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3-year-old's delayed cleft palate surgery 'heartbreaking' says mom told it's non-urgent
Ontario mom Andrea Gerardi's son Marco was born with a submucous cleft palate
Andrea Gerardi has been waiting nearly two years for her son to get a surgery that she says would improve his quality of life, but like many others across the province it's been pushed to an unknown date due to the pandemic.
On Jan. 3, the provincial government mandated that hospitals cancel all non-urgent surgeries in preparation for a spike in Omicron cases. This is the third time since March 2020 that an indefinite postponement on non-urgent medical surgeries has been put in place by the government.
The pause has yet again left many in the dark of when they can expect to get treated, including Gerardi's three-year-old son, Marco, who was born with a submucous cleft palate.
The condition, according to the Windsor, Ont. mother, has left a hole in the back of Marco's throat — one that is not visible from the outside. She said this has impacted the way he talks and sleeps, and it has left him with a cough and a constant runny nose.
"This has been quite the ordeal and you can imagine as a parent how frustrating it is to hear the words 'non-urgent' when a surgery impacts the quality of life for your kid," she said.
Though Gerardi knew about Marco's condition in 2019, it took nearly two years for her to get an appointment with a specialist in London.
Following his September 2021 appointment with the specialist, Marco's surgery was booked for Dec. 22. The surgery would repair the hole in his throat and put tubes in his ears.
But two days before, he tested positive for COVID-19.
In January, when Gerardi called the surgeon's office to reschedule, they said it wasn't possible as all non-urgent surgeries had been cancelled.
"I definitely think [this surgery] is essential ... this surgery should have been done a lot sooner than it is being done, now my son's chances for success [post-surgery] is 70 per cent as opposed to a higher success rate because we waited," she said.
Gerardi added that Marco also has a developmental delay — which impacts his speech — but doctors have told her that on top of speech therapy, the surgery "is a big piece of the puzzle."
Long waitlists across country for pediatric surgeries
Dr. David Price, president of the Canadian Association of Pediatric Surgeons, told CBC News that surgical cancellations for pediatric patients can significantly impact development.
He said there's been a lot of thought given to when a surgery should be performed on a child and how long they can wait for the procedure in order for the patient to have the best outcome.
"During these slowdowns, [those timelines are] often thrown out," he said.
"If children aren't progressing normally as in their cohorts or getting their appropriate care at the same time there can be profound developmental dysfunction, mental dysfunction ... The next thing we have to remember is when are talking about these youngsters ... we are doing things that affect their life, development and personality and behaviour for another 80 years."
Due to COVID-19, Price said he knows that in many places across the country, there are people waiting one to two years for procedures to be done.
"We are going to see the consequences of them. There is a tremendous effort amongst the practitioners in these hospitals to mitigate those consequences, but we can only do so much if we're not doing it ideally in the first place," he said.
For now, Gerardi said she doesn't know when the surgery will take place or if she'll even be prioritized when appointments start to get rebooked.
She said she hopes Marco can get the surgery well below he starts school in September.
Ontario mom Andrea Gerardi's son Marco was born with a submucous cleft palate
Andrea Gerardi has been waiting nearly two years for her son to get a surgery that she says would improve his quality of life, but like many others across the province it's been pushed to an unknown date due to the pandemic.
On Jan. 3, the provincial government mandated that hospitals cancel all non-urgent surgeries in preparation for a spike in Omicron cases. This is the third time since March 2020 that an indefinite postponement on non-urgent medical surgeries has been put in place by the government.
The pause has yet again left many in the dark of when they can expect to get treated, including Gerardi's three-year-old son, Marco, who was born with a submucous cleft palate.
The condition, according to the Windsor, Ont. mother, has left a hole in the back of Marco's throat — one that is not visible from the outside. She said this has impacted the way he talks and sleeps, and it has left him with a cough and a constant runny nose.
"This has been quite the ordeal and you can imagine as a parent how frustrating it is to hear the words 'non-urgent' when a surgery impacts the quality of life for your kid," she said.
