Addressing the mental health of Canadians waiting for elective surgery: a potential positive post-pandemic legacy

Abstract

Addressing the mental health of Canadians waiting for elective surgery: a potential positive post-pandemic legacy T he coronavirus disease 2019 (COVID-19) pandemic has strained many aspects of Canadian health care, especially access to elective surgery. With wait times already relatively long, surgeries for more than 100 000 Canadians have been either delayed or cancelled because of the pandemic. While the physical effects of these treatment delays are readily recognized and treated, the impact of waiting for surgery on the mental health of patients usually receives little attention. About 20% of Canadians experience mental illness in any given year, and rates of anxiety, depression and substance abuse have increased since the start of the pandemic. Unfortunately, the further lengthening of waits for elective surgery may induce or exacerbate mental health burdens associated with COVID-19. 1-3 In Canada, the government of British Columbia is thus far alone in providing a general timeline in their prediction of the 17-24 months needed to add new capacity, catch up with the approximately 24 000 elective surgeries that were either cancelled or delayed, and restore prepandemic surgical case volumes. 4 Mental health affects surgical outcomes and length of hospital stay. 5 There is excellent evidence for physically optimizing patients before surgery through smoking cessation, physical activity and nutrition. Likewise, we also need to recognize the contribution of mental health and provide resources for patients' whose symptoms and ability to self-care have been affected by the pandemic. Equity is also a critically important issue, as people with mental illness are less likely to access surgery and their survival can even be affected. Indeed, the provinces of British Columbia, Alberta and Ontario recently released roadmaps for restarting elective operations, and they prioritize surgical access based on diagnosis. This means that surgeons must perform a manual override to reflect patients' symptom severity or pain. Better supports are needed to allow surgical teams to properly assess not only patients' physical health, but also their mental health, and provide them with timely access to care based on need. As Canadian hospitals are "ramping up" their elective operations, governments, hospital administrators, surgeons and referring doctors have limited

Effects of COVID-19 on Benign Gynecologic Practice

“…COVID-19 EFFECTS ON BENIGN GYNECOLOGIC PRACTICE gynecologic disease have shown that both benign pathologies and waiting longer for elective surgery places a significant burden on mental health and emotional well-being of patients. 11,12 These findings make it evident that patients with any diagnoses or proposed treatment plans would benefit from amelioration of stressors associated with delayed care during the pandemic.…”