Diagnoses of common illnesses dip during crisis, creates backlog: officials

A health backlog that could persist for years has been created as hospitalizations and diagnoses of other illnesses dropped while Albertans focused on the COVID -19 pandemic.

Hospitalizations from heart problems fell during the early months of the pandemic, Calgary cardiologist Dr. Jonathan Howlett told Postmedia, citing data from an Alberta-focused study.

Comparing information on Alberta hospital admissions from March 16 to Sept. 23, 2020 with the same period the year before, hospitalizations for heart failure decreased from 3.98 to 3.78 per cent, according to a study in PLOS ONE.

The drop in numbers is reflective of people putting off medical care for heart conditions, delaying testing and adding to surgery wait-lists, Howlett said. But he's worried people will die without getting care.

“There's a surface feeling where it's good that there's less cardiovascular hospitalization and less testing,” he said. “But that glosses over the real problem that people aren't accessing care. Some will die at home. The ones that make it to the hospital have a higher mortality rate because they're sicker.”

Diagnoses for common types of cancer have also decreased, by up to 8.5 per cent in 2020 compared to 2019, due to “barriers to diagnosis,” said Dr. Matthew Parliament, an oncology professor at the Cross Cancer Institute in Edmonton.

Based on Alberta Cancer Registry data, Parliament noted that prostate cancer diagnoses dropped by 14.1 per cent in 2020, breast and colorectal cancer by 11.1 per cent and bladder cancer by 4.5 per cent.

“We have not seen a recovery period, defined as higher-than-usual case volumes, accounting for the patients we had expected in 2020,” said Parliament. “Evidence suggests there remains a cohort of undiagnosed patients.”

Other specialists note that delays in treating cancers make them more complex further down the road.

Since the beginning of the pandemic, tens of thousands of surgical procedures have been cancelled or delayed in Alberta to free up resources for tackling COVID -19.

Dr. David Keegan, a Calgary family physician, is seeing backlogs build up and conditions worsening as a result.

“I had a guy who we confirmed had cancer,” Keegan said. “I understand it can be surgically corrected, even though it's only stage one. Maybe by the time he gets to surgery it'll be stage two or three? We're condemning thousands of Albertans to higher stages of cancer because of delays.”

Cardiology patients are also at risk of complications from surgical delays, Howlett explained.

“We see our wait-lists growing. Bad things happen to people on wait-lists. If you need open-heart surgery and you don't get it, there's a known risk of heart attacks while you wait. There's a psychological cost to waiting. It's very stressful and affects your quality of life,” he said.

Keegan is seeing other backlogs as a result of patients delaying visits.

Sprains from three months ago have become more painful. About twice as many patients as before COVID are coming to him about keeping their blood pressure and diabetes under control.

The intensified needs of patients, compounded by overworked medical professionals is leading “nowhere good.”

“The likely outcome is more burnt-out doctors, more delayed care to patients (and) family doctors leaving Alberta,” Keegan said. “The average care needs of Albertans will be worse and more complex for a few years until we catch up on these delayed screenings and delayed surgeries.”

Keegan urges Albertans to visit their doctor if something isn't right, to not “sit on” health issues and to go to the emergency room if they have to.

“When people see their doctor, give them a list of their (issues) up front because sometimes they're connected,” he said. “We can just get on it. Or maybe I can ask my nurse to get on some of the items ahead of time to be efficient.”

Howlett understands that fear of catching COVID -19 is deterring people from visiting medical facilities.

“Even in my clinics, people prefer phone consultations and sometimes they don't come in for followups, they're less likely to get testing,” he said.

But, like Keegan, he said clinics like his are “still open for business” despite the strains on the healthcare system.

“Don't hesitate to seek out medical care. We want you to come in and get the care you need,” he said.