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Monday, April 27, 2020

DeSantis expected to announce new plans for elective surgeries this week

Posted By on Mon, Apr 27, 2020 at 10:08 AM

click to enlarge SCREENSHOT VIA FLORIDA CHANNEL
  • Screenshot via Florida Channel

As Gov. Ron DeSantis prepares to release plans for reviving the state’s economy, it appears increasingly clear that allowing hospitals and doctors to resume providing elective medical procedures will be part of the strategy.

DeSantis made appearances this weekend with doctors at Cleveland Clinic in Broward County and Orlando Health and focused, in part, on medical procedures that have been postponed as the state ramped up to fight the coronavirus pandemic. He also pointed to available hospital beds in the state.

“Elective procedures, I think when people hear that, they think it’s like, ‘Oh, you know I’m going to get like, some type of cosmetic surgery or something.’ These elective procedures really do affect patients’ health. You’re talking about screenings, you’re talking about things that are really important,” DeSantis said Saturday during the Cleveland Clinic appearance. “I understand why this was done (postponing procedures) because we didn’t know what was coming down the pike, but the fact that we have availability and can accommodate it, I think we do need to move in that direction.”

DeSantis on March 20 issued an executive order directing hospitals, ambulatory surgical centers, office surgery centers, dental offices and other health-care providers to cease performing elective services. Citing a federal recommendation, the emergency order said “examples of procedures to delay may include, but are not limited to, some endoscopy, most cataract and lens surgeries, non-urgent spine and orthopedic procedures, and cosmetic procedures.”

The executive order stemmed from a push to conserve medical supplies, including personal-protective equipment, as hospitals and health-care workers prepared for a surge in patients with COVID-19, the respiratory disease caused by the coronavirus.

The executive order is slated to last through May 8, but hospital and physician organizations last week sent letters to DeSantis seeking to scale back the restrictions on procedures. The letters came as a DeSantis-created task force worked on recommendations about reopening various industries, including health care. DeSantis is expected to release plans during the coming week.

“As we ease some of these restrictions, the health system is overwhelmingly prepared with equipment, beds, staffing. So I am 100 percent confident that we can handle patients that we’ve put off and I’ll use the term loosely ‘elective’ surgeries,” physician Sunil Desai, a senior vice president of Orlando Health who has served on a working group that is part of DeSantis’ task force, said Sunday. “The one caveat I want to say, and this is a little pet peeve of mine about elective, it’s elective when you set up the time. That’s the only thing that makes it elective. To that patient or that family, it is not elective. It was something that was prepared for.”

During DeSantis’ weekend appearances, doctors also said patients have put off seeking treatment for emergency care, which can lead to complications later. Physician George Ralls, vice president of quality and clinical transformation for Orlando Health, said officials are concerned about an upcoming “surge of unmet medical needs.”

“There are many cases that we have seen come into the emergency departments that were much, much worse than they would have been had they come in a few days before,” Ralls said. “We’ve had patients who ignored chest pain for days and came in in cardiac arrest. We’ve had patients who ignored seizures and came in with much more severe situations.”

Physician Carla McWilliams, an infectious disease specialist at Cleveland Clinic, said hospitals have taken precautions to protect patients with other conditions from being exposed to COVID-19.

“We’re very, very concerned about patients that have other conditions not coming in to seek care and the potential downstream consequences of that,” she said Saturday. “And just to reassure the general public, our hospital, along with every other hospital, has gone to great lengths to create what we call cohort units. And what that means is all patients with COVID are put in a particular area of the hospital with dedicated staff. We have environmental cleaning done on a very consistent basis that essentially excludes or removes any risk to any of the other patients who may be on other floors or in other areas.”

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