100 open heart surgeries postponed in British Columbia as critical coronavirus patients fight over ‘last resort’ machines
VANCOUVER – Some 100 British Columbians have had their open heart surgeries postponed in the past two months due to a shortage of essential resources needed by the sickest COVID-19 patients, sources within the medical system say .
When CTV News Vancouver asked the Provincial Health Services Authority about the estimate, the authority did not deny its accuracy, but insisted that the most serious cardiac procedures still proceed at the same rate as usual. .
“From February 2020 to May 2021, no critical heart surgery was postponed in British Columbia,” a spokesperson wrote in an email. “By focusing on urgent and critical cases, British Columbia was able to ensure that all cardiac surgeries were performed according to recommended wait time goals. “
But the agency overseeing these procedures, Cardiac Services BC, also acknowledged that heart care in the Lower Mainland was affected during the pandemic, although it declined to provide statistics.
The agency did not respond when asked how many people were currently on waiting lists, how many hospitals were unable to treat urgent heart patients and referred them to other hospitals, and how many people had died while awaiting serious cardiac procedures.
While many surgeries have been canceled due to hospitals nearly overwhelmed by COVID-19 patients in Wave 3, sources say CTV News open heart surgeries have been disproportionately affected and will be much more difficult to be recovered due to a critical shortage of equipment and specialized personnel described by physicians as a “last resort”.
When COVID-19 patients do not respond to mechanical ventilation machines that breathe for them, they are sometimes placed on an extracorporeal membrane oxygenation (ECMO) machine, which draws blood from the body and infuses oxygen before it. to send it back inside the body. A team of doctors and specialized technicians, called pulmonary perfusionists, are needed to operate the machine and keep the critically ill patient alive.
ECMO machines and perfusionists are also needed during open heart surgeries, but with coronavirus patients needing them more urgently, scheduled surgeries have declined dramatically, so only the sickest heart patients still have their surgery. surgeries.
“Our intensive care team in British Columbia has been coordinated from the very beginning of this pandemic and has worked with both the cardiac response and the COVID response, the ICUS, to ensure that it is available for the people who need it, ”Provincial health worker Dr Bonnie Henry said when CTV News asked what the plan was for heart patients.
She also said she was not sure if anyone was hurt as a result of it.
In Manitoba, health officials have confirmed that five patients on the cardiac waiting list have died in recent months, and these patients are now being airlifted to hospitals outside the province for medical treatment. urgent. In Ontario, doctors have faced unprecedented demand for ECMO from COVID-19 patients and a public policy think tank says people have died as a result.
A RARE BUT IMPORTANT MACHINE DURING THE SUPPLY PERIOD
ECMO machines are rare. They are generally used for organ transplants, on fatally ill patients and during open heart operations. So Roland Clifford found himself five years ago when he went to the hospital and was told he needed emergency heart surgery.
“They told me I had a widow,” recalls the elder. “I spent eight days in the hospital.
Clifford said he was pushed to the bottom of the list by other more critical patients, but also pushed someone who was there before him.
“I didn’t know I had a problem,” he said. “It’s different if you know you have a problem and you know there is a solution and you have to wait.”
Clifford now volunteers with the Pacific Open Heart Association, which provides support and guidance to new heart patients. He has enormous empathy for those who anxiously await the call for life-changing, life-saving surgery.
“It’s like taking an old car and having an engine overhauled,” he said. “Everything is fine afterwards and they have that to wait, which other patients with other diseases do not have.”
Patients were waiting for the procedure at home or in hospital even before the pandemic, Clifford said.
“You have to be mentally prepared for delays,” he said. “Even if you are hospitalized, this case of bumping can cause tensions within a department. “
HUMAN RESOURCES MUCH MORE HARD TO FIND
Even if the province could find and purchase a slew of new ECMO machines, there is no way it can catch up on open heart surgeries by running operating rooms for longer hours, like the province sought to eliminate other surgical backlogs.
Among the specialists required to operate ECMO machines are perfusionists, who require years of training and were already scarce when the acute care system was not strained by hundreds of COVID-19 patients.
“This is not a problem that can be fixed quickly,” said David Bieber, spokesperson for the Health Sciences Association, a union representing skilled medical workers in British Columbia.
“This is a pre-pandemic problem, because the fact is that for the last few decades we have had a very austere approach to wage agreements for public sector workers in the health system and, therefore, in many countries. In this case, they earn less (in British Columbia) than they could in other provinces.
Like nurses and other frontline workers, Bieber says, perfusionists, respiratory therapists, technicians and others his union represents are exhausting themselves, with many considering leaving the healthcare field after a grueling 15 months of the pandemic.
“They work a very large amount of overtime and most haven’t taken a day or two of vacation in over a year; it’s completely unsustainable, ”Bieber said, although he applauded the province for taking steps to begin to address the problem in the longer term.
“They have spent money to provide new training places for a lot of these professions and it is a step in the right direction,” he said. “We hope that they will act quickly in terms of dealing with the delay in pay.”
With no easy fix in sight and the province refusing to discuss how it plans to catch up to a growing open heart surgery waitlist, patients must wait impatiently to see where they stand. on the priority list.
“The critical heart is like critical COVID,” Clifford said. “I guess someone has to decide what’s going where.”