Stand by, patients: Health authorities start resuming some medical procedures

Newfoundland and Labrador's four regional health authorities said Wednesday they are starting to rollout plans to revive procedures and services that were suspended two months ago by the COVID-19 pandemic, but patients should prepared for a new type of normal.

However, patients waiting to see specialists or who have had procedures cancelled should not expect a full return to how the health system had been operating before the pandemic.

People anticipate that we will see a surge again and we may have to again push services back down to accommodate covidpatients. So, we are certainly not out of the woods yet.- Larry Alteen

"The focus is really on those patients who are in the most urgent need of care. While there has been a lot of talk about elective surgery, this is trulywhat I considerurgent surgery, it is booked surgery, but I'm thinking about cancer surgery, people who are waiting for cardiac surgery. Those types of high prioritiesare what we are focused on first," said Dr. Larry Alteen, vice-president ofmedical services at Eastern Health.

Alteen said the recent string of days without new cases of infections means the health-care system can start using some of the hospital beds that were freed up for an expected surge of new COVID-19 cases.

"We did have some surge but it just wasn't as big as was anticipated.Now, because we don't have a lot of covid activity in the community, the province and the RHAs thought it was time that we could start bringing some services back," he said.

However, each health authority said they were keeping a close eye on bed availability and the availability of personal protective equipment as their plans move forward.

Health boards working together

In four separate but quite similar news releases, the authorities indicated services will be restored gradually.

"Medical imaging, endoscopy, cardiac diagnostic and surgical services have been identified as areas within the health-care system that can gradually and safely begin to resume service at this time," Eastern Health, the province's largest regional health authority, said in a statement.

Central Health, Western Health and Labrador-Grenfell Health also said work is now underway to set priorities for which cases are handled first.

Health Minister John Haggie said on Wednesday that there were about 5,500 surgeries delayed as a result of the COVID-19 pandemic.

He said the health authorities will be bringing their surgery capacity up by about 25 per cent, but it will still take some time for the delayed surgeries to all be completed and there's no real timeline for the backlog to be cleared out.

There are literally thousandsof procedures that have not been done. The job is trying to get that backlog cleaned up and trying to keep it from growing and growing.- Larry Alteen

Newfoundland and Labrador moved to what's called Alert Level 4 on Monday, triggering some small changes in public health emergency orders.

The transition also allows regional health authorities to start bringing patients back into institutions, although in a very controlled manner.

"What we will initially be focusing on are those diagnostic procedures that are most likely to reveal imminently treatable conditions that would otherwise pose a risk to health," saidDr. Martin Vogel, vice-president of medical services at Central Health.

"We're thinking there of things like endoscopies to pick up colon cancers."

Vogel said he's consideringwhich patients need to be treated, not simply which procedures can be done. He said the health authorities are now taking on the "next layer of the cake."

Patients will be contacted directly about rescheduled appointments by physicians' offices or by other health officials.

Patients who do get a call can expect to see a very different hospital, and a very different hospital experience, according to Dr. Dennis Rashleigh, a vice-president at Western Health.

"If it would be an investigation or a procedure that would potentially have historically been walk-in in nature, it will no longer be walk in," he said. "It's going to be a booked appointment, appointments are going to be spread out so that we don't have multiple people in the waiting rooms, waiting rooms are being changed so people can't sit next to each other, and we'll be doing some pre-screening of all individuals before they come to insure they don't have any infectious symptoms."

Alteen said moving to Public Health Emergency Alert Level 4and offering more medical services means the health authorities can start reducing long wait lists that have grown longer.Alteen said there's still a possibility that another, larger surge may stillcome.

"As we loosen public health restrictions, there is a sense that we may see a surge and certainly people anticipate that we will see a surge again and we may have to again push services back down to accommodate covid patients. So, we are certainly not out of the woods yet," he said.

In the meantime, hospital emergency rooms are still open, and some health officials say patients should not hesitate to call their doctor if their condition is getting worse or head to an emergency room if it becomes an emergency.

"Do not think that the emergency room is teeming with COVID," said Vogel.

"They have adequate protections in place, adequate precautions in place, adequate personal protective equipment for both staff and for patients to protect them from that eventuality. If your medical condition is changing, contact your primary care provider, if it's urgent, go to the [emergency department]."

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