Intermountain delaying almost all surgeries amid COVID-19 surge


Intermountain Healthcare is pausing almost all surgeries to preserve capacity amid a crush of COVID-19 patients, the not-for-profit integrated health system announced Friday.
The pause on “urgent but not immediately life threatening” surgeries begins Sept. 15 and will probably last a couple of weeks, Intermountain Healthcare CEO Dr. Marc Harrison said at a news conference. The suspension of surgeries affects 13 of the Salt Lake City-based health system’s 24 hospitals. Rural hospitals and its orthopedic specialty hospital and children’s hospital are exempt.

The delta variant is surging in states with low vaccination rates, straining hospitals in those areas. In neighboring Idaho, public health leaders activated “crisis standards of care” this week that allow northern Idaho hospitals to ration care because there are more COVID-19 patients than they can handle. Intermountain Healthcare operates a single hospital in southern Idaho, Cassia Regional Hospital in Burley.

Almost half of Utahns are fully vaccinated against COVID-19, compared to 40% in Idaho, which has one of the lowest vaccination rates among the states. Nationwide, 53.6% of people are vaccinated. Utah’s health department reported 2,196 new COVID-19 cases on Sept. 9, the highest since Jan. 21.

Beyond the potential harm to patients, postponing profitable surgeries is hard on hospitals’ finances. Hospitals collectively lost an estimated $60 billion a month because of delayed procedures during the pandemic last year. The financial risk is compounded by the fact that hospitals are instead treating expensive, complicated COVID-19 cases with uncertain reimbursement.

Intermountain Healthcare’s intensive care units are exceeding capacity, and about half of the beds are occupied by COVID-19 patients, Harrison said. Approximately 350 patients are hospitalized with COVID-19 at Intermountain facilities, and 87% of them are unvaccinated, Harrison said.

“These are patients who absolutely do not need to be in the hospital,” Harrison said.

The surgeries Intermountain Healthcare is deferring are not minor or purely elective, Harrison said. As examples, a patient with a partly obstructed neck artery who is showing mini-stroke symptoms and is at risk of having a deadly stroke or someone with severe back pain that limits mobility would be unable to access care, he said.

“You are going to get to wait for that procedure because we don’t have a bed because it is filled with an unvaccinated person with COVID,” Harrison said. “We don’t take this lightly.”

Intermountain Healthcare is treating more COVID-19 patients than ever before, and experts project cases will rise even further. Intermountain will need about 40 new intensive care beds and 70 additional general medical beds and is hiring travel nurses to staff them, Harrison said.

Other health systems with hospitals in the Salt Lake City region said they haven’t yet needed to postpone surgeries across the board.

University of Utah Health, a five-hospital chain also based in Salt Lake City, has been postponing non-urgent inpatient surgeries on a case-by-case basis for several weeks, spokesperson Kathy Wilets wrote in an email. The system reviews all elective cases scheduled in the coming 48 hours and balances them against bed availability, she said.

HCA Healthcare has eight hospitals in the area that are at or near capacity because of the latest COVID-19 surge, spokesperson Brittany Glas wrote in an email. The hospitals reschedule procedures based on urgency, the dynamic in that specific hospital and physician judgment, she said.

MaineHealth in Portland announced this week it’s postponing some elective surgeries across its 12 hospitals. Maine’s intensive care census hit its highest point since the start of the pandemic. Indiana University Health in Indianapolis, the largest hospital chain in the state, began delaying elective inpatient surgeries this week amid a severe delta variant surge there.

Unvaccinated people should get their shots to protect themselves and their communities, Harrison said.

“I will remind you that for all these patients that we have in the hospital right now with COVID, not a single patient is in the hospital with a complication of a vaccination,” Harrison said. “Vaccinations are safe and they’re effective and they’re saving lives every day and by having folks who have chosen to not be vaccinated, we’re seeing implications to our public health.”

One thing Intermountain Healthcare is not doing is mandating COVID-19 vaccinations for its roughly 41,700 employees, as many of its not-for-profit peers have done. More than 80% of Intermountain’s employees are vaccinated, and that number is growing, Harrison said. “We do not believe that mandates are the answer to every problem,” he said.

Intermountain Healthcare may soon be forced to change course. President Joe Biden announced Thursday that the roughly 17 million people who work at healthcare facilities that treat Medicare or Medicaid patients will have to be fully vaccinated for COVID-19. Large, for-profit hospital chains like HCA Healthcare and Community Health Systems have also declined to implement mandates.


Source: modernhealthcare.com

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