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Hospital officials want cautious reopening, beginning June 9

SAH subject to provincewide COVID-19 guidelines, no word yet on region-by-region return to full range of medical services; hospital hopes to reach 75 per cent normalcy by late July
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Sault and Algoma residents will no doubt be welcoming news that Sault Area Hospital (SAH), as reported earlier, is planning “a safe, cautious reopen and reschedule of services.”

The announcement came after the Ontario government lifted its March directive, which restricted elective and non-urgent surgical and clinical procedures, programs and clinics due to COVID-19 restrictions on the entire province.

A SAH news release, issued Tuesday, states resumption of services will roll out in two phases.

“The earliest that some services or procedures will be reintroduced will be June 9, 2020,” SAH officials wrote.

“Phase 1 of the recovery plan will focus on the resumption of surgical and cardiac procedures and tests. We will be resuming services at about 60 per cent of our normal activity. Our decisions regarding which cases will be rescheduled is based on an established priority.”

“Phase 2 will see our services resume to approximately 75 per cent of our normal case activity. This increase will be reached by mid to late July.”

That’s certainly better than the restrictive measures Sault and Algoma residents have had to deal with since March, but for many, SAH’s two-phase reopening plan, up to a maximum of 75 per cent normal case activity by late July after what seems like an eternity since March’s shutdown, won’t be enough, or quick enough.

The Sault and Algoma region has an aging demographic, the health of people in the region, in many cases, not as good as those in other regions of Ontario.

In addition, COVID-19 numbers reported by Algoma Public Health (APH), with 21 COVID-19 cases and no deaths, is better than numbers reported by other regions, including other northern Ontario regions.

Numbers show the Timmins region accounts for more than half of the 11 virus-related deaths in northern Ontario, with seven fatalities. The Porcupine Health Unit (PHU) case fatality rate is 10.8 per cent, higher than the provincial rate of 8.2 per cent.

So why the (seemingly) slow approach to reopening at SAH?

“By declaring a state of emergency, the province essentially wants us all to function as one unit. The Ministry was very clear, when they shut down, that everybody had to adhere to directives that were put out in March...we still have not received any messaging from the Premier that he’s going to have a regional approach (to getting hospitals back up to speed),” said Dr. Silvana Spadafora, SAH chief of staff, speaking to SooToday during a news conference on Tuesday.

Premier Doug Ford, speaking to the media Tuesday, did indeed state his government is open to working with health agencies to reopen the province on a region-by-region basis.

Until specific guidance regarding reopening hospitals in each region is received, Spadafora said “all activity is being heavily organized and mandated as per directives and guidance from the Ministry of Health.”

Spadafora was joined at Tuesday’s news conference by Wendy Hansson, SAH president and CEO, Dr. Joseph Reich, SAH medical director, surgical program and chief of surgery, and Sue Roger, SAH vice-president of clinical operations and chief nursing executive.

A return to ‘normal activity’ at SAH, Reich said, would include, for example, a wide range of elective surgeries, such as gallbladder surgery and arthroplasty (surgical reconstruction or replacement of joints).

SAH, Roger said, has heard from Sault and area patients eager to know where their surgery status stands during the COVID shutdown. 

“We certainly have heard from people who have waited for cataract surgery to renew their driver's licence, from people who are waiting for knee replacements, who have mobility issues. We have heard those stories, but we’ve heard them with understanding. Our community has been very sympathetic through the work we have done...and when we hear ‘I’m waiting,’ it is with understanding. They say ‘we know you’re doing the right thing for all of us, but when it’s my time, please remember,” Roger said.

SAH, in its news release, added “patients will be notified of their rescheduled surgeries and other appointments.”

“Please do not contact the hospital about a postponed appointment. Patients who are waiting for surgery will be contacted directly by their physician’s/surgeon’s office. Virtual visits will continue to be utilized by physicians as much as possible to support patient appointments.”

Despite these abnormal COVID times, officials said no SAH staffers will be handling such calls from concerned patients. 

“Generally the physician is the person that best knows the patient. He or she has seen the patient in their office and understands the patient...and will contact their patients in a way that gets them into the right priority here at the hospital,” Roger said.

“There are nuances that are best served (by doctors),” Reich said.

The entire SAH plan is subject to change.

“It’s important to note that SAH may need to stay in a specific phase for several weeks at a time, or longer, or return to an earlier phase, depending on occupancy, personal protective equipment (PPE) and drug supply status,” the SAH press release stated.

“There are so many variables...we’re learning as we go (about COVID-19),” Hansson said.

However, Hansson said, “we’re very optimistic because our community and health care teams have done such a phenomenal job (in complying with provincial state of emergency measures, such as social distancing)...that (compliance) will allow us to continue with our plan to reopen."

“We’ve been putting together a robust plan for the reintroduction of services.”

Despite the serious nature of the provincial COVID-19 shutdown, SAH cancer patients, since March, have still been receiving necessary chemotherapy and radiation treatments, while the most serious surgeries have also been performed at the hospital, Spadafora said.

As far as SAH’s need for protective equipment is concerned, Roger said “generally, our PPE is in good shape, from gowns, surgical masks, visors, goggles, face shields...we have a good supply.”