead to more strain on hospitals by requiring bigger surgeries and longer recovery times, not to mention additional pressures on other health-care workers including home care staff and physiotherapists, said Collins.
“If a patient’s presenting later in their disease process they almost certainly will require more resources treatment-wise and care-wise in general,” said Collins.
The study found the six procedures plummeted to their lowest point in April and began a rebound in May in June as services gradually returned, however a sizeable backlog remained. It did not take into account the current second wave engulfing some hospitals.
The study estimates that an additional 307,498 procedures would need to be performed over a 12-month period to clear the backlog — a 6.1 per cent increase compared to what would have been expected over the course of a year.
Of the six backlogged procedures studied in June, the increased wait was greatest for cataract patients who waited an additional 75 days for surgery, for a total average of 331 days.
Worst yet to come?
Collins said she didn’t expect the health-care system to rebound fully for at least a year, noting the numbers don’t include data on all of the halted procedures, nor those procedures or screenings that might have resulted from patients who cancelled their doctor’s appointment over COVID-19 fears.
The CMA said the suggested investment is a conservative estimate that doesn’t include increased costs in personal protective equipment, additional cleaning measures and any new policy guidelines that would further reduce capacity.
HealthCareCAN president Paul-Emile Cloutier said the study only presents a snapshot of time during those first months of the pandemic and doesn’t fully forecast the pressures he expects will mount.
His fear is that “at one point, the system will crack.”
“I believe that the worst is yet to come with the second wave of COVID-19,” said Cloutier, whose group advocates for health organizations and hospitals across Canada.
“For me, the greater concern is the human costs behind their figure…. [Health-care staff] are exhausted. They’re tired. They have worked extremely hard and double shifts constantly during the first wave of COVID-19.”
The report landed as hundreds of health-care and support workers walked off the job in Alberta, forcing the government to cancel all non-urgent surgeries.
The job action involving aides and support staff came amid tensions with the United Conservative Party government who vowed to slash up to 11,000 health jobs to save money during the pandemic. Some of the cuts are to come from further contracting out of laundry and lab services, with assurances that nurses and front-line clinical staff would not be affected.
Brenda Ongahak has been waiting for about a year to get surgery on her knee.
Last week, she travelled from Kugluktuk, Nunavut, to Yellowknife to get that surgery done — only to be told on the day of the procedure that the hospital would be delaying her surgery due to faulty equipment.
The hospital started suspending some elective surgeries on Thursday, said David Maguire, spokesperson for the N.W.T. Health and Social Services Authority.
On Friday night, the health authority sent a news release saying Stanton Territorial Hospital in Yellowknife had suspended or cancelled a “small number” of those surgeries after sterilization equipment malfunctioned at the hospital. Maguire confirmed in an email Tuesday that 31 surgeries were cancelled through July 23 to 31, and there’s no timeline in place for when the equipment will be fixed.
“We continue to evaluate each surgery scheduled and are cancelling elective surgeries that can be rescheduled at a later date,” he said, adding that emergency surgeries will go ahead.
The health authority says the sterilization equipment uses steam and heat to clean medical instruments and supplies. Last week, staff noticed the equipment was leaving moisture in the trays the items are sterilized in. That prevents the instruments from being stored for use again, Maguire explained.
Pain in the knee
Ongahak said she arrived in the Northwest Territories last Tuesday, and went for her pre-operation appointment the next day. On Thursday morning she was in the hospital for her surgery and everything seemed good to go.
“[The doctor] said I was ready to go into surgery once he was done with the other patient … and came back telling me that they have to reschedule me,” she said.
Ongahak has arthritis in her right knee and has injured it in the past.
This has made it difficult to take part in the activities she used to love, such as going for walks, volunteering at the recreational complex, and playing with her niece and nephew’s children.
Travelling from Nunavut amid a pandemic requires some forethought, especially when you have five children ranging in age from 15 to 25.
She says it can be difficult, but she was able to get help from other family members.
Recurring sterilization equipment problems
Last October, CBC News learned that water leaks and mould have plagued the new hospital, and that staff repeatedly expressed concerns that vulnerable patients weren’t protected from risks caused by cleaning up those problems.
