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Med center hospitals suspending elective surgeries

Houston Chronicle logo Houston Chronicle 3/20/2020 By Todd Ackerman, Staff writer

Hospitals in the Texas Medical Center are suspending elective surgeries, part of its planning for a potential surge of patients with the new coronavirus.

Memorial Hermann, Houston Methodist, Baylor St. Luke's, Harris Health and Texas Children's informed their staff and patients Wednesday night of the new policy, which should be fully phased in by Monday and stay in effect until at least mid-April. It will impact their Medical Center and satellite campuses.

“We realize that this change will cause ripple effects across people’s schedules and lives as well as across our own operations,” said a letter to Memorial Hermann Health System doctors and staff jointly signed by Dr. David Callender, president, and Dr. Jamie McCarthy, chief physician executive. “Our goal (is) to take the most proactive and preventative measures possible to ensure we can protect the health of everyone.”

Callender described the decision to suspend non-urgent surgeries as a consensus among not just medical center hospitals but the nation’s hospitals. He and others cited guidance advocating suspending such procedures by both the U.S. Surgeon General and the American College of Surgeons.

The move represents a way to empty beds for a possible influx of patients with COVID-19, the illness caused by the coronavirus, which has infected more than 10,000 people in the U.S. The Houston area would have an insufficient number of beds if large numbers here require hospitalization, according to area-specific modeling released by Harvard University researchers this week.

Hospital officials define non-urgent elective procedures as those in which there is no anticipated short-term or long-term negative impact due to a delay. Examples include non-emergency appendectomies and surgeries to reduce weight, replace joints and repair muscle tears.

Examples of urgent elective surgeries include lumpectomies and mastectomies, mitral valve repairs, C-sections and those for nerve injuries.

Non-urgent elective surgeries are routinely performed at hospitals and produce significant profits. Houston Methodist estimated roughly 75 such surgeries are done every day at its flagship hospital in the medical center. It downplayed any loss of income because the surgeries are just being postponed, not canceled.

Methodist’s suspension goes into effect Friday. But even before the suspension, its medical center hospital did 50 percent fewer surgeries Thursday than usual, said a spokeswoman, because doctors and patients were already postponing procedures because of COVID-19.

Methodist on Thursday posted an FAQ on its website for patients with answers to such questions as what they should do now and why the notice was so short.

U.S. Surgeon General Jerome Adams made the case for suspending elective surgeries in a tweet last Saturday that screamed “PLEASE CONSIDER STOPPING ELECTIVE PROCEDURES.” He wrote that each one “1) brings possible #coronavirus to your facilities; 2) pulls from personal protective equipment stores; and 3) taxes personnel who may be needed for #Covid-19 response.”

Nationally, some hospitals bristled at what they called a blanket request that “didn’t provide clear agreement on how to classify various levels of care.” But hospitals in the Texas Medical Center seemed confident Thursday their doctors know which elective surgeries to postpone and which to go ahead with.

Hospitals suspending the surgeries aren’t confined to the elite Houston medical campus. The University of Texas Medical Branch at Galveston informed employees Tuesday that it is in the process of contacting patients to cancel elective procedures until after April 5 with exceptions for some cases made by operating room leadership in consultation with clinical chairs.

Other hospitals are moving in the same direction. HCA Houston Healthcare said it is working with doctors to prioritize surgeries on their urgency. And MD Anderson Cancer Center said it is reviewing all scheduled appointments to identify those that can be rescheduled without potentially affecting clinical outcomes for patients.

Despite the targeting of dates in mid-April to resume elective procedures, hospital officials acknowledged that the duration of the suspension depends on when community spread stops. They also defended taking the action now, even though hospitals haven’t been hit yet with masses of patients.

“Given the marked rise of cases in the last several days, we think the move is warranted now,” said Callender. “You want to reduce the extent of the spread, slow it down. If you wait until you have a surge, it’s too late to try to flatten the curve.”

todd.ackerman@chron.com

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