Year Ahead

The Year Ahead: Health in 2023

The future of ER’s, the next viral pathogen and COVID long-haulers shape health-care in the year to come

This story is part of our annual “Year Ahead” guide. Read the rest of our predictions for 2023 here.

In 2023, Canada faces a huge shortage of health-care workers, plus the lingering effects of long-haul COVID. Get ready for an explosion of innovations in medical care to fill the gaps in the system—AI-run ERs and holographic checkups among them. Here’s a look at the year ahead in health-care: 

1. Checkups with a hologram will become the norm

Imagine beaming in your family doctor, Star Trek–style, for a routine checkup. Last year, a research team from Western University did just that, transmitting a hologram of a U.S.-based doctor into a boardroom on the school’s campus in London, Ontario. The technology relies on specialized 3D cameras and HoloLens goggles, which are similar to virtual reality headsets. Compared to a Zoom call, the two-way holographic technology allows a doctor to better mimic an in-person appointment with a patient, read facial and body language and provide more accurate diagnoses. Even NASA tried out the tech, sending a doctor—again, as a hologram—to visit astronauts aboard the International Space Station. Researchers say the tool could be especially beneficial for people in remote communities who lack easy access to medical care. 

2. Hospitals will run on AI

In the coming year, hospitals will rely on AI to improve patient outcomes and reduce wait times. More than 300 Canadian startups are currently working on AI-centric health innovations, including apps that diagnose cardiac disease, analyze data from wearable devices and monitor chronic wounds. One such company, Unity Health Toronto, recently completed a trial of its AI program ChartWatch, which functions as an early warning system. It can accurately predict, up to 48 hours in advance, whether a patient will need to visit the intensive care unit. The company has also developed a tool that forecasts when a hospital’s ER will be busiest, examining factors like impending heat waves and even crowd injuries at major events (like a Blue Jays game). Then it recommends how many nurses and doctors should be scheduled to stickhandle care. With hospitals struggling under ever-growing demands, Unity Health is working on a plan to roll out its AI tools across the country. 

3. To fight nurse burnout, employers will provide more perks

A recent survey by the Registered Nurses Association of Ontario found that more than 75 per cent of nurses are burnt out after two years of the pandemic, and nearly a third of respondents said they want to leave the profession entirely in the next year. We’re facing a mass exodus unless hospitals and provinces give nurses reasons to stay—like better mental-health resources and more opportunities for student-loan forgiveness. To increase the number of nurses in B.C, for example, the government recently announced a $3-million investment to fund bursaries that cover (nearly) the full tuition cost for health aides in one-year nursing programs.

4. Futuristic implants will save a whole lot of lives 

Among the latest shiny advancements in medtech are 3D-printed implants. The technology takes a three-dimensional scan of a body part and reproduces it using materials like titanium and silicone. Health Canada recently approved the first Canadian-made 3D-printed implant: a mandibular (or lower-jaw) plate to be used for facial reconstruction surgery, produced by the Quebec-based 3D Anatomical Construction Laboratory. The company says 3D printing allows for more customizable implants, which could improve surgery success rates and reduce wait times, and one Quebec hospital is set to launch a clinical trial for the aforementioned jaw implant. Other prospective printable body parts include heart valves, knee and hip joints and retinas made of whisper-thin carbon.

5. COVID long-haulers will become a post-pandemic priority

The symptoms of long COVID can be harrowing: can’t-get-out-of-bed fatigue, severe heart palpitations and a disorienting loss of taste and smell, to name a few. The condition is poorly understood and difficult to diagnose; experts don’t even know how many Canadians have it. All that will change in 2023, as doctors, including Ontario’s chief medical officer, push for a long-COVID strategy that would improve testing and treatment for the emerging illness. Eighteen long-COVID clinics in five provinces have already opened to provide care for affected patients. And scientists at Ontario’s Lawson Health Research Institute have identified unique biomarkers that they say could diagnose long COVID using a simple blood test—and possibly lead to new treatments.

