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What should hospitals and healthcare systems do during the second wave of COVID-19 with regard to elective procedures? This article outlines the choices physician leaders currently have and walks the reader through difficult decision-making with a helpful context. The authors review three options: continue all surgeries, defer all surgeries, and continue surgeries as scheduled, but do not schedule more.
Balancing the needs of patients and the demands required to maintain financial viability of institutions is a huge challenge. Ultimately, each healthcare system needs to remain vigilant to the changing needs of their community and ICU.
– Kolene E. Bailey, MD
This abstract is available on the publisher's site.
You are a physician leader on a senior committee that is responsible for your hospital’s Covid-19 response. For the past week, the hospital census has been over 90% of capacity, and almost all usual intensive care unit (ICU) beds have been occupied, more than half with patients who have Covid-19. You are using 10% of the ICU surge capacity created by your hospital to accommodate patients with Covid-19. The hospital has limited personal protective equipment (PPE) available, although supplies are adequate for current use. The 7-day average for daily new cases of Covid-19 in your region is 30 cases per 100,000 people; the rate is rising but has fluctuated for the past week. Hospitals in neighboring regions have similar capacities and limited availability to accept transfers of patients with Covid-19 from other hospitals. The local government has mandated that people wear face masks in public, but there is no stay-at-home order.