I am also comfortable speaking in English.
Let's do it in English.
Thank you for having me at this meeting.
As the chair said, I'm the president of the Quebec association of cardiac surgeons. I've been there for three years. I have been a practising surgeon at the Montreal Heart Institute for the last 25 years.
This is not going to last six minutes, but obviously I'll be open to questions.
Having a quarter-century perspective on the health system, I can diagnose accurately what happened during the pandemic, especially with non-COVID patients with cardiovascular disease.
What we saw in the beginning was that a lot of room was made in case the hospital system became overloaded. For many weeks and months, patients were not operated on at the normal rate. Emergencies were basically the only kinds of operations we did. This had a consequence on our waiting lists.
Most of the hospitals in the province of Quebec have waiting lists. We try to have a percentage of patients outside of acceptable delays within lower than 10%. This is a calculation based on safety. If this is greater than 10%, we're taking chances, because it's very hard to predict what's going to go on with cardiovascular disease.
During the pandemic, even though we weren't at 10% before but most likely around 20%, the percentage of patients outside of acceptable delays for surgery rose to 40%, and sometimes 45%. This is basically playing Russian roulette. Oncology is important, but in cardiovascular disease we're fighting against sudden death and sometimes it's very hard to predict the course of the disease. This is one of the points I've made: a very large increase in the number of patients outside of acceptable delays.
The second thing is that patients not having access to cardiovascular care meant that some of them waited and waited at home, and then showed up at the hospital in an unstable situation, in a worse position than they would normally have been in. What happens in those cases is that they obviously have more complications and they stay longer in the hospital if they survive. This brings about greater resource utilization and less room for other patients, including COVID patients in the ICUs, and so on.
The third consequence is that, again, patients not having access to diagnostic procedures show up at a later stage, they have more severe disease and their chances of recuperation and, for example, going back to work are lessened. Normally they would have come in with a mild heart attack, but if they come in with a more severe one, they lose function and they become heart failure patients. They become a burden for our system that would not have happened had they been treated promptly with the right timing.
Some of the problems we're raising now on the long-term consequences of the pandemic are chronic problems related to underfunding, at least in the cardiovascular arena. Definitely there's going to be a backlog of operations. In that, I'm thinking of heart surgery but also cardiology, because these are the same patients. I believe we have to react urgently and consider long-term investments, because some of the problems we are facing right now have been going on for 20 years or more and have never been addressed properly.
Are there any questions?