"I'm just extremely sad and I'm extremely frustrated for my son, because he can't communicate as efficiently as I think he would if he had that surgery. There's nothing more heartbreaking I think for a parent who knows that there's a solution out there and it's just out of reach, because of something that is so out of our control."
Though Gerardi knew about Marco's condition in 2019, it took nearly two years for her to get an appointment with a specialist in London.
Following his September 2021 appointment with the specialist, Marco's surgery was booked for Dec. 22. The surgery would repair the hole in his throat and put tubes in his ears.
But two days before, he tested positive for COVID-19.
In January, when Gerardi called the surgeon's office to reschedule, they said it wasn't possible as all non-urgent surgeries had been cancelled.
"I definitely think [this surgery] is essential ... this surgery should have been done a lot sooner than it is being done, now my son's chances for success [post-surgery] is 70 per cent as opposed to a higher success rate because we waited," she said.
Gerardi added that Marco also has a developmental delay — which impacts his speech — but doctors have told her that on top of speech therapy, the surgery "is a big piece of the puzzle."
Long waitlists across country for pediatric surgeries
Dr. David Price, president of the Canadian Association of Pediatric Surgeons, told CBC News that surgical cancellations for pediatric patients can significantly impact development.
He said there's been a lot of thought given to when a surgery should be performed on a child and how long they can wait for the procedure in order for the patient to have the best outcome.
"During these slowdowns, [those timelines are] often thrown out," he said.
"If children aren't progressing normally as in their cohorts or getting their appropriate care at the same time there can be profound developmental dysfunction, mental dysfunction ... The next thing we have to remember is when are talking about these youngsters ... we are doing things that affect their life, development and personality and behaviour for another 80 years."
Due to COVID-19, Price said he knows that in many places across the country, there are people waiting one to two years for procedures to be done.
"We are going to see the consequences of them. There is a tremendous effort amongst the practitioners in these hospitals to mitigate those consequences, but we can only do so much if we're not doing it ideally in the first place," he said.
For now, Gerardi said she doesn't know when the surgery will take place or if she'll even be prioritized when appointments start to get rebooked.
She said she hopes Marco can get the surgery well below he starts school in September.
question! is it the same situation in the US? the waitlists and backlogs in healthcare.
I have money, will I get things done quick in the US?
I have money, will I get things done quick in the US?
US hospitals aren't free. It's the same or even worse here. Some time-sensitive surgeries cannot be performed because of unvaccinated occupying the beds and ICUs. Pre COVID, you can get the best treatment on the planet but it is super expensive. With money, you can buy the treatment here. But you got to be a multi-millionaire to do that. Medical bankruptcy is the number one bankruptcy in the US. Healthcare is a failure in terms of affordability. But innovation in healthcare is next level here. End of the day, Money speaks.
https://www.thebalance.com/medical-bankruptcy-statistics-4154729
Best thing to do is go to some country like India or Thailand and get treated there. Canadian Healthcare blows for non emergency
Toronto 911 operator says 'people are being hurt' by waiting on hold for up to 10 minutes
Management says staffing is a challenge, but 911 service is fulfilling duty to public
A baby not breathing, a drowning and a person suffering from a gunshot wound.
Those are all examples of emergencies where callers waited on hold for longer than two minutes before a Toronto 911 operator said they were able to answer the call.
"Everything that we do at our job as call-takers is about seconds," the operator said. "People are being hurt, and they don't know they're not getting the help that they need."
CBC News is not identifying the 911 operator because they're not authorized to talk about their work at the Toronto Police Service's 911 communication centre, which answers all emergency calls for the city.
Callers being put on hold when trying to report an emergency was a problem even before COVID-19. Two years before the pandemic, Toronto police were working to address wait times by hiring and training more operators to meet increased demand for 911.
Now internal documents obtained by CBC News show how long wait times are more than one-offs in Canada's largest city. Reports, emails and snapshots of Toronto's 911 call queue paint a picture of an emergency service struggling to retain staff amid burnout-fuelled shortages.
