I write this blog as I sit in my house. I shouldn’t be here. I should be in surgery all day today and tomorrow. But I am not doing surgery because we are under orders to “shelter in place,” which started last night at midnight.
The reason for the extraordinary order to shelter in place is a valid smart one. Coronavirus is spreading like wildfire. And though most who get it will be fine, those who are affected (rates vary, but 10-20% need medical care, and I know some who are not in the “high risk” group) will soon overwhelm our hospitals . We have to flatten the curve.
What is considered an elective surgery?
The ban canceled all elective surgeries, defined as “any surgery which can safely be postponed for 30 days.” The current ban extends to April 7.
Not all elective surgeries are equal. Some are considered more “urgent,” think cancer surgeries. I just received a note from one of my hospitals. For elective surgery deemed urgent in nature, they state there is an appeal process to give priority when they are able to do surgery again. They identify two categories of these urgent elective surgeries:
- Category A, have a medical justification with risk of significant morbidity or mortality in the next 14 days;
- Category B, have risk of significant morbidity or mortality within the next 30 days.
We know how frustrating this is, after waiting and planning so much.
This has wreaked havoc on everyone, in every profession, of every age. I am writing this blog so you can consider your options and what I am guessing is the likely timeframe. These are unprecedented times. We do not have a “playbook” to guide us.
Options I am discussing with my patients:
- Wait and see when surgeries are allowed again. My surgery center is not a hospital. It is a small outpatient surgery center for elective surgery on healthy individuals.
- The current ban extends to April 7, but I would expect the elective surgery ban to extend farther. Until we start to see hospitals emptying and not filling, I think they will reserve all outpatient centers as back ups for critical care and supplies.
- My guess would be 6-8 weeks, which correlates with the note I got today from one of my hospitals, who said they are canceling cases until April 30.
- I anticipate once the centers are open again that we will add days and hours on to accommodate those displaced.
- Reschedule your surgery until the fall.
- Know this may not be foolproof, as many epidemiologists suggest there may be a flare of coronavirus in the fall.
These are extraordinary times. We all need to support and protect each other during this time.