Omaha-area hospitals will postpone and reschedule most nonessential surgeries and medical procedures for the next 90 days in an effort to conserve critical medical supplies, prevent staff burnout and free up beds as more coronavirus cases emerge in Nebraska.
The decision, announced Wednesday night in a joint statement by eight hospital systems and surgical centers, comes as hospitals gear up for a possible surge of patients with COVID-19, the illness caused by the novel coronavirus.
Starting as soon as Friday, doctors will consult with their patients and ultimately decide if a procedure can be safely delayed “without risk to life or limb,” said Dr. William Lydiatt, the vice president of medical affairs and chief medical officer for Methodist and Methodist Women’s Hospitals.
Ninety days is what hospitals are currently planning for, but that timeframe could be longer or shorter depending on the severity of the coronavirus spread. OrthoNebraska, for example, is unlikely to care for coronavirus patients, and is postponing surgeries for smaller increments of time that can be adjusted, board chairman Dr. Charles Burt said.
The health systems enacting this are:
- Boys Town
- CHI Health hospitals in Omaha and Council Bluffs
- Children’s Hospital & Medical Center
- Methodist Health System
- Midwest Surgical Hospital
- Nebraska Medicine
- VA Medical Center
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Surgeries for high-risk cancers; critical heart issues; or trauma, such as car accidents or gunshot wounds, will continue. But procedures such as routine colonoscopies, cataract surgery and knee replacement surgery may be rescheduled.
“Anything that we feel can safely be delayed will be delayed, and then rescheduled at a later time when the (coronavirus) curve has crested and is coming down, hopefully way down,” Lydiatt said.
For the last week or so, Methodist patients were already calling to cancel surgeries due to the coronavirus scare, he said.
Dr. Gary Anthone, the chief medical officer and director of public health for the Nebraska Department of Health and Human Services, said he and Nebraska Gov. Pete Ricketts support the decision.
“This action helps minimize risk for health care providers and their patients and helps preserve needed personal protective equipment for COVID-19 response,” Anthone said in a press release.
The move is preemptive, intended to allow hospitals to turn their attention to treating COVID-19 patients. Earlier this week, the Nebraska Dental Association recommended that its dentists postpone any nonemergency dental care until April 1.
“Right now, each of the hospitals in the area have some capacity for patients,” Lydiatt said. “But we are anticipating that there’s going to be a significant surge, just like there has been in many other cities in the United States, particularly on the two coasts.”
One of the top priorities is to preserve the limited supply of what’s called personal protective equipment, or PPE. That includes respirator masks, surgical masks, gloves and gowns that protect doctors, nurses and other health care workers from infection.
The U.S. Centers for Disease Control and Prevention has warned of shortages of protective equipment nationwide, and recommended hospitals postpone elective procedures and nonurgent outpatient visits once the coronavirus begins to spread in a community.
The American College of Surgeons released guidance Tuesday recommending doctors make decisions on a case-by-case basis. Delaying surgery may worsen outcomes for some patients.
“Given the uncertainty regarding the impact of COVID-19 over the next many months, delaying some cases risks having them reappear as more severe emergencies at a time when they will be less easily handled,” the organization said.
There are other considerations to putting off some procedures, Lydiatt said, including protecting and pacing doctors and nurses who may soon find themselves on the front lines of treating COVID-19 patients, or even becoming sick themselves.
“Bringing patients into the hospital during a significant pandemic is also problematic because they run a potentially high risk of getting the infection … or transmitting it to others,” he said.
The hope is that the drastic measures taken by state and local officials in the last week — limiting crowds and closing schools — will help slow the spread of the coronavirus and reduce a surge of patients needing hospitalization.
The hospitals and surgical centers that issued the announcement Wednesday are presenting a united front on this, Lydiatt said, even though they will take a financial hit from delaying procedures.
“The area health systems are coordinating our response and role in fighting this virus,” said Dr. Nicholas Bruggeman, the chief medical officer for OrthoNebraska, in a statement. “As this rapidly evolves, we will continue to monitor the situation and respond in the best interest of our community, patients and staff members.”