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Moving health care forward in New Brunswick during COVID-19

It has been more than two months since New Brunswick shut down. From restaurants to parks, shopping malls to surgical suites, much of the province was quickly silenced. It was shocking and unsettling, but with the benefit of hindsight we can see that the restrictions put in place helped New Brunswick avoid the worst of COVID-19.

On the health care front, my physician colleagues have been working hard on the frontlines of care during the pandemic, in hospitals and community clinics, providing primary care and emergency services. Many of us prepared for the worst, training and rehearsing scenarios should a severe outbreak hit our province.

The province has reopened restaurants, retail stores, and other public spaces in the ever-evolving “new normal” that must balance public safety with economic and societal needs. Urgent surgeries that had been postponed are now available, but many New Brunswickers are still waiting to get the care they need.

On Friday, New Brunswick entered the “yellow phase” of recovery. Per the government’s COVID-19 recovery plan, this means that, “Regional Health Authorities will increase service levels and occupancy within hospitals and clinics in the province. This will be done in a progressive manner to continue to ensure safety of patients and staff.”

Physicians are eager to take this next step. Media reported last week that there is a 15,000-patient backlog of surgery patients in Horizon Health Network alone. Horizon CEO Karen McGrath said it could take 12 to 18 months of no virus resurgence before the backlog is cleared.

It is time to give these New Brunswickers the care they need. The New Brunswick Medical Society (NBMS) is prepared to work with government and health-care stakeholders to reopen essential health services. This is the time to think outside the box to deal with this backlog in a safe, timely manner.

While we must remain vigilant should a second wave of COVID-19 impact our province, given our current state of no active cases we need to start moving patients through the health system to give them the care they need and avoid a more severe backlog of urgent cases in the future. With physical distancing and other safety requirements to protect patients and health-care providers, every procedure takes longer than it did just three months ago. If we don’t begin moving forward now, I fear patients will face even greater delays.

British Columbia announced earlier this month an ambitious plan to manage its backlog of elective surgeries. In early March, 93,000 patients were waiting for elective surgeries. The province soon cancelled all electives to prepare for COVID, postponing 30,000 surgeries.

That province intends to “minimize productivity loss” by improving efficiencies, hiring hundreds of new health-care workers, expanding the hours that operating rooms are running, and asking clinics to take on more surgeries.

The province is planning bold moves, something the New Brunswick health system needs. If this pandemic has had a silver lining, it has shown us that our province can react swiftly to challenges when we work together.

In health care, the NBMS and government collaborated to expand virtual care services across the province, allowing physicians to provide care to patients remotely for routine issues where possible. This week, we expanded the list of services available through virtual care. This has been transformative to our health system, keeping patients and health-care workers safe during the pandemic but also easing travel concerns for patients and enabling more flexible scheduling of appointments.

The NBMS had advocated for virtual care as an important tool for many years, but when the pandemic made it necessary, our province was able to make it happen in short order. Virtual care can’t replace all visits to a hospital or community health clinic, but it is an important tool that can benefits physicians and patients today and in the future.

Recognizing the tremendous challenges that physicians are experiencing with respect to acquiring personal protective equipment (PPE) during the COVID-19 pandemic, the NBMS collaborated with Department of Health and Service New Brunswick to ensure physicians in community practices are properly protected with appropriate PPE. This was a significant undertaking, but quick thinking and collaboration are key to moving ahead during a health crisis.

We need to think outside the box on other pressing health-care issues, including the backlog of elective surgeries. It’s clear that we need to recruit more health-care workers, including physicians. Recruitment and retention of physicians is a challenging issue across Canada, and it may only be exacerbated by the COVID-19 pandemic. We are competing with every other jurisdiction in the country, so we must be creative and aggressive to entice health-care workers to choose New Brunswick.

On behalf of all physicians in the province, I would like to once again thank New Brunswickers for their efforts to keep the curve flat.

New Brunswick is a leader in North America, thanks to the quick action of chief medical officer of health Dr. Jennifer Russell and other health leaders, government, and the citizens of our province.

Let’s continue to lead the country and move health care forward just as well as we curbed COVID-19.

Dr. Chris Goodyear, FRCSC, is a general surgeon in Fredericton and the president of the New Brunswick Medical Society.