6. The next viral pathogen will loom on the horizon

Last year, the monkeypox virus surprised experts by spreading to more than 100 countries, including Canada. It could be a harbinger of viruses to come. Between 2012 and 2022, Africa experienced a 63 per cent increase in outbreaks of pathogens that transfer from animals to people, compared with outbreak rates from 2001 to 2011. Scientists are closely monitoring several other viruses that could pose a threat. That includes SARS—yes, it’s still around, and no, we don’t yet have a vaccine for it—and the deadly, Ebola-adjacent Marburg virus, which spreads through contact with bodily fluids and kills up to 88 per cent of the people it infects, depending on the strain.

7. Customized care will reduce cancer deaths

Cancer treatments have radically improved in the last few years. Drugs and immunotherapy, for example, can now be customized based on a patient’s genes and the genetic makeup of their cancer. These personalized treatments work by switching off genes that lead to the growth of a particular cancer—often with less harmful side effects and better results than traditional approaches like radiation or chemotherapy. Yet many Canadians are unable to access these breakthrough treatments, largely as a result of Health Canada’s lengthy price negotiations with pharmaceutical companies, which contribute to longer delays than in most other OECD countries. Patient advocacy groups are applying pressure to speed things along, because the stakes are high: 226,445 years in patient lives could have been saved by these treatments in the past decade alone.

8. Family doctors will get paid their due

The dearth of doctors is, of course, a country-wide phenomenon, but some provinces are especially hard-hit. Nearly one in four British Columbians doesn’t have a family doctor and can’t get one. GPs are opting to work for higher pay in hospitals or drop-in clinics rather than setting up their own practices. The result is an ever-widening health-care gap; family physicians can often identify health issues early, before they become hard (or impossible) to treat. Groups like the College of Family Physicians of Canada say the current fee-for-service billing model—which rewards faster patient turnover—should be replaced with a proper salary for GPs, with bonuses for extra hours worked. Provinces have also begun offering incentives: B.C. is providing a $25,000 signing bonus for new family doctors, as well as student-debt forgiveness up to $130,000. More controversially, a clinic in Victoria now charges patients a $110 monthly fee for access to a family doctor. 

9. Without enough nurses, ERs will keep closing

Staffing shortages are the biggest challenge facing hospitals in 2023. Temporary emergency-room closures have become all too common, especially in smaller communities, forcing patients to travel farther and face longer wait times. An ER in Clearwater, B.C., for example, was shut down more than 30 times last year, even over several long weekends when demand is typically highest. Experts say there’s no quick fix. The Ontario Council of Hospital Unions estimates that 46,000 more hospital staff are needed in that province alone, while the Canadian Medical Association has called for a nationwide human-resources plan for health care. Facing growing public pressure, the Ontario government has announced plans to fund more surgeries in private clinics and cover registration fees for nurses trained abroad.

10. mRNA vaccines could cure cancer and AIDS

Researchers are optimistic that the mRNA vaccines developed to fight the coronavirus could also be used to combat a slew of other diseases. Before they emerged as a lifeline during the pandemic, mRNA vaccines were studied for nearly 30 years as a way to encourage the body to make proteins that our immune systems can use to fight off infections. The accelerated testing and approval of the mRNA vaccines has opened the door for other possible uses, including bolstering the influenza vaccine, which is often less than 50 per cent effective. The mRNA-based vaccines have also shown promise as a cancer treatment that helps produce antigens that attack tumour cells. Likewise, they could act as the basis for an HIV vaccine: Moderna recently partnered with the International AIDS Vaccine Initiative on a Phase 1 trial to test a shot’s response in healthy humans; if all goes well, an approved HIV vaccine is only a few years off.

This story is part of our annual “Year Ahead” guide. Read the rest of our predictions for 2023 here.

This article appears in print in the January 2023 issue of Maclean’s magazine. Buy the issue for $9.99 or better yet, subscribe to the monthly print magazine for just $39.99.

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