SUDBURY -- It's going to be slow and steady as Health Sciences North looks to resume normal activity following the first wave of COVID-19 cases.

"We don't have much wiggle room so that's why we're being very prudent in our recovery approach," said CEO Dominic Giroux. "That's why we cannot afford, as a hospital, next week to reintroduce all surgeries and procedures, including the ones that have longer, average length of wait stays."

Giroux said Northern Ontario has been told to keep about 10 per cent of its capacity open in the event of a second wave of COVID cases.

The hospital has been dealing with capacity issues for years. Giroux has repeatedly said the hospital was built too small to handle demands that are placed on it.

HSN is currently at 91 per cent capacity; before the pandemic it was at 112 per cent. It had dropped into the 60s after they cancelled all elective and minor procedures.

"Since mid-March we have performed about 1,000 urgent surgeries and procedures, but unfortunately we had to reschedule about 2,000 surgeries, 1,400 endoscopies and 1,000 minor procedures that were elective and non-urgent so these 4,400 appointments will have to be rescheduled."

The hospital has rolled out its ramp-up plans, which it hopes to accomplish in four steps. Next week, they will be focusing on endoscopies, minor procedures and surgeries that require less than two days of hospitalization.

"Phase 2, which we expect may occur in July, we will be seeing the same volume of cases, but we will be doing surgeries and procedures that typically require (more than) two days of hospitalization," Giroux said. "Phase 3 later on in the fall will bring us to 75 per cent normal capacity and phase 4 would be 100 per cent."

He said it will take them many months to get back to normal, but added there isn't as big a backlog as some might expect, since doctors were also doing less referrals these last few months.

Alternative level of care patients – the term for people who don't need to be in hospital, but can't be home on their own – have been moved to the Clarion Hotel and will remain there until at least June.

A request has been made to the province to extend those accommodations, Giroux said, for at least a few more months.

Hospital staff will also continue some enhanced protocols put in place at the start of the pandemic.

"Each department of HSN has developed a recovery plan and that includes ramp down provisions or triggers should we see a surge of COVID-19 patients," he said.

"I have to tell you, I've been blown away by the planning that has been done over the last month for the recovery. Each department is mindful of sustaining some of the gains that have been made out of necessity from the pandemic."

For example, he says mental health and addictions staff have done more visits through virtual care than they typically do in a given year.

"There's also been many improvements in the cancer centre, moving to digitally able care, and those gains will be sustained in the future," he said.

Even when back up to speed, Giroux said operations will be far from what they were pre-pandemic.

"There are new infection prevention and control requirements that are in place, we need to respect physical distancing requirements, the efficiencies in the operating rooms will not be the same," he said.

"We're kind of assuming that we're probably losing about 20 per cent of efficiency anytime you do activities in the OR, so this we'll need to adapt ourselves to and that's why we're adapting a phased-in approach."

Nickel Belt MPP France Gelinas said Sudbury's already stressed hospital is going to need more support when they ramp up activity again.

"When the CEO of Health Sciences North says it's going to be a marathon, not a sprint, what he's really saying is he's asking people to be patient," Gelinas said. "But when you are in pain, when you have been waiting for a long time, let me tell you, you pick up the phone and call your MPP and say this is not acceptable."

Gelinas, the NDP's health critic, said the hospital is already at 91 per cent capacity and there are no elective surgeries yet.

"All of those people that have been waiting months and months, they're still in pain, they still need that surgery," she said. "Same thing with the hips, same thing with the cataracts, same thing with thousands of people that are now on wait lists that have gone from months to pretty soon years. Those are northerners that deserve equity of access."

CTV Northern Ontario has reached out to the Ministry of Health and Minister of Health Christine Elliott to determine what supports will be made available to the region, if any, to get healthcare in the region back on track.