Most Elective Surgeries To Be Delayed In 0% ICU Counties Due To Bed Need

The California Department of Public Health (CDPH) announced Tuesday that elective and non-life-threatening surgeries would be delayed for three weeks at some hospitals to make more beds available for COVID-19 patients.

In the order by the CDPH, it was specified that only counties in a region that is currently under stay-at-home orders that has no ICU availability with a CDPH ICU availability calculation of open ICU beds being under 10% would be covered. As of Wednesday, this includes 14 counties in the San Joaquin Valley and Southern California, including Los Angeles County.

Among the elective procedures being suspended are Tiers 1 and 2 in the Elective Surgery Acuity Scale (ESAS) which will include non-emergency spinal surgery, colonoscopies, carpal tunnel procedures, and some treatments for low risk cancers. In addition, the order lays out procedures for patient transfers once a hospital reaches crisis care levels, as many counties can now be ordered to accept incoming patients from 0% areas. Serious procedures, such as emergency surgeries, heart procedures, and cancer removal, will still continue as needed.

The order will only last for three weeks, but may be extended if COVID-19 cases, hospitalizations, and deaths continue to rise in the 0% ICU areas.

“If we continue to see an alarming increase of COVID-19 patient admissions at hospitals statewide, some facilities may not be able to provide the critical and necessary care Californians need, whether those patients have COVID-19 or another medical condition,” said CDPH director and state Public Health officer Dr. Tomás J. Aragon on Tuesday. “This order helps ensure that patients continue to receive appropriate medical services by better distributing available resources across the state to prevent overwhelming specific hospitals, counties and regions.”

Elective surgeries had been previously delayed at many hospitals in many counties across California due to the need for beds during COVID-19 surges, but the CDPH’s order was the first time that the state had intervened.

“We’re low on beds, and we even have beds in hallways,” explained Margo Hewitt, a hospital administrator in Southern California. “Surgeries like these don’t take up too much room in hospitals bed-wise, but right now, every bed counts. We’re only putting these surgeries in a holding pattern for three weeks. Hopefully the number of cases will go down, including the number coming into hospitals.

“We’re all being pushed to the breaking point with COVID cases, and this gives a little bit more room for us. This gives us some more beds, and we hope we can save more lives this way. Hopefully we’ll have greater ICU bed capacity once the surge ends. But right now, Public Health has deemed this as the best way to increase bed space right now for COVID patients coming in.”

The order is expected to end in late January.