Another round of elective surgery suspensions: 5 updates for ASCs

Facing climbing rates of COVID-19, some states have reinstated bans on elective procedures while healthcare operators in other areas have voluntarily halted elective cases.

Five updates on new restrictions:

1. Texas rapidly expands restrictions. On June 25, Texas Gov. Greg Abbott issued an executive order suspending elective procedures in four counties: Bexar, Dallas, Harris and Travis. All hospitals in those areas were directed to postpone any nonemergent procedures to preserve bed capacity for climbing numbers of COVID-19 patients. The suspension was expanded June 30 to four more counties: Cameron, Hidalgo, Nueces and Webb.

After COVID-19-related hospitalizations hit a record high of 9,610 on July 8, Mr. Abbott quickly escalated the ban. Hospitals in more than 100 counties were ordered to postpone nonessential procedures at 11:59 p.m. July 10. Hospitals were still permitted to perform procedures that won't deplete bed capacity, and Irving, Texas-based Christus Health said it would take advantage of the exception. It was unclear whether surgery centers were allowed to proceed with elective cases.

Mr. Abbott first halted elective procedures March 13, but loosened the initial round of restrictions April 22.

2. Mississippi follows suit. The Mississippi Department of Health banned all non-urgent and elective procedures in hospitals and clinics across the state, effective July 12 through July 20.  Procedures requiring overnight hospitalization and elective medical admissions that could be delayed were all banned, unless the patient had "an extensive and compelling reason." Due to a COVID-19 surge, the state's five largest hospitals have run out of intensive care unit space.

3. Florida systems take precautions. Some organizations have voluntarily suspended certain operations to preserve bed capacity for climbing numbers of patients with COVID-19. After Florida reported record daily increases in new cases, Nashville, Tenn.-based HCA Healthcare announced the week of June 29 that it would pause inpatient procedures at Largo Medical Center, Northside Hospital in St. Petersburg, Palms of Pasadena Hospital in St. Petersburg and St. Petersburg General Hospital. The hospitals' ASCs and outpatient departments would remain open.

Beginning July 10, Clearwater-based BayCare Health System delayed elective procedures at St. Anthony's Hospital in St. Petersburg, Morton Plant in Clearwater, and Mease Countryside hospitals in Clearwater and Dunedin. BayCare's ASCs weren't covered by the restrictions.

At the beginning of July, Miami-based Jackson Health System, Hollywood, Fla.-based Memorial Healthcare System, and Coral Gables-based Baptist Health South Florida also limited certain inpatient surgeries, according to the Washington Examiner. James A. Haley Veterans' Hospital in Tampa followed suit within a week.

4. Arizona's hospitals hunker down. After the state of Arizona activated "crisis of care" standards June 29, Phoenix-based Valleywise Health chose to halt all nonessential elective surgeries beginning July 1, the Washington Examiner reported. Other hospitals prepared for surges by making no new additions to the surgical schedule, according to Ross Goldberg, MD, president of the Arizona Medical Association.

As of July 8, 90 percent of Arizona's adult ICU beds were in use. The state recorded 3,617 new COVID-19 cases July 7.

5. Is Tennessee next? Based on data available as of July 6, Tennessee was among the 15 states with the fewest COVID-19 restrictions. However, on July 9, the state reported its highest single-day death toll related to COVID-19, with 22 fatalities.

In Jackson, Tenn., Jackson-Madison County General Hospital said it would consider closing its surgery center and halting elective cases if the community's COVID-19 numbers continued increasing. As of July 8, the hospital was already treating 45 COVID-19 patients and using 90 percent of its beds and ICU capacity.

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