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Ontario lays groundwork for scheduled surgeries to resume as COVID spread slows

TORONTO — Ontario is planning to resume thousands of surgeries that have been postponed due to the COVID-19 pandemic, though those operations are likely still weeks away and the backlog will take months to clear.
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TORONTO — Ontario is planning to resume thousands of surgeries that have been postponed due to the COVID-19 pandemic, though those operations are likely still weeks away and the backlog will take months to clear.

Health Minister Christine Elliott has spoken of wanting to resume cancer and cardiac surgeries first, but a framework released Thursday lays out various criteria and leaves those decisions up to hospitals themselves and regional committees.

"We're trying to take a measured and equitable approach to it," Elliott said.

"There may be some hospitals that decide to proceed with other procedures, whether it's for cataract surgery, or whether it's the hips, knees, joint replacement, some orthopedic issues. It will depend on what the hospital is able to do."

There's no timeline for when procedures will be allowed to resume, but Elliott said it is "several weeks" away. She noted that urgent surgeries in situations where a patient's life is at risk have continued.

In assessing whether elective and scheduled surgeries can resume, the framework says hospitals should: be in a community with a "manageable" and stable level of COVID-19; have adequate personal protective equipment and medication; and have enough inpatient and intensive care beds.

Hospitals should reserve 15 per cent of beds for COVID-19 patients and have a 30-day supply of protective gear on hand, the framework says.

The framework for deciding how to prioritize re-scheduling surgeries includes looking at the patient's condition, risks to delaying the surgery, COVID-19 exposure and transmission risk, and resources needed, such as operating room time, blood, and medication.

Scheduled procedures were put on hold on March 15 in a directive that remains in place nearly two months later. Officials say it could take months to clear the backlog.

The province's Financial Accountability Office has estimated that between March 15 and April 22, up to 52,700 procedures were cancelled or avoided.

Up to 12,200 more procedures are delayed every week of the pandemic, the FAO said.

Premier Doug Ford noted that by pausing those procedures, the health-care system very quickly added more than 5,000 acute care beds, meaning the province was prepared for any potential surge in COVID-19 cases.

Ontario reported 399 new cases of COVID-19 on Thursday and 48 more deaths.

That brought the province to a total of 19,121 cases — a 2.1 per cent increase over Wednesday's total — including 1,477 deaths and 13,569 resolved cases.

The number of people in hospital with COVID-19 and the amount of people in intensive care remained stable, and the number of people on ventilators dropped from 174 to 155.

In long-term care, which uses figures from a different database than the provincial totals, 37 more deaths were reported Thursday for a total of 1,111.

The premier said Thursday there would be a "complete review, not just of long-term care" after the worst of the pandemic had passed.

"There's better ways of doing things," he said.

Meanwhile, a personal support worker employed at a long-term care home in the Ottawa suburb of Orleans has died of COVID-19.

Sienna Senior Living, which operates Madonna Care Community, confirmed a male worker's death from the virus on Thursday afternoon but provided few other details. 

"He was a loved and respected team member and will be missed by his colleagues and the residents he cared for," the company statement said. 

Ford had a call Wednesday afternoon with cottage country mayors and while he said they are asking seasonal visitors to stay away for now ahead of the May long weekend, the premier didn't go quite that far.

"When you go up north, if you want to check on the plumbing on your cottage or heat, seeing what's going on up there — this isn't going to be the typical May 24 weekend," he said.

"I'm asking you, please don't bring a whole whack of people up. It's not the party weekend that it's been in the past."

Ford said there will be plenty of long weekends to come, but people who do travel to their cottages should continue public health measures such as not holding gatherings, practising physical distancing and avoiding non-essential travel.

The premier said earlier this week that there was only so long he could "hold the big gates back" if people travelled only to their cottages, brought their own food and didn't go into town.

Cottage country mayors and health officials have urged seasonal residents to stay home to avoid taxing the health systems in small towns and rural areas.

This report by The Canadian Press was first published May 7, 2020.

Allison Jones and Nicole Thompson, The Canadian Press