Report gives insights into impact of COVID pandemic on health care

By Theodora MacLeod - Lethbridge Herald Local Journalism Initiative Reporter on August 3, 2023.

The Canadian Institute for Health Information has released a report exploring some of the impacts the COVID-19 pandemic has had on the health care system. The report also outlines four priorities the provincial/territorial governments and the Government of Canada have agreed to focus on to improve Canadian health care.

The report, which was released Tuesday, aims to provide a snapshot of our current health care system, pledging to direct resources and attention to key areas such as expanding accessibility to primary health care providers, reducing backlogs and supporting health care workers, improving access to mental health and substance use services, and utilizing digital information sharing to enhance communication amongst referring physicians and specialists, as well as between patients and their care providers.

According to Statistics Canada, surveys between 2019 and 2021 found that 88 per cent of Canadians (87 per cent of Albertans) reported having a health care provider they saw regularly.

Primary care providers – general practitioners, family doctors, and nurses or nurse practitioners – provide general health monitoring, while also treating some chronic diseases, and making referrals to specialists. They often act as the first point of contact for those seeking advice or care.

For 12 per cent of Canadians however, most of whom are in rural, remote, and underserved areas, obtaining primary care is a struggle. The numbers vary by province, with Quebec not providing any statistics, and only 24 per cent of Nunavut residents having a primary care provider.

Young adults, age 18 to 34 are reported to be the least likely to have regular providers out of any age group. While the report does acknowledge the rise in telehealth and virtual care, they have yet to gather information on how virtual care may or may not improve access for Canadians.

Despite the number of Canadians who reported having a primary care provider, a poll released by Ipsos – a market research company – in February stated that while 72 per cent of Canadians rated the quality of health care they accessed as “good” in 2020, at the height of the pandemic, that number has fallen dramatically to just 60 per cent.

An unrelated survey in August 2022 found that 40 per cent reported it was difficult or impossible to access services such as emergency and non-emergency care, surgeries, tests, and specialist appointments in the past six months.

As expected, the pandemic had a significant and lasting impact on the Canadian health care system. One key effect is seen in the reduction of surgeries performed from March 2020 to September. That period saw 743,000 (13 per cent) fewer surgeries performed than in the years before the outbreak of COVID-19. Though Alberta had a 10 per cent decrease, Newfoundland had the highest with 21 per cent fewer surgeries.

Laura Greer, a patient advocate from Ontario says, “One thing that for sure the pandemic has taught us is how central … our health care system is to a well-functioning society. We need to do the work to ensure that we’ve got that resilient health care system so it’s there when people need it.”

Though there were 18 million overtime hours worked in public hospitals in 2020-2021, which is roughly 9,000 full time jobs, the first year of the pandemic saw eight per cent fewer health care services provided by physicians than the year prior. Unfortunately, the decrease in services and increased demand on health care workers has created a backlog, which the governments are committed to reducing as they aim to grow the workforce.

With regards to mental health, it is largely acknowledged that the pandemic had ill effects on the mental states of many Canadians.

However, studies from 2018 show that even prior to the outbreak of COVID-19 of Canadians over 12 years of age, approximately one in five reported requiring mental health supports in the previous year.

Unfortunately, nearly half of those people did not feel their needs had been met or fully met. Nine per cent of Albertans in the 2018 study are reported as having been diagnosed with an anxiety or mood disorder.

Of the provinces included (all except Quebec, no territories are cited) the rate in Alberta is second only to Nova Scotia, which has a recorded 10 per cent. The Canadian average was eight per cent and many cited cost as a barrier, though wait times are also cited in the report as an ongoing concern.

For the final priority, the governments will focus on digitizing and modernizing access to health information. Patient records, including test results and referrals, are currently accessed electronically by 40 per cent of Canadians (33 per cent of Albertans), with only two out of five doctors using electronic information sharing to connect with other doctors.

Though these initiatives are priority areas that will benefit all Canadians and help strengthen the health care system, the report acknowledges the issue of unequal access, particularly for Indigenous communities and people.

Citing anti-Indigenous racism as a contributing factor to negative patient outcomes and preventable deaths, the Canadian Institute for Health Information says they have not included data specifically relating to the experiences of First Nations, Métis and Inuit communities.

While the acknowledgement is important, the lack of actionable plans leaves a substantial gap in the analysis of the Canadian health care system. Hopefully future reports will have the resources to provide a complete snapshot.