What Florida ASCs are seeing as COVID-19 hospitalizations surge

The number of COVID-19 cases and hospitalizations is surging in Florida, which recorded its highest number of daily caseloads since the pandemic began in August.

Many hospitals in the state have delayed elective procedures and shifted focus to treating COVID-19 patients. Hospitalizations in Florida are up 89 percent over the past two weeks as of Aug. 12.

"Given a delta variant spine, the hospital environment has changed dramatically with elective procedures postponed by both of the large hospital systems in Orlando and day-to-day reviews of how to proceed," said Dave Russell, COO of Digestive and Liver Center and Endo-Surgical Center of Florida. "As an independent practice with multiple endo-surgical centers, all our COVID protections remain in place and volume is increasing as expected, both for patient visits and procedures."

ASC physicians and administrators are keeping a close eye on the situation and are ready to make changes if necessary.

"While we are prepared to pivot quickly, we do not see significant change in operational protocols over the next several months," Mr. Russell said. "Telehealth visits for established chronic patients have decreased, in part due to payers like Florida Blue, which reduces reimbursement for telehealth compared to in-office visits."

Cherokee Gonzalez, BSN, RN, regional director of ASCs for Florida Medical Clinic, said she was preparing to receive elective procedures that hospitals deferred. She said she expects the next few months to be busy but thinks the state government will keep ASCs and other alternative care sites open.

"We are stocking up on supplies and making agreements with staffing agencies to obtain additional staff," Ms. Gonzalez said. "Probably most importantly, we are looking at ways to maintain and care for the staff we have."

Chukwuka Okafor, MD, an orthopedic spine surgeon at the Spine Institute of Central Florida in Lakeland, said nearly all nonteaching hospitals in the Tampa Bay area have postponed elective surgeries.

"[Hospital executives] anticipated [the delay] would be for three weeks, but with the numbers of COVID-19 patients filling up hospitals on the rise, there is a good chance that the hold on elective surgeries will continue beyond three weeks," Dr. Okafor said. "Initially the hold was on elective surgeries requiring overnight stay in the hospital, however, after 24 hours of this type of hold, the hold was changed to all non-elective surgeries, even if it required only 30 minutes of post-surgery stay. As you can imagine, that leads to lots of frustrated patients."

Dr. Okafor and his partners are developing an ASC, and he said the pandemic has delayed the process. He expects to open the center before the end of the year and anticipates the facility requiring patients to wear masks far into the future, despite Florida Governor Ron DeSantis' executive order against them.

"[The mask policy] will continue for us until way into the future, when we know for sure that based on evidence-based criteria they are no longer needed to protect all patients and team members," Dr. Okafor said.

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