And this is not the first time the hospital has had issues with its sterilization equipment.
In 2011, at least 290 surgeries were cancelled or postponed as a precaution after the hospital’s sterilization equipment broke down twice that year, necessitating more than $ 100,000 in repairs.
In 2017, elective surgeries at Stanton were cancelled when its main sterilizing machine failed.
Last year, surgeries and other medical procedures at Stanton Territorial Hospital in Yellowknife were cancelled after the hospital’s CT scanner and sterilizing equipment broke down.
The health authority’s spokesperson Maguire could not say if the current issues with the sterilization equipment are related to those in the past, saying the authority has not determined the cause in this instance.
“When the new hospital was built an entirely new medical device reprocessing unit was built and all of the sterilizers are new,” he said.
“This is a new issue that needs to be solved as these are new systems in the new hospital.”
Maguire said environmental factors can also affect the quality of steam in the sterilizers, including increased chlorine in the system due to high rainfall or turbidity (cloudy water), increased humidity, and high water levels — an occurrence that’s been well documented in Yellowknife this summer.
He said the authority has put together a team that’s meeting twice daily to manage the situation and work toward a solution.
‘I do trust them’
Ongahak says that, overall, she is grateful that the hospital found out about the sterilization equipment issues before going through with her surgery
“I do trust them because I know they should be checking their machines regularly and making sure everything is working,” she said.
“I’m kind of thankful, but then I’m [also] not, because I didn’t have the knee surgery,” she added. “I guess safety first, which is good.”
But Ongahak said she has kept her bag mostly packed in case another surgery date comes along soon.
This is an excerpt from Second Opinion, a weekly roundup of eclectic and under-the-radar health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.
The sacrifice Canadians have collectively made to flatten the coronavirus curve also includes immeasurable suffering from postponed surgeries, says a B.C. man who lost his mother not to the virus but to cancer.
Min Hua (Jasmine) Yang, 60, started having abdominal pain, fever and then breathing difficulties in January. She went to an emergency department in Surrey, B.C., and was diagnosed with a rare form of ovarian cancer in March.
Her son, Jonathan Hu, 31, said oncologists recommended surgery in early April as the best treatment for Yang’s three, late-stage tumours. But the COVID-19 pandemic lockdown included postponing or cancelling non-emergency surgeries like Yang’s — and an estimated 394,575 others across Canada.
“There is a lot more people who are suffering or dying other than just a number of deaths that you see from the coronavirus,” Hu said.
Canada’s health-care systems made a choice to cancel surgeries and to devote hospital staff and resources to COVID-19.
“We were really frustrated,” Hu said.
The family “felt powerless” as they watched Yang deteriorate daily during chemotherapy that was not part of the original treatment plan for her sex cord stromal cancer. The surgery was postponed weeks to May 4.
Yang died two days earlier.
“The choice that we made has consequences and we’re living with those consequences right now,” Hu said.
Dr. Iris Gorfinkel, a family physician in Toronto, worries about unintended consequences from those choices for her patients, too.
For example, virtual care excludes the physical exams she performs to quantify the degree of pain a patient has.
WATCH | The complications of resuming surgeries during pandemic:
Many provinces are starting to resume non-emergency surgeries delayed because of the COVID-19 pandemic, but it’s a complicated balance of trying to clear the backlogs and keeping patients safe. 2:03
“You put your hand on that person’s belly you see immediately they’re not doing well because you can feel how they’re reacting,” Gorfinkel said. “I know from my own practice I’m more likely to order tests because of that uncertainty, which is another cost to the system because I don’t want to be wrong.”
Patients are also left wondering whether delays in tests and procedures made a difference in their care, Gorfinkel said.
It’s one reason why health-care professionals across the country are preparing to do more procedures and surgeries.
Surgery backlog mounts
In May, B.C. Health Minister Adrian Dix estimated it could take up to two years to clear the backlog of 30,000 patients whose surgeries were postponed or not scheduled since mid-March in that province alone due to COVID-19.
In Quebec, Dr. Gilbert Boucher, head of the province’s association of emergency medicine specialists, said the flow of patients sick with medical conditions besides COVID-19 has resumed in much of the province.
