OVID-19 was declared a pandemic by the World Health Organization (WHO) in March 2020, 1 and health care systems across the globe braced for a potentially large influx of patients with COVID-19 within hospitals. These situations played out in countries such as Italy, where health care systems quickly became overwhelmed. 2 In light of the impact of the pandemic on health care systems globally, many Canadian provinces reallocated health care resources to care for patients with COVID-19 by reducing surgical capacity. Consequently, a staggering number of nonurgent surgeries (surgeries for conditions not immediately threatening life or limb) 3 were delayed. For example, early in the COVID-19 pandemic response, Ontario delayed 185 000 surgeries, and the number of delayed surgeries during the fourth wave in Alberta climbed to more than 30 000 -a number that continues to increase at the time of writing (unpublished data, 2021). 1,4,5 The effect of delaying nonurgent surgeries in Canada has not been fully explored, but it is estimated that the backlog from just the first wave of COVID-19 in some provinces will take 84 weeks to clear. 5 Prepandemic evidence suggests that excessive surgical wait times can lead to poor physical health, increased anxiety, and decreased social interaction, ability to work and overall quality of life. 6,7 Factors that mediate the impact of delays in access to surgical care include patient choice in the delay, and the quality and quantity of communication from health care providers. 6,7 It is unclear whether these prepandemic factors (poor physical and mental health, and quality of life) are consistent with the effects of delaying surgery in the context of the
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