While hospitals in Gwinnett continue to treat patients for the COVID-19 novel coronavirus, there is one sign that life around the medical centers is beginning to return to something more akin to normal amid a pandemic.
Some of those hospitals are starting to resume some elective surgeries.
Eastside Medical Center began resuming some of those surgeries last week, while Northside Hospital Gwinnett and Northside Hospital Duluth began implementing their hospital system’s phased-in resumption of elective surgeries on April 27.
“This is a caseload that’s been out there and deferred because of the COVID pandemic and those are the folks that we’re really wanting to get back in now so they can get that needed healthcare addressed in an expeditious fashion,” Eastside Medical Center Chief Medical Officer Dr. Stephen Higgins said.
The resumption of elective surgeries at some local hospitals comes as health officials said the number of COVID-19-related hospitalizations begins to subside. Last Friday, Gwinnett, Newton and Rockdale Health Departments district health director, Dr. Audrey Arona, said hospitalizations because of the coronavirus are at 18%, down from a peak that she said had been above 20%.
On Monday, Gov. Brian Kemp said hospitalizations and the use of ventilators had hit its lowest point since reporting began in early April.
The governor said that, statewide, 1,134 COVID-19 positive patients were hospitalized, 1,987 critical care hospital beds were in use and 881 ventilators were in use. By comparison, the statewide figures for May 1 were 1,483 COVID-19 positive patients hospitalized, 2,119 critical care hospital beds in use and 989 ventilators in use., according to the governor’s office.
“This data shows that we are headed in the right direction in our battle with COVID-19,” Kemp said. “Every day, Georgians are recovering from the virus, freeing up hospital space as we continue to safely reopen our state and ramp up testing and contact tracing. This challenge is far from over. We are not out of the woods yet, so we must remain vigilant in following proper protocols from public health officials. The people of Georgia can rest assured that we are making progress, and together, we will win this fight.”
What is an elective surgery?
Higgins clarified that referring to a surgery as “elective” does not necessarily mean it’s an optional surgery. He said a better description would be to call it “scheduable.”
“You could have a patient who is in dire need of a knee replacement, they’re having a lot of pain and suffering and disability related to that, but it’s something that could be scheduled,” Higgins said. “So that’s an example of something that is categorized as elective, but it’s really not optional.
“It might be a woman who has a chronic abdominal or pelvic pain and needs a hysterectomy. That’s not really an urgent situation, but it is causing discomfort and suffering to that individual.”
How local hospitals have been handling surgeries
Not every hospital has resumed elective surgeries just yet.
Northeast Georgia Medical Center, which has campuses in Gainesville and Braselton, has not yet set a date for resuming elective surgeries, hospital spokeswoman Beth Downs said. That may not be too surprising since Gainesville has recently emerged as a hot spot for COVID-19 cases, however.
Surgeries at Northeast Georgia Medical Center are still being limited.
“We are doing urgent and emergent (surgeries),” Downs said.
But, the situation is different for Eastside Medical Center and Northside Hospital.
Eastside CEO Trent Lind said his hospital put together an advisory council over the last two months as it scaled back surgeries because of the pandemic. That council evaluated cases where surgery was necessary due to the acuity and urgency of the individual situation.
The hospital also followed guidance from the Center for Medicare and Medicaid Services, also known as CMS, which created tiers for different levels of cases.
Level 1 cases were those surgeries deemed elective that could wait for awhile until they were necessary while Level 2 cases were those where there was a greater need to perform a surgery sooner rather than later, such as a patient was experiencing pain. Meanwhile, Level 3 cases were the more urgent care cases where surgery was needed immediately, Lind said.
“Our surgical advisory council helped us to evaluate cases that were necessary and fell into that Level 3 category, maybe some Level 2, and then just (May 4), we started back with the elective cases that really fall into that Level 1 category,” Lind said.
Eastside Chief of Staff Dr. Michael Kissel said the hospital is also beginning with outpatient surgeries where people can be operated on and then go home the same day.
“That allows us to kind of slowly ramp up versus just opening the flood gates to every surgery,” he said. “We’re taking this very slowly and methodically to make sure everybody stays safe, and then after a couple of weeks, if everything is still going well in the state of Georgia and Gwinnett County and Snellville, then we’ll start expanding to surgeries where patients will stay inpatient longer.
“This is within guidelines from CMS and all of the anesthesia and surgical societies.”
Meanwhile, at Northside Hospital System, officials began surgeries late last month with specific cases that involved cancer, as well as time-sensitive procedures that had previously been delayed, hospital spokeswoman Katherine Watson said.
“The safety of our patients and staff remains paramount, and all patients will be required to undergo pre-surgical testing for COVID-19 within 72 hours of a scheduled procedure,” she said. “Clinical leadership will review surgical cases on a day-to-day basis. Close monitoring of ICU bed usage, the volume of COVID-19 patient visits and admissions, and any increased incidence of COVID-19 in the community will guide and inform this process as we move into further phases.”