The last three weeks, however, have included struggles with finding space, including for patients discharged from hospital who are unable to return home or to long-term care.
At Montreal’s older hospitals with four-bed rooms, many cannot be used while COVID-19 cases continue in the community. One tertiary care centre lost 30 per cent of its beds during confinement, Boucher said.
Hospitals with wards for people testing positive for COVID-19 had doctors and nurses working overtime for the last three months.
“Those people are getting tired so we just don’t have the staff to staff the operating room and to do the gastroscopy and the colonoscopy and all those follow-up” procedures, said Boucher. “It’s summer for everybody so people do need a little break.”
Medical experts say to ramp up surgeries, a “four-sided Rubik’s cube” of prerequisites, known as the 4S’s, first need to align:
Screening for COVID-19 safely.
Increased staffing capacity.
Supplies such as personal protective equipment and medications like anesthetics.
Space and systems in place to keep patients clear of COVID-19 before and during hospitalization and for patients and their family members to understand the importance of quarantine in the first 30 days after surgery.
In addition to surgery delays, the COVID-19 pandemic has led to global shortages of some drugs.
Christina Adams, chief pharmacy officer for the Canadian Society of Hospital Pharmacists, said drug makers have increased production of medications for critical care, such as the injectable anesthetic propofol that’s reportedly chronically short in the U.S.
Patients with COVID-19 who require continuous ventilation need two to three times the usual amount of propofol compared with patients requiring surgery under general anesthesia, Adams said.
She added that Health Canada anticipated global shortages and expedited imports of non-Canadian labelled products, such as from the European Union, to ensure supplies weren’t interrupted.
“Right now, the situation is not bad,” Adams said.
COVID-19 greatly compounds surgery risks
Janet Martin an associate professor of anesthesia and perioperative medicine at Western University and an international team of surgery researchers, estimated that 28.4 million elective surgeries worldwide could be cancelled or postponed this year based on the 12-week peak of disruptions to services in hospitals.
For Canada, the cancelled surgeries include hip and knee replacements and procedures to confirm whether or not someone has cancer.
“That’s exactly for whom we are doing this type of research,” Martin said.
If hospitals successfully increase capacity by 10 per cent by running operating rooms longer and partly on weekends, Martin figures it will take nearly 90 weeks to clear Canada’s backlog.
In a study published last month in The Lancet, Martin and co-authors followed 1,128 patients in 24 countries who had emergency and elective surgery this year before March 31.
Nearly one in four patients died within a month, the researchers found. For those undergoing elective surgery, the mortality risk rose from below the one per cent to 18 per cent.
One in two (51 per cent) developed serious pulmonary complications, including needing ventilation.
“We were absolutely surprised,” Martin said. “That is far and above what we had ever expected.”
As the increased risks from surgeries due to COVID-19 become apparent from the new data, Martin hopes hospitals will find ways to better protect patients.
For his part, Hu emailed CBC News looking for information on how many others in Canada like his mother who weren’t infected with COVID-19 but missed treatment and died.
It’s impossible to know exactly how delays affect an individual patient.
Gorfinkel said while such societal fallout can only be measured in retrospect, there are definitely consequences from postponing routine screenings during the pandemic, such as mammograms or tests to look for blood in feces, which can be a sign of a colorectal cancer or a growth that can easily be treated.
“Would an earlier diagnosis have made a difference?” Gorfinkel said of the questions she’s anticipating from her patients. “Much of the time it may not but the fact is we can’t be certain.”
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The hum of oxygen being pumped into Oula Jaber’s lungs is constant. One look at the long, blue tube connected to her throat and it’s clear that’s what’s keeping her alive.
For two years, Jaber has been waiting for a procedure that could potentially allow her to live without the tube and return home from her room in the complex-care ward of Trillium Health Partners hospital in Etobicoke.
Her daughter, Fatima Salem, has been trying to get a date for the surgery but has had no luck, and in the time her mother has been waiting for the operation, she’s missed Salem’s wedding and the birth of her grandchild.
“Had it been done already, she would have been home right now,” a frustrated Salem said. “My mom missed out on a lot of major life events,” she added. “There are days where I go home and just cry myself to sleep.”
Watch Salem describe their situation below.
