Postponing medical procedures to make room for COVID patients comes at a cost, doctors warn

Quebec City resident Marie Blouin remembers all too well what it's like to have an important procedure delayed. 

Her mastectomy was put on hold during the first wave so her hospital could make room for COVID-19 patients.

"I had to go on every day — to live knowing I had cancer," she said, recalling how badly she wanted the disease removed as quickly as possible.

"It was really, really difficult to go through because I was isolated from my family, I was lonely, I didn't know what to expect and I did not know when I would undergo surgery."

Blouin's operation was delayed by a month and she's doing better these days, but now her thoughts are with the thousands of patients who are receiving unwelcome phone calls in the coming days and possibly weeks.

Quebec is once again cutting back on non-urgent surgeries and procedures to free up beds and staff for the expected influx of COVID-19 patients, but experts say these delays could lead to long-term consequences.

"People's conditions will deteriorate over time," said Dr. Arsene Basmadjian, who heads the province's cardiologists' association and practises at the Montreal Heart Institute.

"Other people will not get a diagnosis early enough."

Operating room activities were ordered cut by 50 per cent this week provincewide, and two-thirds of beds are to be freed up for COVID-19 patients.

But beds aren't the principal issue as Quebec can keep adding beds to the health network, but they're useless if the province does not have the staff to care for patients, Premier François Legault has said.

With thousands out sick or on preventative leave, coupled with the ongoing staff shortages, health authorities have had no choice but to scale back certain services.

This means orthopedic surgeries, screening tests and follow-up appointments will all be delayed, says Dr. Diane Francoeur, the president of the Quebec Federation of Medical Specialists. 

"It also means that there are cancers that will not be diagnosed during the relief period," said Francoeur. "Cancer does not take a break."

Beyond that, orthopedic surgeries, elective or not, can have a major impact on people's lives, she said, and postponing them is "really not trivial."

Daily case numbers remain high across Quebec

There are more than 800 COVID patients being treated in the province's hospitals, and more are expected in the coming week as the daily number of infections continues to hover well above 1,000.

Delaying cancer surgery can be dangerous in some cases, said Dr. Martin Champagne, president of the province's association of hematologists and oncologists.

A small, local tumour that can be treated with surgery alone may progress to needing additional treatments like chemo and radiation therapy, he explained. 

Champagne said the backlog of services will be felt across the network.

"This leaves us to fear the worst for the months to come, since we will amplify the crisis of diagnostic delay and patient care," he said. 

Legault allows holiday shopping for now

Legault said the best way to get the hospital network back on track is for the population to follow public health guidelines.

Legault said all options are on the table, but so far there are no plans to further tighten restrictions as was done in the spring.

Holiday shopping still has the green light and schools are staying open while patients — many of whom have already been waiting for ages — are being told their much-needed medical procedure has been put on hold.

"Unfortunately, it's a balance," said Legault.

"Right now we have to make sure that we have the beds available to treat patients with COVID-19. Especially if they are old, they are at risk of dying."

Health Minister Christian Dubé warned the population that, despite the good news about the arrival of vaccines, people should not let their guard down.

"For me, the best gift that I could give to my mother, your grandmother, our parents, is to make sure that they can have the vaccine in January, February and March," he said.

"And if we're not careful, they might not be there in 2021. And the next few weeks are very critical for that."