Children could be left disabled for life due to COVID-delayed surgeries

SickKids is the largest pediatric hospital in Canada, but even before the pandemic, the hospital was struggling to fully incorporate the demand for surgeries. Just one year ago, one third of children awaiting surgery at the hospital had missed their "window." Yet despite the much more benign effects which COVID-19 has on children, the pandemic has nevertheless greatly increased the number of kids who are missing their windows of opportunity.

"[COVID-19] has changed the way we do absolutely everything here at the hospital," said Lindy Samson, the chief of staff and chief medical officer of a similar children's hospital in Ottawa. "[Our] ability to do the same number of surgeries in a given day in a given operating room has been greatly impacted."

While adults have also seen their surgeries delayed for months due to the coronavirus pandemic, the effects of waiting are often far more disaffecting for children. As children grow and develop quickly, missing a window of opportunity can leave them stunted for the rest of their lives.

One example is the case of four-year-old Emmett Fisch of North York, who has two legs of different lengths. Fisch can walk and do normal children's activities for now, he sports a heightened shoe on his right foot, made possible due to his right leg being only four centimeters shorter than his left.

Fisch was to undergo a series of four leg lengthening surgeries, whereby his doctor would break his right thigh bone and insert a metal frame, allowing his leg to lengthen and his femur bone to grow. However, if left untreated, the difference in length will grow to twelve centimeters by the time Fisch is 16, at which point the difference between his two legs in size will be too difficult to treat and will leave him unable to walk.

"With a SUPERhip procedure, the hip would form much more normally if I was able to do it a couple of years ago," said Dr. Simon Kelley, associate chief of surgery at SickKids and Emmett's doctor.

"Each year that passes his remodelling capacity—his ability to develop and reshape and form his own hip—is diminished. So you get a progressive deterioration in the results."

In a sign of hope, however, it appears that the Ontario government is responding to calls for help. According to Dr. Kelley, SickKids has requested $24 million from the Ontario government in order to handle the backlog of schedules surgeries.

The government has since announced that hospitals across the province will be collectively receiving $283.7 million to remove their surgery backlogs, with special focus on SickKids, CHEO, McMaster Children’s Hospital, and London's Children's Hospital.

It may already be too late for some children, however, who have had their surgeries delayed over a year at this point due to the pandemic.

"You can't turn back the clock," said Dr. Kelley. "You miss a development window and it's gone."