The Toronto Blue Jays find themselves in a tough spot without Alek Manoah.

Losing Manoah — scheduled to visit with an elbow specialist Thursday to determine the severity of the UCL sprain in his right elbow — for any length of time will be significant, as the Blue Jays don’t possess a viable sixth starter to replace him with. Any pitching depth they had coming into the year has dissipated due to injuries and struggling performances.

But the loss of Manoah goes much deeper than that. This latest setback is a devasting blow that has arrived just as he was starting to resemble the pitcher who was an All-Star in 2022 and finished as an AL Cy Young finalist. He had begun to climb back up the mountain after falling straight to the bottom amidst last year’s never-ending woes. Now, he has to start over again.

It is a heartbreaking development for the 26-year-old hurler. While it remains unclear how much time he’ll miss, Toronto’s depleted starting rotation is just one injury away from reaching a DEFCON 5 crisis. Understandably, the health of this pitching staff has heightened dramatically in recent days, especially for a club whose dwindling playoff hopes rely heavily on its run prevention.

At the very least, the Blue Jays will be without Manoah for a few weeks, meaning someone else will have to assume his turn in the rotation versus the Baltimore Orioles on Tuesday. So, who might the organization turn to for both the short and long term?

We already know the answer to one of those questions, as the Blue Jays announced Trevor Richards will start Tuesday against the O’s, jumping back into the opener role he occupied last year following Manoah’s first of two minor-league demotions. And that probably means Bowden Francis — activated from the 15-day IL prior to first pitch — will provide length out of the bullpen behind him.

The Blue Jays piggybacked Francis with Richards on three occasions in 2023, and though it placed immense pressure on the rest of the starting staff, that strategy kept the team afloat. But it wasn’t a long-term solution, nor should it be here, considering it’ll require operating with a seven-man bullpen.

It could, however, prove beneficial in the short term for a team without a fifth starter currently in a stretch of 19 games in 20 days.

Francis was stretched out to 60 pitches over 3.2 innings in his final rehab outing with triple-A Buffalo last week — a relief appearance where he struck out five while allowing an unearned run on one hit and a walk. As such, a combination of him and Richards, who’s also capable of tossing multiple innings, should be able to go, at minimum, twice through the order like they did in ’23.

If things run smoothly, perhaps Francis could be stretched out as a starting pitcher again. But much of that may ultimately depend on the length of Manoah’s absence.

Assuming Rodríguez avoids any setbacks, chances are he’ll be back with the Blue Jays later this month, possibly as soon as after Wednesday’s rehab outing with the Bisons. That should help as the team looks to replace the innings lost from Manoah.

The only issue is he isn’t anywhere close to being stretched out as a starting pitcher. Toronto is gradually building up his workload, progressing to two innings in his third rehab outing last Friday. But since he’ll be used in relief Wednesday rather than starting, his innings total likely won’t increase by much, if at all.

Rodríguez impressed as a starter prior to hitting the IL, pitching to a 4.11 ERA with 16 strikeouts over four starts. He looked the part, too, using his intense me-against-the-world mindset to fuel himself on the mound. As much potential as he features, though, the Blue Jays have to guard against putting too much on his plate after his 2023 season ended following last year’s WBC.

With that in mind, it’s probably unrealistic for the 27-year-old to assume Manoah’s turn in the rotation, at least immediately. If anything, there’s a much higher chance the Cuban right-hander moves to the bullpen upon returning to the majors, especially with Jordan Romano injured and Erik Swanson working through his command woes at triple-A.

But the great thing about Rodríguez is he’s versatile, so don’t be surprised if he factors into the Francis-Richards team-up at some point.

With multiple arms on the mend, this would’ve been the perfect opportunity for Ricky Tiedemann — Toronto’s top prospect per MLB Pipeline — to earn his shot at the big-league level. But he, too, is unavailable while nursing an elbow injury. And there aren’t many alternatives, at least appealing ones, to pivot to within the organization.

Mitch White and Wes Parsons are long gone after they pitched their way off the roster. While Chad Dallas was among the organization’s top success stories last season, he’s faltered at triple-A thus far and is currently on the IL, eliminating another potential call-up.

The reality is nobody from the Bisons’ rotation, outside of Rodríguez, can be trusted in meaningful situations at the big-league level. Look at Buffalo’s primary four starters right now; there isn’t a flattering statistic among them.

Beyond tripe-A, the list of potential call-ups becomes even thinner, although it’s worth wondering if we could see Adam Macko — who’s on Toronto’s 40-man roster — up in the majors in the second half.

The 23-year-old lefty, acquired along with Swanson in the Teoscar Hernández deal a few years ago, owns a 3.86 ERA and 3.30 FIP with 63 strikeouts across 49 innings in 10 starts this season. It’s his first season at double-A, but given how effective he’s been and the lack of talent at the level above, it wouldn’t be surprising if his development moved to Buffalo soon.

This next part likely won’t be easy. At this point of the season, major league-calibre starters aren’t typically available unless a team is willing to overpay for one, which, given their current position, the Blue Jays shouldn’t fall under that umbrella.

The best Toronto’s front office can do is scoop up a serviceable arm off waivers, somebody like White, who they could’ve reacquired but didn’t after he was recently designated for assignment by the Milwaukee Brewers. However, that’s not the most advisable path for a club fighting to save its season while facing arguably its toughest test.

In the short term, the Blue Jays are probably better off trying to piece things together with their current in-house options. If their season becomes unsalvageable, perhaps selling at the July 30 trade deadline will present an opportunity to build a more sustainable wave of pitching depth for a future run in 2025.