The staffing issues mean there are sometimes fewer than 10 operators answering 911 calls for a city of nearly three million people, leading to average longest wait times ranging from two to 10 minutes.
"We're not fulfilling our duty to the public," said the 911 operator. "We all took this job to help people, we all took this job to answer your call, to be there — and we can't do it."
Peaks in call volume create wait time: manager
The manager of Toronto's 911 communication centre told CBC News the service is safe and fulfilling its duty to the public despite any staffing challenges.
"There's always going to be those peaks in call volume that create wait time — it's inevitable," said Kerry Murray-Bates. "Financially or logistically, it's just not possible to staff [for] a van attack every day. It doesn't make sense."
The communication centre received just under 900 emergency calls in the roughly two hours around the April 2018 Toronto van attack, which killed 10 people and injured 16 others. By comparison, in the same time period a day earlier, the call centre received 400 calls, said Murray-Bates.
The team uses historical data to best "match our workforce to our workflow," she said, and continues to train and recruit new staff to fill vacancies.
Since June 2021, the 911 operator captured nearly 250 snapshots of 911 wait times from 45 different days on the job. The longest wait time among the queue board photos shared with CBC News was six minutes and 51 seconds, with 62 people waiting on hold and nine operators taking calls.
The operator captured 140 queue board images where the longest wait time was over two minutes in length, 43 where it was over three minutes and 13 where it was over four minutes long — all over different days of the week and times of the day.
Internal service reports also show monthly average longest wait times ranged from nearly four minutes to nearly five minutes for June through November of last year. The longest wait time recorded in those months was on Sunday, Oct. 3, at 7 p.m., when someone waited for 10 minutes and two seconds for one of nine operators to pick up the call.
From June through November, those same reports show the average wait time each month never exceeded 33 seconds, for a combined average wait of 25 seconds.
From June 1 until Dec. 1, the Toronto service's emergency-call answering times fell below the National Emergency Number Association (NENA) standard of answering 90 per cent of all 911 calls within 15 seconds every day except one.
While the NENA standard is voluntary, like most 911 communication centres, Toronto's service strives to meet it, said Murray-Bates.
"What doesn't come with the NENA standard is any sort of parameters on how you will meet the NENA standard," she said. "Our average wait times last year were between eight seconds and 33 seconds. So, on average, we're doing pretty good."
When it comes to longest wait times — like that 10-minute wait in October — Murray-Bates said the metric reflects "a moment in time" and changes quickly.
"One impactful accident on the Gardiner Expressway can generate 50 calls," she said. "That creates a spike in our call volume, which then creates some impact to our wait times."
'We need to thrive, not just survive'
But emails to staff from Murray-Bates about improving service and staffing reveal some concerns.
In an October 2021 email, she acknowledges "that staffing continues to be a struggle," but says she is optimistic the situation will improve soon when new recruits finish their training.
"My goal is that we get to a place where every phone position is filled and we are reaching our service levels, that members are not frazzled, anxious and angry," Murray-Bates wrote. "We need to thrive, not just survive."
The email also says the Toronto police chief's office, the police board chair, and the police union have all given "incredible attention" to the staffing issues and Murray-Bates is confident concerns will be addressed.
In an interview, Murray-Bates confirmed her team had received support from those three offices, but didn't specify what kind of support. Instead, she said they have to maximize staffing within the rules and budget approved for the communication centre.
Within a month of that first email, the tone of Murray-Bates' subsequent emails shifted.
"Despite our best efforts, we keep losing members to long-term absence, which is having a serious impact on not only members who remain, but to the citizens we serve," she wrote in November.
"Our numbers are not good."
The email then details management's efforts to counteract the shortages, such as by combining some police dispatch positions to free up staff to answer 911 calls instead.
Murray-Bates also said in the email that they anticipated losing more staff to the city's mandated vaccine policy on Dec. 1, and they "already lost a few members from the most recent call-taking class."
