Beware of the backlash of the pandemic

One wave after another, COVID-19 has overwhelmed our healthcare system and resulted in over 12,000 deaths. But if we are not careful, the sneaky backlash of the pandemic could also be very disastrous.

The load shedding, which is reaching its peak in hospitals, has already forced extremely worrying postponements of treatment or operations…

A 34-year-old mother of four who cannot be operated on for advanced cervical cancer due to lack of space in intensive care, even though she also has multiple sclerosis.

A 71-year-old man with degenerative heart disease whose open-heart surgery has been postponed, with no date for a rescheduling.

Horror stories pile up1. And unfortunately, the difficult choices are not over, since this weekend could be “the hardest in the health network”, warned Prime Minister François Legault.

For all these patients who remain in limbo, the anguish of not having a clear diagnosis and the stress of not knowing when their treatment can begin is unbearable.

But beyond the physical and moral suffering, these delays kill. The numbers are stark: every four week delay in surgery increases the risk of death from cancer by 6-8%2.

All these patients whose treatment has been postponed are collateral victims of the pandemic. But that’s just the tip of the iceberg, as testing too has lagged.

Many patients have not consulted a doctor, due to the closure of several clinics or the fear of catching COVID-19 on the way to the hospital. Screening efforts, particularly for breast cancer, have been put on hold. And access to diagnostic tests has been limited.

Unfortunately, we cannot quantify with certainty the drop in diagnoses, because Quebec is the only province that does not compile the data. After more than 10 years of work, it is appalling that we have not yet produced a dashboard that would give the right time. How do you want to have an action plan, if we don’t even know what the starting point is?

Still, based on the drop in pathology reports, we can deduce that there were “missing” about 5% of cancer diagnoses last year.

It’s not because the cancer has retreated. No, the enemy just goes under the radar. And when the diagnoses fall, late, all these cancers will be at a more advanced stage.

Delays in cancer screening and treatment during the first three waves are expected to cause a 1% increase in deaths in Quebec over the next 10 years. Nearly 3,000 deaths will be directly linked to the pandemic, calculates a working group from McGill University3.

We must do everything to limit this excess mortality.

Individually, the easiest way to do this is to get vaccinated to avoid overloading hospitals.

For its part, Quebec must use all necessary means to replenish the ranks of health personnel. In this regard, we are delighted to learn that absences related to COVID-19 have fallen from 20,000 to 15,000. We also hope that the $500 million envelope advanced on Thursday will make it possible to meet urgent needs.

But we must see further. And think differently.

For example, why not develop other independent screening programs based on the model of the Québec Breast Cancer Screening Program?

Quebec is the only province that does not have a structured colorectal cancer screening program for people aged 50 to 74, which is deplorable since we have been thinking about it for 15 years.

By sending letters to all the people concerned, we would be sure to reach all Quebecers, including those who do not have a family doctor. They would be asked to take a sample and, depending on the result, a colonoscopy.

The problem is that there are already more than 110,000 patients waiting for a colonoscopy in Quebec, and almost two-thirds are already waiting beyond the standards of the Ministry of Health.

Sooner rather than later, an additional budget will have to be provided to deal with the delay in screening and the inexorable increase in cancer cases due to the delay in treatment and the aging of the population.

Ottawa, which stubbornly does not want to discuss health transfers before the end of the pandemic, must realize that the provinces need stable and recurring funding, not just lifelines when the boat is to flow.

Otherwise, thousands of lives risk being swept away in the undertow.

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