Canadians still waiting significantly longer for surgeries than before pandemic: report

Three years after the start of the pandemic, surgical backlogs and wait times are only just starting to improve, according to new data from the Canadian Institute for Health Information (CIHI), with patients still waiting significantly longer for surgeries than they did before the pandemic.

Over the course of the pandemic, roughly 937,000 fewer surgeries were performed in Canada compared to pre-pandemic rates.

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Around 24 per cent of that total reduction was due to a decrease in joint replacement or cataract surgeries alone.

In 2022, nearly 40 per cent of patients who required a knee or hip replacement or cataract surgery were not able to receive one within the recommended time frame.

The problem persists across all forms of surgery, according to the new report, which tracks the number of surgeries and trends in wait time since March 2020.

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And while surgery volumes are rebounding, experts say the backlog won’t disappear until we’re operating at a higher pace than we did before the pandemic.

“It is encouraging to see that surgery volumes in certain provinces are nearing pre-pandemic levels,” Tracy Johnson, director of health system analytics at CIHI, said in a release. “Reducing wait times is a complex challenge, and pre-pandemic surgery numbers will need to be exceeded to recover and to reduce surgical backlogs, although the findings vary across provinces and territories.”

The report compared surgery statistics recorded during the pandemic to those recorded in 2019 to gain a picture of how much still needs to change to recover from the blow the pandemic struck to our health-care system.

VOLUME OF SURGERIES DROPPED MORE WHEN COVID SURGED

The largest decrease in surgeries during the pandemic occurred during the first four months of the pandemic, followed by the Delta wave in May 2021 and the Omicron wave in January 2022.

At the start of the pandemic, as public health measures necessitated the cancellation of numerous surgeries and closures of health care facilities to in-person patients to try and stem the transmission of the virus, there were 173,000 fewer surgeries performed.

During the Omicron wave in January 2022 — which is still the largest spike of COVID-19 that Canada has seen throughout the entire pandemic — there were more than 77,000 fewer surgeries performed nationally, marking a change of 32 per cent less surgeries than 2019 levels.

Over the last three years, the only times the volume of surgeries surpassed 2019 levels nationally were in March 2021, March 2022 and June 2022. March 2021 saw the largest increase—seven per cent higher than 2019 numbers.

When looking at provincial data, things become more complicated.

British Columbia and Prince Edward Island only experienced large decreases in surgery volumes during the first six months of the pandemic.

Newfoundland and Labrador, Manitoba and Quebec all saw large decreases during the Delta and Omicron waves, with surgeries dropping 18 to 21 per cent fewer than before the pandemic during these waves.

Ontario, Canada’s most populous province, had the largest decrease in terms of the number of surgeries not performed, with 424,000 fewer surgeries during the pandemic compared to 2019.

British Columbia and Alberta saw 78,000 fewer surgeries throughout the pandemic. Manitoba had 48,000 fewer surgeries, Saskatchewan had 37,000 fewer surgeries, Nova Scotia had 21,000 fewer surgeries, New Brunswick had 20,000 fewer surgeries, and Newfoundland and Labrador had around 34,000 fewer surgeries.

Prince Edward Island has had just 140 fewer surgeries since March 2020.

“Decreases in surgical volumes have been the result of many factors including the timing and impact of COVID-19 cases and the health system responses, which included the cancellation of scheduled surgeries,” the report stated.

Previous reports from CIHI on surgery statistics during the pandemic haven’t included Quebec due to limits on the availability of data, making this report also the first time that Quebec data has been included. In Quebec alone, there were around 200,000 fewer surgeries performed in the first 25 months of the pandemic, compared to before the pandemic began.

Surgery decreases were even across gender and age groups, but were impacted by socioeconomic status.

“Results for the 31-month period also suggest that the pandemic had a greater effect on those living in lower-income neighbourhoods, for whom surgeries decreased to a greater extent,” the report stated.

WAIT TIMES STILL A PROBLEM

Across the country, wait times are still dragging on for Canadians hoping to access surgeries such as joint replacements and cataract surgeries.

Only 50 per cent of patients nationally were able to receive a knee replacement within the recommended six months in 2022, even though the number of Canadians receiving knee replacements rebounded to close to pre-pandemic numbers between April and September.

The fact that wait times are still poor for so many even as surgical volumes rebound is partly due to the backlog that doctors are still dealing with, the report stated.

Only 23 per cent of knee replacement patients in New Brunswick were able to access surgery within the recommended time frame in 2022, compared to 39 per cent in 2019.

The province which saw the largest drop in patients able to access a timely knee replacement compared to their pre-pandemic capacity was Quebec. In 2022, only 32 per cent of knee replacement patients had surgery within the recommended time frame compared with 72 per cent in 2019.

Ontario managed to secure timely surgeries for 68 per cent of knee replacement patients in 2022, the highest percentage of any other provinces during that year, but still down from the 80 per cent who received timely surgery in 2019.

Cataract surgeries have rebounded faster than joint replacement surgeries, likely because they don’t need to be performed in hospital operating rooms, the report stated.

There were 10 per cent fewer Canadians receiving cataract surgeries in 2022 compared to 2019 levels. Around 66 per cent of patients have been receiving their cataract surgeries within the recommended time frame since wait times stabilized in October 2020.

Between April and September 2022, around 57 per cent of patients waiting for hip replacements received treatment within the recommended time frame, compared to 75 per cent of these patients pre-pandemic.

An interactive tool on CIHI’s website allows a breakdown on different surgeries and their wait times within the last five years across all provinces.