"To be brutally honest with you, we don't know what more we can do to help this issue," she wrote. "We know members are tired, stressed and burnt out. Our job is so unique that no one else can do what we do."
'We're doing the right things'
Responding to that email, Murray-Bates told CBC News "you have to put it into the context of we're doing the right things here."
"We are focusing on our testing and recruitment and our hiring process," she said. "We're trying to make it more robust so that we get the best candidate in the door, which is going to lend to our success rate in retaining those people, which is going to lend to our staffing."
Right now, there are 35 recruits in training and the communication centre has a job posting up to fill 24 more vacancies, said Murray-Bates. She said she hopes candidates for those spots will begin training in May.
The maximum number of 911 operators budgeted for is 301.
Roughly 60 per cent of recruits successfully make it through training and the majority of staff they lose are newly trained, said Murray-Bates.
"We provide the best training we can, we provide the best support we can to our communication officers," she said.
"We realize they're tired, but that comes with being a 911 operator, right? Staffing is not the only stressor in a 911 centre — it's inherent in the job."
Temporary staffing solution 'overwhelming'
But the 911 operator told CBC News that management's temporary solution to reduce wait times caused by staffing issues — giving them more work when they're assigned to dispatching — has just added to that stress.
All 911 operators are trained as both call-takers, who answer and process emergency and non-emergency calls, and as dispatchers, who co-ordinate police response to those calls.
Operators can be assigned to only take calls, only dispatch, or to spend half of their shift doing each.
To alleviate emergency call wait times when staff is low or call volumes are up, the service is now combining some police dispatch jobs. This means that where two divisions would normally each have their own dispatcher, they're now sharing a single dispatcher and the other is assigned to take emergency calls instead.
"It's absolutely overwhelming us," the operator said. "You're managing every emergency that the police would be involved in for that entire area, for six to 12 hours."
Having one dispatcher handle two divisions is not new, said Murray-Bates, and some divisions were already combined to a single dispatcher. But if the radio traffic becomes unmanageable, a dispatcher can notify a supervisor and they'll split up the divisions again, she said.
"It's worked very well, actually, for us to allow more people to be on the phones."
Management says staffing is a challenge, but 911 service is fulfilling duty to public
A baby not breathing, a drowning and a person suffering from a gunshot wound.
Those are all examples of emergencies where callers waited on hold for longer than two minutes before a Toronto 911 operator said they were able to answer the call.
"Everything that we do at our job as call-takers is about seconds," the operator said. "People are being hurt, and they don't know they're not getting the help that they need."
CBC News is not identifying the 911 operator because they're not authorized to talk about their work at the Toronto Police Service's 911 communication centre, which answers all emergency calls for the city.
Callers being put on hold when trying to report an emergency was a problem even before COVID-19. Two years before the pandemic, Toronto police were working to address wait times by hiring and training more operators to meet increased demand for 911.
Now internal documents obtained by CBC News show how long wait times are more than one-offs in Canada's largest city. Reports, emails and snapshots of Toronto's 911 call queue paint a picture of an emergency service struggling to retain staff amid burnout-fuelled shortages.
The staffing issues mean there are sometimes fewer than 10 operators answering 911 calls for a city of nearly three million people, leading to average longest wait times ranging from two to 10 minutes.
"We're not fulfilling our duty to the public," said the 911 operator. "We all took this job to help people, we all took this job to answer your call, to be there — and we can't do it."
Peaks in call volume create wait time: manager
The manager of Toronto's 911 communication centre told CBC News the service is safe and fulfilling its duty to the public despite any staffing challenges.
"There's always going to be those peaks in call volume that create wait time — it's inevitable," said Kerry Murray-Bates. "Financially or logistically, it's just not possible to staff [for] a van attack every day. It doesn't make sense."
The communication centre received just under 900 emergency calls in the roughly two hours around the April 2018 Toronto van attack, which killed 10 people and injured 16 others. By comparison, in the same time period a day earlier, the call centre received 400 calls, said Murray-Bates.
