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ONTARIO: Delayed cardiac surgeries due to pandemic may have caused 35 deaths

Thousands of surgeries were postponed or cancelled in order to ensure enough acute and critical capacity in Ontario hospitals for a possible surge of COVID-19 patients
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TORONTO — An Ontario hospital network has estimated that 35 people may have died during the COVID-19 pandemic because their cardiac surgeries weren't performed, Health Minister Christine Elliott said Tuesday.

The report was released by Toronto's University Health Network, Elliott said, though the organization did not immediately respond to a request for comment.

Thousands of surgeries were postponed or cancelled in order to ensure enough acute and critical capacity in Ontario hospitals for a possible surge of COVID-19 patients.

"I don't want to call it collateral damage because they are deaths and that is very concerning and sad to all of us, but we were required to make decisions," Elliott said.

"Because of the space that was created in our hospitals and the decisions that were made to make sure that we had enough acute care and critical care beds and ventilators available for people with COVID-19 ... thousands of lives were saved."

A spokeswoman for Elliott later said the study was "an analysis of historical data to model and estimate how many individuals scheduled to have a cardiac procedure may have been impacted as a result of COVID-related planning."

"To be clear, the study does not report on confirmed cases or individuals known to have been impacted," Hayley Chazan said in a statement.

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

That freed up 6,849 acute care beds and 585 critical care beds, the FAO said.

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

"While lower demand for hospital services creates immediate availability of hospital resources for COVID-19 patients, it also will lead to significant demand pressure for hospitals in the longer-term," the FAO report states.

"Since most of the delayed procedures are medically required, the longer procedures are postponed, the worse health outcomes Ontarians could have and the harder it will be for hospitals to eventually clear the backlog of delayed procedures."

Ontario's reopening framework released this week sets out resuming some surgeries in the first stage, and Elliott said cancer and cardiac procedures are priorities.

"Any death that's happened as a result of COVID-19, whether directly or indirectly, is a tragedy," she said.

"We feel for those families who have lost family members, whether it has been from cancer death, a cardiac death or a COVID-19 death, but these were decisions that we had to make."

Ontario reported 525 more COVID-19 cases Tuesday, ending several days in a row of declines in new cases and likely pushing back any reopening of the province's economy.

In a reopening framework announced Monday, the provincial government said the chief medical officer will be looking for a consistent, two-to-four-week decrease in the number of new cases before advising moving to the first stage.

The new provincial total of 15,381 cases is an increase of 3.5 per cent over the previous day's total and includes 951 deaths — 59 more than the previous day — and 8,964 resolved cases.

Premier Doug Ford said Tuesday he wants to see a "downward swing."

"We had three good days then all of a sudden today it spiked up again," he said. "We need consistency right across the board, to see a downward slope over the next couple of weeks."

Dr. David Williams would also be looking for fewer new hospitalizations, and those numbers also rose Tuesday, though the numbers of people in intensive care and on ventilators declined slightly.

Ontario's framework contained few specifics, but Ford said later this week he will be releasing sector-specific guidelines for how businesses can safely operate, whenever they are allowed to reopen.

The province announced Tuesday it is launching a new website to solicit ideas for regulatory changes that can help businesses retool to produce health products or operate in new ways during the pandemic.

The Ministry of Long-Term Care reported 34 new deaths in residents of those facilities — a number that comes from a different database than the overall provincial figures.

While health officials have said community spread is in a peak period, cases in long-term care homes are rising. There are outbreaks in 154 long-term care homes, up from 150 on Monday.

Some homes have been hit particularly hard, with 11 of them reporting 20 or more deaths.

Ontario has called in operational support from the Canadian Armed Forces for five homes — Orchard Villa in Pickering, Altamont Care Community in Toronto, Eatonville Care Centre in Toronto, Hawthorne Place in Toronto and Holland Christian Homes' Grace Manor in Brampton.

Orchard Villa has seen 48 of its residents die, Eatonville has had 37 deaths, and Altamont has seen 32 residents and one personal support worker die.

Two homes reported major increases in deaths from the previous day. The total at Isabel and Arthur Meighen Manor in Toronto rose from 22 on Monday to 32 on Tuesday in the 52-bed facility. The total at Forest Heights in Kitchener rose from 24 to 31.

The NDP is calling for public health units to take over direct management of long-term care homes "where seniors aren't well-protected," and for the province to mandate requirements for infection control, staffing and communication with residents and their families.

This report by The Canadian Press was first published April 28, 2020.

Allison Jones, The Canadian Press