More surgeries being scheduled, but not enough to clear pandemic backlog, nationwide data suggests

Canadians continued to face longer wait times for joint replacements and an array of cancer surgeries as the COVID-19 pandemic progressed, a new report shows, putting further pressure on hospitals and provincial governments to tackle the backlogs — all while the country grapples with a healthcare staffing crisis and an aging population.

Released on Thursday, fresh estimates from the Canadian Institute for Health Information (CIHI), an independent, not-for-profit organization that provides data on Canada's health-care system, suggest major dips in surgeries in the first two years of the pandemic continued to have a ripple effect by 2022.

"The most recent data shows that while the monthly number of scheduled surgeries is nearing pre-pandemic levels, this is insufficient to clear the backlog and improve wait times," reads the CIHI report.

There were close to 36,000, or 20 per cent, fewer knee replacements performed nationwide between April 2020 and September 2022, compared to pre-pandemic levels. Hip replacements weren't far behind, with 12,000, or 11 per cent, fewer procedures performed during the same period. 

Those drops translated to longer waits: In 2022, only around half of patients had a knee replacement within the recommended six-month time frame, versus 70 per cent before COVID hit, while fewer than 60 per cent of people had hip replacements within the recommended time frame, compared to 75 per cent pre-pandemic.

The data shows "catching up has been more challenging for joint replacement surgeries, which are primarily performed in hospital operating rooms, than for cataract surgeries, which can be done in day procedure rooms or community clinics," the report continued.

Tracy Johnson, CIHI's director of health system analytics, said widespread surgery cancellations in 2020, followed by closures during later waves of COVID, all contributed to the backlog. Ongoing staff shortages in hospitals are making the problem worse, she said, coupled with higher demand for joint replacements in recent years due to Canada's aging population. 

"The particular surgeries that are farther behind are those that we call 'scheduled' surgeries. They're ones that are not life-threatening," continued Johnson, noting that people's quality of life and ability to work are often still impacted in the meantime. 

It's a feeling Julia Barbagallo knows well. 

Despite being diagnosed with osteo-arthritis — a degenerative joint disease — a decade ago, the Laval, Que., resident tried to maintain an active lifestyle, doing activities like CrossFit, jogging, hiking and martial arts. 

But as her condition worsened, her mobility became more limited. Now, at age 55, she requires a cane to walk and says her hip is in constant pain. "It goes from the groin to the hip to the back, inside the hip, down the knee," Barbagallo explained. "It's always moving and it keeps me awake at night."

One surgeon told her the wait for a hip replacement could be a year and a half; another said it would be a year. Barbagallo and her husband are also exploring a faster route to surgery at a private clinic, at a cost of roughly $30,000. 

"My health is deteriorating, basically, if I don't do this as soon as possible," she said.

Dr. Thomas Forbes, surgeon-in-chief at one of the country's largest hospital facilities — the University Health Network (UHN) in Toronto — said clinicians feel the pain of patients stuck waiting and are trying to tackle backlogs as best they can.