The team uses historical data to best "match our workforce to our workflow," she said, and continues to train and recruit new staff to fill vacancies.
Since June 2021, the 911 operator captured nearly 250 snapshots of 911 wait times from 45 different days on the job. The longest wait time among the queue board photos shared with CBC News was six minutes and 51 seconds, with 62 people waiting on hold and nine operators taking calls.
The operator captured 140 queue board images where the longest wait time was over two minutes in length, 43 where it was over three minutes and 13 where it was over four minutes long — all over different days of the week and times of the day.
Internal service reports also show monthly average longest wait times ranged from nearly four minutes to nearly five minutes for June through November of last year. The longest wait time recorded in those months was on Sunday, Oct. 3, at 7 p.m., when someone waited for 10 minutes and two seconds for one of nine operators to pick up the call.
From June through November, those same reports show the average wait time each month never exceeded 33 seconds, for a combined average wait of 25 seconds.
From June 1 until Dec. 1, the Toronto service's emergency-call answering times fell below the National Emergency Number Association (NENA) standard of answering 90 per cent of all 911 calls within 15 seconds every day except one.
While the NENA standard is voluntary, like most 911 communication centres, Toronto's service strives to meet it, said Murray-Bates.
"What doesn't come with the NENA standard is any sort of parameters on how you will meet the NENA standard," she said. "Our average wait times last year were between eight seconds and 33 seconds. So, on average, we're doing pretty good."
When it comes to longest wait times — like that 10-minute wait in October — Murray-Bates said the metric reflects "a moment in time" and changes quickly.
"One impactful accident on the Gardiner Expressway can generate 50 calls," she said. "That creates a spike in our call volume, which then creates some impact to our wait times."
'We need to thrive, not just survive'
But emails to staff from Murray-Bates about improving service and staffing reveal some concerns.
In an October 2021 email, she acknowledges "that staffing continues to be a struggle," but says she is optimistic the situation will improve soon when new recruits finish their training.
"My goal is that we get to a place where every phone position is filled and we are reaching our service levels, that members are not frazzled, anxious and angry," Murray-Bates wrote. "We need to thrive, not just survive."
The email also says the Toronto police chief's office, the police board chair, and the police union have all given "incredible attention" to the staffing issues and Murray-Bates is confident concerns will be addressed.
In an interview, Murray-Bates confirmed her team had received support from those three offices, but didn't specify what kind of support. Instead, she said they have to maximize staffing within the rules and budget approved for the communication centre.
Within a month of that first email, the tone of Murray-Bates' subsequent emails shifted.
"Despite our best efforts, we keep losing members to long-term absence, which is having a serious impact on not only members who remain, but to the citizens we serve," she wrote in November.
"Our numbers are not good."
The email then details management's efforts to counteract the shortages, such as by combining some police dispatch positions to free up staff to answer 911 calls instead.
Murray-Bates also said in the email that they anticipated losing more staff to the city's mandated vaccine policy on Dec. 1, and they "already lost a few members from the most recent call-taking class."
"To be brutally honest with you, we don't know what more we can do to help this issue," she wrote. "We know members are tired, stressed and burnt out. Our job is so unique that no one else can do what we do."
'We're doing the right things'
Responding to that email, Murray-Bates told CBC News "you have to put it into the context of we're doing the right things here."
"We are focusing on our testing and recruitment and our hiring process," she said. "We're trying to make it more robust so that we get the best candidate in the door, which is going to lend to our success rate in retaining those people, which is going to lend to our staffing."
Right now, there are 35 recruits in training and the communication centre has a job posting up to fill 24 more vacancies, said Murray-Bates. She said she hopes candidates for those spots will begin training in May.
The maximum number of 911 operators budgeted for is 301.
Roughly 60 per cent of recruits successfully make it through training and the majority of staff they lose are newly trained, said Murray-Bates.
"We provide the best training we can, we provide the best support we can to our communication officers," she said.
