Health Care Services

Concerns about contracting COVID-19 and response measures to reduce transmission have impacted our health system and how we seek care. We are reviewing how the COVID-19 pandemic has changed the way patients access health care and how health care is delivered through the use of virtual options. We are also examining how health care has also been affected by delayed elective surgeries and access to screening programs, as well as patients avoiding health care visits because of fear of exposure to COVID-19.

We have organized the reports according to site of health care services and broader issues affecting delivery of health care services:

Hospital Services
Other Health Care Services
Health Care Delivery

The Project Team is collaborating with FNHA and MNBC to highlight distinct First Nations and Métis people’s experiences, knowledge, voices, and recommendations. Additional information can be found in the Indigenous Health and Wellness section.

Hospital Services

To limit the spread of COVID-19, hospitals implemented new safety protocols and practices, while also postponing non-urgent surgeries. We are reviewing the issues surrounding access and barriers that have emerged due this, as well as the health consequences among patients.

Emergency Department use

The rate at which individuals seek care in emergency departments (ED) may decrease due to practices to minimize exposure and transmission of COVID-19 in ED settings (e.g., changes in resource management, clinical triaging, use of new technologies), measures that re-organize hospital resources for anticipated COVID-19 cases, as well as the patient’s fear of exposure and transmission.

Chapter 8: Emergency Department Use in B.C. during the COVID-19 Pandemic (PDF)

Delay in non-urgent scheduled surgeries

Between March 16 and May 18, 2020, non-urgent surgeries were postponed or not scheduled in BC to limit the spread of COVID-19, to ensure that hospitals had the capacity to address COVID-19 patient needs, and to conserve personal protective equipment (PPE) until supply chains improved. Long wait times for non-urgent surgeries can result in poorer health outcomes including mortality, quality of life, and quality of care, as well as take a psychological toll on patients and families, including anxiety and distress.

Acquired infections in health care sites and long-term care & assisted living facilities

Increased cleaning protocols, use of personal protective equipment (PPE), single site staff policies, and visitation restrictions have likely reduced acquired infections and exposure to communicable diseases in health care sites and facilities.

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Other Health Care Services

In addition to hospital services, we are examining the impacts on health care services that are provided in other clinical settings, including screening and diagnostic services, primary care, and specialty services.

Delayed/deferred cancer screening

In order to prepare for a potential surge of COVID-19 cases in March 2020, non-urgent medical services were suspended. Breast and colon cancer screening were suspended between March 24 and June 8, 2020 and cervical cancer screening rates fell due to decreased access to primary care access services. A delay in cancer screening may increase the risk of delayed cancer diagnosis, and may subsequently limit the treatment window, functional recovery, survival, and patient quality of life.‎

Delayed/deferred diagnostic services

To ensure the safety of patients and the capacity of hospitals to address anticipated COVID-19 patient surges, all non-essential hospital-based imaging services between March 19 and May 14, 2020 were postponed. Increases in wait times for diagnostic services can result in downstream delays in health care service access, including diagnosis for surgical referral, biopsy, and post-surgical rehabilitation care.

Primary care access

The COVID-19 pandemic and response measures can pose challenges for individuals to access primary care (family doctors/general practitioners, nurse practitioners). Increased isolation and fear of catching COVID-19 may cause individuals to not seek care until their condition worsens.

Specialty services/clinics access

Access to specialty services and clinics may have been impacted by response measures, leading to longer wait periods between receiving a referral and consultation, as well as delays in treatment (e.g., cancer, asthma).

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Health Care Delivery

During the COVID-19 pandemic, the way we access health care has evolved to include more virtual options. Virtual health care delivery has the potential benefit of reaching more people, particularly in rural and remote communities that may have had a shortage of in-person health services before the pandemic. At the same time, health care workers are working under more intense conditions during the pandemic and may be susceptible to stress or burnout. We are monitoring the changes and impacts in health care delivery, as well as reviewing how these are meeting or not meeting population needs.

Health human resources

Adequate working conditions (e.g. usual workloads, safe physical working conditions) play a protective role for workers’ health. For some health care workers, COVID-19 and related response measures can exacerbate working conditions (e.g. excessive workloads, concerns about limited personal protective equipment (PPE), heightened risk of exposure to infection at work). This can lead to stress, chronic stress, and/or burnout.

Implementation of virtual health options

Community clinics and health care providers, including primary, community, and specialist care, provided virtual care options as a safe and effective way to continue providing health services during the COVID-19 pandemic. Widespread use and investment into virtual care services in BC have highlighted gaps and inequities.

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