Oula Jaber’s daughter tells the story of how her mother has waited two years in hospital for a surgery. 1:35
Jaber’s case is an extreme example of a problem that plagues health care not just in Ontario but across the country — increasing wait times for a wide range of surgical and diagnostic procedures. Those wait times often force patients to stay in hospital beds that are badly needed by others.
Four years ago, complications from pneumonia forced Jaber to rely on a breathing tube and rendered her unable to speak. A year later, doctors said there was hope she could live without the tube, but scar tissue had already grown around it.
According to medical notes from various doctors shared with CBC News by Jaber’s family, a surgeon was found two years ago at Toronto’s Princess Margaret Cancer Centre who could perform a procedure called a laryngoscopy.
The operation is required to remove the scar tissue before a procedure can be done to remove the tube.
Jaber, 57, was put on a waiting list, and is still waiting.
Had it been done already, she would have been home right now.– Fatima Salem, daughter of Oula Jaber
“There’s no worse feeling than seeing a loved one suffer,” said Salem, who is an only child and was raised by her mother.
‘No transparency whatsoever’
Salem said she called many times, only to be told the specialist at Princess Margaret was on vacation or out of the country on business. She said staff did not tell her where her mother was on the wait list.
“There is no transparency whatsoever,” said Salem.
The University Health Network (UHN), under which Princess Margaret operates, told CBC News it can’t discuss patient cases but “surgeons with specific specialities can have long wait lists” and work within the “[operating room] time they have available to them.”
Salem said her efforts to speed up the process also yielded few results. She said her mother was referred to two other doctors who eventually said they were not equipped to perform the procedure.
She pointed out the bill for the bed, approximately $ 1,700 a month, is subsidized by taxpayers.
During Question Period Thursday, opposition leader Andrea Horwath referenced CBC News’s story and asked the health minister, “why anyone should have to live in a hospital bed year after year waiting for procedures that should be available but simply don’t arrive?”
Health minister Christine Elliott said Jaber’s case was “rare and unusual” and that there are “very few surgeons who are able to perform this procedure. This was not anything to do with hallway health care.”
This is video of the exchange from this morning of the <a href=”https://twitter.com/OntarioNDP?ref_src=twsrc%5Etfw”>@OntarioNDP</a> leader asking about <a href=”https://twitter.com/fsaalem?ref_src=twsrc%5Etfw”>@fsaalem</a>’s story. <a href=”https://twitter.com/hashtag/onpoli?src=hash&ref_src=twsrc%5Etfw”>#onpoli</a> <a href=”https://t.co/8CfuhvMXoD”>pic.twitter.com/8CfuhvMXoD</a>
The Ontario government does not track wait times for laryngoscopies, stating the data it collects is based on recommendations from “clinical experts.”
Generally, though, two recent reports show wait times for diagnostic tests and surgeries have increased in Canada. The Fraser Institute published a report Tuesday that showed a median wait time across 12 medical specialities of 20.9 weeks in 2019, compared with 19.8 weeks the previous year.
It’s the second longest median ever recorded by the conservative think tank. However, Ontario had one of the shortest median wait times, at 16 weeks.
In March, the not-for-profit Canadian Institute for Health Information reported 30 per cent of patients across the country who needed cataract surgery or hip or knee replacements did not get the operation completed within recommended wait times. The numbers were similar in Ontario.
Both studies said long wait times lead to mental and physical stress, and financial hardship.
‘Not rocket science’
Natalie Mehra, executive director of a patient advocacy group called the Ontario Health Coalition, said the operating rooms in Ontario are underfunded. She doesn’t find it surprising Jaber has been waiting for two years for her surgery.
“When the government has put in the resources to reduce the wait times, they have been reduced,” she said. “It’s really not rocket science.”
In a statement, the Ministry of Health told CBC News the government is making “significant investments” to end hallway health care, including funding for home and community care and building more long-term care beds.
Meanwhile, Salem said the wait for her mother’s surgery means someone else has to wait for a complex-care bed.
Although the numbers fluctuate from day to day, Trillium Health said there were 14 people waiting for a bed as of Tuesday.
“There are many people [who] need this room more than my mom at this point,” said Salem.