When the Ontario government began to see the toll COVID-19 was taking on health-care systems around the world, it made the decision to postpone elective procedures to free-up space in hospitals for a major influx of coronavirus patients.

According to Ontario's Financial Accountability Office, that has meant an estimated 52,700 procedures have been avoided so far, either because they've been cancelled or postponed, or because the patients have avoided coming to the hospital, out of concern over the virus. Each week this continues, another 12,200 more procedures are foregone.

Meanwhile, Health Minister Christine Elliott indicated for the first time there may be collateral damage from the decision to postpone elective surgeries.

"Any death that has happened because of COVID-19, whether directly or indirectly, is a tragedy," she said on Tuesday. "We feel for those people who have lost family members, whether it is a cancer death, a cardiac death, or a COVID-19 death."

However, she said the decision was necessary and based on the need to protect as many people as possible. Elliott cited a report on cardiac deaths that she said estimates 35 people may have died as a result of postponed cardiac surgeries. However, her office later clarified that the study showed an estimate of the number of people who could have been impacted by the policy and was not a report on confirmed cases.

Allowing hospitals to begin doing some elective surgeries again is in the first stage of the province's framework for reopening the province, but the Doug Ford government has not yet given a date when that will occur.

Meanwhile, the FAO found the decision to cancel elective surgeries opened up a lot of hospital space, but noted it isn't all being used. It found that cancelling elective surgeries and other measures freed up 6,849 acute care beds, 585 of them critical care beds.

At the same time, it took steps to create an additional capacity of 1,500 acute care beds, including 1,492 critical care beds, with the creation of field hospitals.

The FAO report shows why the government took measures to expand capacity: prior to the pandemic, Ontario's hospital occupancy rate was about 96 per cent and there were only about 906 acute care beds, 357 of them critical care beds, unoccupied, the FAO estimated.

As of April 14, there were 910 acute care beds in use by COVID-19 patients, out of 10,255 available, including 243 critical care beds in use out of 2,434 available.

However, the situation could have been far greater. The FAO also modelled the use of hospital resources that would have resulted if the government had delayed the social distancing measures, including the state of emergency, by five days — it found there would have been more than 1,100 critical care patients in hospital to date, over four times greater than the peak Ontario has experienced.

However, the FAO also found Ontario would still have had sufficient critical care beds in that scenario, because of the expansion efforts.

Financial Accountability Office Peter Weltman said his office created the report as the situation was developing and it was done at the request of an MPP. He also noted that his office had discussions with officials in the Ministry of Health who had concerns that the report suggested the province overbuilt its hospital response to the pandemic, and they noted that the province has been using some of the excess hospital capacity to support the evolving crisis in long-term care.

That effort has included sending teams of hospital workers to support the long-term care homes, many of which are experiencing devastating outbreaks, as well as hospitalizing some ill long-term care residents.

The report also shows how the massive effort to increase hospital capacity came together quickly.

On March 2, only two weeks before the cancellation of elective surgeries, Elliott had said that the overcrowding of Ontario's hospitals was a "separate consideration" from the province's response to the coronavirus. At that time, she said hospitals had isolation rooms that could be used should they be faced with a number of COVID-19 patients. "

"So that's a really separate consideration from the situation in hospitals today and I'm confident that our hospitals can handle any patients that they might receive with the Coronavirus," she said at the time.

More than 12,000 medical procedures delayed each week in Ontario as COVID crisis continues, watchdog estimates

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