Social Policy in Ontario

The CMA report is titled “A Struggling System” and is released just as public policy makers and the medical community scrambles to prepare for what could be a fifth wave, driven by an even more transmissible virus variant called Omicron.

“If this variant does end up being more significant, or the impacts on the system are similar to Delta again, or worse, we were in a situation already where there’s no backdrop to the system. It is starting to fail,” said CMA president Dr. Katharine Smart.

In an interview Smart said that throughout the pandemic the system relied on “temporary Band-Aid type solutions (and) this sort of hope that things are just going to fix themselves. Instead, what we have is a system that’s continuing to decline. We’re not really hearing from any level of government an actual plan about how to fix it.”

Smart said “one of the issues is that the system needs more investment. But I think it’s also quite clear that the system itself is broken in many ways, and it needs to be reimagined for modern, the modern times … Otherwise, it’s going to be Canadians who pay the price with their health, and that’s obviously what’s already happening.”

To date, 29,618 Canadians have died of COVID-19 directly. When the pandemic first hit, medical professionals switched to virtual consultations with patients which helped offset a bigger toll.

But in-person specialist visits with people suffering from chronic diseases plunged in the early months of the pandemic, and are still lagging.

Nearly a year into the crisis, by January this year, visits for patients with hypertensive heart disease were still 60 per cent lower than usual, and 87 per cent lower for patients with diabetes.

“Missed or delayed chronic disease management can lead to serious and expensive complications, like heart attacks or even death,” said the report.

The report estimated backlogs in Ontario for key cancer screening services: it lists a gap of 389,347 Pap tests, 307,617 mammograms, and 297,299 fecal tests that detect colon cancer that needed to be performed.

Other services like home care assessments by nursing home care providers — which are a form of health screening for seniors to determine what their health needs are — declined during the first wave between March and April 2020 by 44 per cent, and while they rebounded somewhat, it said the majority are still virtual appointments.

The report looked at backlogs for eight procedures: breast cancer surgeries, coronary artery bypass graft, CT scans, MRI scans, colectomies, knee replacements, cataract surgery and hip replacements, and found backlogs due to COVID delays ranged from 46 to 118 days.

It also comes as another group, Health Charities Coalition of Canada, also called on MPs on Monday to act to fill the health gaps revealed by the pandemic.

“It is impossible to understate the impact the COVID-19 pandemic has had on health care delivery and, in consequence, on patients,” the coalition said in a release.

It cited examples people with diabetic foot problems who during the pandemic had more severe infections and “increased emergencies necessitating more amputations, and the amputations they had tended to be more extensive.”

To date, Health Canada says 1.7 million Canadians have been infected with COVID, and public health doctors again on Monday urged those who have not yet been vaccinated to get their shots, even as countries now confront the decision to broaden booster shots for the general population.