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“The system doesn’t turn on a dime,” he added. “We have a big complex system. I wouldn’t say it was easy to postpone procedures across the province. But it’s not as easy to gear them up, and it’s not as easy to shift directions if something happens that is unpredictable.”

He said the plan for resuming elective surgeries, as well as diagnostics and other procedures put on hold in late March, might look something like the government’s Re-Open Saskatchewan plan, which leaves much “to be determined.”

Livingstone said the SHA will not “define an exact timeframe” for resuming postponed surgeries until it knows more about how many people will need them. He pointed to reports that people have been “shying away from hospitals” due to fear.

“The last thing we want to do is start burning through elective surgeries only to have our facilities fill up with people with medical needs that we haven’t met or diagnostic needs that were postponed,” he said. 

“So we will be developing that plan over the next couple of weeks.”

According to the SHA, that plan will look at the risk of COVID-19 transmission, supplies of personal protective equipment and patient needs to decide which services come back online first.

That’s no comfort to 65-year-old Garth Hetterly of Aberdeen. He has been waiting since October for an overnight surgery for a bone spur in his neck. It was scheduled for April 2, but postponed last month due to COVID-19.

He’s now dealing with severe pain that forced him to leave his job as an accountant. He fears it could be “career ending” if it isn’t dealt with soon.

“I sit in pain all the time,” he said.

Hetterly wants the SHA to resume elective surgeries on Wednesday, and sees no excuse for any delay. He finds the SHA’s worst-case planning scenario “unreasonable.” The uncertainty about when procedures will restart leaves him feeling like he has “no future.” He fears he could be waiting until July or August.

“I don’t know if I will make it,” he said. “I don’t know if I can physically hang on.”

As of April 22, about 3,800 elective surgeries had been postponed province-wide due to COVID-19 preparations, with cataract, joint, dental and gynecological procedures particularly affected.

The SHA acknowledged that its planning is based on “conservative” assumptions. It is assuming that every infected person will pass COVID-19 on to three others, despite evidence that the current number is less than one.

The estimate of three is based on limited Saskatchewan data from before restrictions were put in place, as well as artificial intelligence and comparisons with how other viruses have spread in the province.

Those assumptions would result in about 255,000 cases of COVID-19 province-wide over the course of the pandemic, less than the previous planning scenario with 335,000 cases. But its still enough to fill up intensive care units with 412 patients at the peak of the disease. Just over 400 would need mechanical ventilation to survive.

There are enough ventilators for 486 patients. That means Saskatchewan is no longer facing a significant risk of being “overwhelmed” by a surge, a significant worry when the first modelling information was released in early April.

The SHA is also planning to reduce its maximum capacity of hospital beds by about 1,000, relative to its previous planning scenario. There are still plans for cohorting patients and for field hospitals in Regina and Saskatoon as needed.

Health officials stressed that those numbers are meant to inform planning, not predict the future.

“We’re not saying this many people will die or this many people will come to hospital or this many people will actually get COVID,” said Jenny Basran, the SHA’s senior medical information officer.

“What we’re saying is in a ‘what if’ scenario, what if the worst-case scenario were to happen, what do we as a health system have to be ready to very quickly stand up and get care ready.”

Derek Miller, the SHA’s emergency operations centre lead, said the process of restarting postponed procedures will be “a cautious and methodical approach.” He noted that cases have “flared up” really quickly in some areas, like in New York City.

“We all really hope that we won’t see anything like this,” he said. “But we need the system to be able to be prepared to actually respond should this happen.”