MUHC now postpones some heart and cancer surgeries

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Faced with an increase in hospitalizations for COVID-19, the McGill University Health Center is already resorting to postponing cancer and heart surgeries to free up beds for those suffering from the pandemic disease, the Montreal Gazette has learned.

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Under the government’s policy of deliberately reducing clinical services during the pandemic, known in French as délestage, hospitals were ordered to postpone elective surgeries deemed less urgent, such as joint replacements and hernia repairs. But with soaring hospitalizations and a record 20,000 health workers absent due to COVID (plus another 50,000 suffering from burnout and other medical leave), Quebec hospitals are now postponing more serious operations.

Some scheduled heart surgeries are postponed largely because they require few postoperative intensive care beds, Dr. Liane S. Feldman, chief surgeon at MUHC, said in an interview. On Friday, Quebec declared a total of 229 ICU stays for COVID, two fewer to tie the record set on January 14 of last year. During the first wave of the pandemic, ICU stays peaked at 227 on April 23, 2020.

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However, Feldman urged heart patients whose surgery was postponed to contact the MUHC if their health suddenly deteriorates to justify an emergency operation. The purpose of scheduling cardiac surgeries in advance is precisely to prevent the patient’s condition from dangerously deteriorating.

“We are definitely making délestage decisions,” Feldman said Thursday. “That is mainly what I have occupied my morning: who will we have to remove from different sectors, at least in the surgical mission, to be able to create more capacity of beds in the ICU and in the regular rooms.

“We know that there are many people in pain waiting for surgery, and they have been waiting and canceling many, many times,” he added. “We are seeing these medically urgent and time sensitive cases, but we are all well aware that there are many people who need surgery and they have been canceled so many times.”

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MUHC’s hospital network has shrunk to 65 to 75 percent of its pre-pandemic surgical volumes, and Feldman predicted that percentage will decline in the coming weeks due to the wave driven by Omicron.

François Shalom, 67, a Pierrefonds resident, was told he would undergo surgery at the MUHC this month to replace a worsening congenital defective aortic valve, but has since been informed that it has been discontinued.

“I’m not expecting a facelift here,” Shalom said. “A cardiologist told me in September that it was imperative that I have a valve replacement ‘in the next few months.’

“My symptoms are getting worse,” he added, “but I’m not trying to skip the line, taking the place of a more urgent case than my own. I’d like to know when I can expect life-saving surgery. “

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Shalom was also told that his heart surgeon is in quarantine until January 17 because he may have been in contact with a COVID carrier.

On Thursday, Dr. Lucie Opatrny, the main official of the Quebec hospital, warned that “the délestage runs the risk of accentuating in the days and weeks that follow.”

Opatrny explained that under the most severe degree of délestage, Level 4, there are “even heart surgeries… that are neglected. There are even cancers, like prostate cancer in some cases, that can be neglected ”. But it did not confirm that such operations are now postponed.

This story will be updated.

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