Delaying surgery over COVID fears could be risky move, OR doc warns

Operating room manager Alana Toole is so confident in what she and teams across Nova Scotia have done to keep patients safe, she doesn't hesitate when asked if she'd go through with surgery during the pandemic — or if she'd recommend a loved one do so.

"Absolutely, without a doubt," said Toole, who works at the Aberdeen Hospital in New Glasgow. "One hundred per cent."

Between July and November of this year, a total of 1,085 patients cancelled or postponed an operation; 11 fewer patient-initiated delays or cancellations than those same five months last year.

But those numbers took a big jump in November as the province contended with fast-rising COVID cases and community spread. There were 49 more cancellations last month than in November 2019, according to Nova Scotia Health.

Although there's no documented explanation for the sudden rise in cancellations, hospitals have said they are worried it is linked to COVID fears.

Delaying surgery not always the safest choice

Dr. Greg Hirsch said he feels hospitals — and specifically operating rooms — are safe.

"Is there anything perfectly safe? No," said the surgeon. "But it's also not perfectly safe to sit with a condition that could be worsening while you wait."

Nova Scotia's chief medical officer of health, Dr. Robert Strang, signalled the arrival of the pandemic's second wave in the province on Oct. 1, but the highest number of new COVID infections was recorded in November. 

"We're aware, at least anecdotally, that patients are declining to come in sometimes because of concern of coming into the hospital when there's a higher level of COVID in the community, as we've recently experienced," said Hirsch.

Months practising COVID protocols

Toole said hospital staff have created a set of COVID-specific safety procedures that are 30 pages long and operating room staff have spent months practising them.

Staff have even created a buddy system to ensure doctors and nurses are properly putting on and taking off personal protective equipment such as gowns, gloves and face shields.

"Having somebody make sure that your gown is closed and you have proper face protection and all of those things, it's just like a second check before they go into the surgical theatre," said Toole.

Patients are also screened multiple times for possible exposure to the virus, and in some cases, are asked to tighten their social circle in the two weeks leading up to surgery.

Toole said keeping patients safe during the pandemic has been a top priority for staff at Nova Scotia's 17 surgical sites.

She said she doesn't believe the inherent risk of infection is greater now than it was before COVID.

"I think that the teams really have done everything possible to ensure that the safety of the patient is paramount in everything that we do," she said.

'The safest thing' is getting treated, says doc

Hirsch urged those with concerns to talk to their surgeons before cancelling or delaying a procedure.

"We want patients to get the care they need," he said. "There are some conditions that are treated surgically that will deteriorate [if] not done in a timely fashion."

Cancer patients or those with potentially life-threatening issues should not wait for the pandemic to pass, he said.

"If you're sitting on a cancer or an aneurysm, we want you to come and get the care because that's going to be the safest thing for you."