U.S. hospitals, patients cancel elective surgery as coronavirus spreads

FILE PHOTO: An auxiliary tent stands outside the entrance to the emergency department at EvergreenHealth Medical Center, where an emergency department doctor is reportedly in critical condition with coronavirus (COVID-19) according to local media, in Kirkl

By Deena Beasley

(Reuters) - U.S. hospitals, anticipating a need for beds as more people are diagnosed with coronavirus, are postponing elective surgeries, while some patients, leery of going to a hospital, are canceling appointments themselves. Several hospitals in the hard-hit Seattle area, including EvergreenHealth, have suspended elective procedures like knee replacements for the next 30 days. Emergency surgeries like appendectomies or a broken wrist that needs surgery will continue.

New York Mayor Bill de Blasio on Sunday said he would sign an executive order to postpone all elective surgeries at New York City hospitals so doctors and nurses can focus on treating patients infected with the virus.

The goal is to free up hospital beds so the healthcare system does not become overwhelmed during a potential influx of coronavirus cases, while at the same time limiting exposure of healthy individuals to the infectious disease.

The American Hospital Association, however, warned of a need to balance the requirements of caring for coronavirus patients while providing vital services to others who need care.

"Many patients, such as those with cancer or a need for cardiac surgery, will not be able to postpone medical interventions," the trade group said on Sunday in a letter to U.S. Surgeon General Jerome Adams.

The U.S. Centers for Disease Control and Prevention has recommended that hospital elective procedures, surgeries and non-urgent outpatient visits be postponed once the virus has started to spread through a community.

Shares of hospital operators Tenet Healthcare Corp and HCA Healthcare both fell 19 percent on Monday, Tenet closing at $14.98 and HCA ending at $84.45.

The American College of Surgeons, an influential medical association, recommended on Friday that hospitals, health systems and surgeons "minimize, postpone, or cancel elective operations" until it becomes clear whether the health care infrastructure can support the expected spike in critical patient care needs.

The latest CDC statistics show 3,487 coronavirus cases, including 68 deaths. So far, the Seattle area and New York City have seen the most cases.

New York-Presbyterian Hospital on Monday said it was postponing all elective surgeries and procedures until further notice. The system of 10 New York area hospitals said urgent and emergency surgeries would continue.

Tenet, which operates 65 surgical hospitals in 14 states, said it was closely monitoring CDC guidance. Tenet has not given a blanket directive to postpone elective surgeries, but said its physicians are evaluating all non-urgent elective procedures on a case-by-case basis.

"We are continuing to provide emergent and urgent life-saving procedures and diagnostics as scheduled," Tenet said in an emailed statement. "Our ambulatory surgery centers will continue to support hospitals in managing this crisis."

Some Americans are making the call to reschedule a procedure or operation on their own, to protect themselves against being exposed to the virus in a healthcare facility.

Los Angeles-area resident Richard Aidem, 64, said he canceled a hospital colonoscopy scheduled for later this month due to concerns about the virus.

"I had a heart transplant. That means I have a weak immune system," he said. "It would be worse for me than the average person. My anti-rejection meds would interfere with my body fighting off the disease."

Aidem has another surgery scheduled in mid-April to repair a rotator cuff, but that is set for an outpatient surgery center. "It's not the hospital, so I don't think people who are sick are going to be going there," he said. "I don't plan on canceling that unless they do."

The Ambulatory Surgery Center Association, which represents outpatient surgery centers, on Monday said its members can continue to provide safe surgical care for patients whose conditions cannot wait until hospitals return to normal operations. These include procedures such as orthopedic or spinal surgery that, if delayed, would result in continued pain and debility for the patient, said spokeswoman Kay Tucker.

Experts estimate that about 80 percent of people infected with the virus, SARS-CoV-2, will have only mild symptoms. The CDC recommends that these patients remain at home, isolating themselves as much as possible.

About half of the remaining 20 percent of infected individuals are likely to develop serious symptoms from COVID-19, the respiratory disease caused by the highly contagious virus, with the most severe cases requiring hospitalization. The elderly and people with underlying health conditions, such as diabetes, heart disease and cancer, are most at risk.

(Reporting By Deena Beasley; Editing by Dan Grebler)