"We realize they're tired, but that comes with being a 911 operator, right? Staffing is not the only stressor in a 911 centre — it's inherent in the job."
Temporary staffing solution 'overwhelming'
But the 911 operator told CBC News that management's temporary solution to reduce wait times caused by staffing issues — giving them more work when they're assigned to dispatching — has just added to that stress.
All 911 operators are trained as both call-takers, who answer and process emergency and non-emergency calls, and as dispatchers, who co-ordinate police response to those calls.
Operators can be assigned to only take calls, only dispatch, or to spend half of their shift doing each.
To alleviate emergency call wait times when staff is low or call volumes are up, the service is now combining some police dispatch jobs. This means that where two divisions would normally each have their own dispatcher, they're now sharing a single dispatcher and the other is assigned to take emergency calls instead.
"It's absolutely overwhelming us," the operator said. "You're managing every emergency that the police would be involved in for that entire area, for six to 12 hours."
Having one dispatcher handle two divisions is not new, said Murray-Bates, and some divisions were already combined to a single dispatcher. But if the radio traffic becomes unmanageable, a dispatcher can notify a supervisor and they'll split up the divisions again, she said.
"It's worked very well, actually, for us to allow more people to be on the phones."
No provincial oversight for 911 services in Ontario
In Ontario, municipalities are responsible for 911 emergency services and there is no provincial oversight or legislation that sets standards for call-answering.
NENA's Canadian director, Holly Barkwell, says her organization is pushing for 911 standards in provinces and territories that don't have them — and has also been advocating for national 911 standards for decades.
"Tying funding to standards and service levels absolutely works," she said. "We don't have any way to compare service levels across the country."
Both provinces' minimum standards are higher than the NENA standard, which Toronto's 911 communication centre is trying — but mostly failing — to meet.
"We've gotten lucky," said the 911 operator. "Someone has to answer that phone call, and yes, it should be within just a few seconds — because those seconds mean everything."
Toronto's auditor general is currently working on an audit of the 911 communication centre's operations to assess whether it provides access to emergency services in a timely manner. The audit is expected to be completed this year.
In Ontario, municipalities are responsible for 911 emergency services and there is no provincial oversight or legislation that sets standards for call-answering.
NENA's Canadian director, Holly Barkwell, says her organization is pushing for 911 standards in provinces and territories that don't have them — and has also been advocating for national 911 standards for decades.
"Tying funding to standards and service levels absolutely works," she said. "We don't have any way to compare service levels across the country."
- 'It's never been this bad': Security guard expects to be put on hold every time he calls 911
- 'Seconds count': Woman sounds alarm after she says 911 call put on hold for 5 minutes
Both provinces' minimum standards are higher than the NENA standard, which Toronto's 911 communication centre is trying — but mostly failing — to meet.
"We've gotten lucky," said the 911 operator. "Someone has to answer that phone call, and yes, it should be within just a few seconds — because those seconds mean everything."
Toronto's auditor general is currently working on an audit of the 911 communication centre's operations to assess whether it provides access to emergency services in a timely manner. The audit is expected to be completed this year.
I doubt something else .I think they are testing the new noc based stuff ,his/her noc might not be eligible. Who knows?People are dumb. They don’t really know the diff between applying to PR and entering the Pool.
It is just a guess
Thats what my friend did. He had a issue with his back and doctors in the US took forever to diagnose and infact they did not find the real issue. He went to India for vacation and approached a doctor for this issue. He got treated in a week. He is doing great now. He would have been disabled if had not got treated in time. One issue with US doctors is many don’t diagnose immediately. They take forever.
May be but she thinks she applied to PR and people were shocked to see an FSW getting rejected. In real, she just entered the pool.
What did you expect from that group lolPeople are dumb. They don’t really know the diff between applying to PR and entering the Pool.
Applied on April 2021 , dayum , January 2022 it is nowPeople are dumb. They don’t really know the diff between applying to PR and entering the Pool.
and hilarious it is when such queries reach shitbeir
