MORGANTOWN — As the COVID surge continues and more holiday gatherings with more potential to spread the virus are just days away, WVU Medicine and Mon Health System are taking additional measures regarding elective surgeries to address the growing demand for COVID care.
On Nov. 30, Gov. Jim Justice announced that hospitals across the state would be cutting back on elective surgeries in order to have adequate space and staff to handle the COVID surge.
The Dominion Post talked with Dr. Ron Pellegrino, Ruby Memorial chief operating officer, David Goldberg, president and CEO of Mon Health, and Mark Gilliam, chief administrative officer of Mon Health Medical Center about the steps they’re taking now.
WVU Medicine
Following Justice’s announcement, Ruby’s initial scaling back involved surgeries requiting post-surgical hospitalization, Pellegrino said. That helped substantially for several weeks.
However, “the steady climb of patients needing hospitalization, both locally and regionally, is starting to take effect,” he said. “Some of the same-day procedures we’ve had to back off on and will back off a little further over the coming week.”
Most of the new changes will go into effect then end of this week and early next week, he said.
On Tuesday, Ruby’s COVID patient count stood at 100, with 35 in ICUs. Numbers change day to day, hour to hour. At 5 a..m Wednesday, its COVID-positive census was 110. .Ruby had one adult ICU bed available, three adult stepdown and 10 other adult beds.
Meanwhile, he said, other people also require critical care.
As the need for space to care for COVID patients – especially at the ICU level – has grown, he said, they are starting to expand into other areas of the hospital to care for COVID patients. For example, they turned one area of the hospital used for more conventional care into space able to handle ICU level patients.
Also, some peri-operative areas – pre- and post-op – are being used to take care of critical care patients.
And it’s not just space, he said. They need people to staff ICU beds around the clock – nurses and other staff. So they are pulling people from other areas, including ORs and peri-operative areas, and people from other areas who have had critical care experience but have moved to other roles.
They’re looking at deferring non-urgent day surgeries out to mid- to late January for now, he said, with the hope that on the back end of potential holiday surges they may be able to start adding cases back.
“We’ve cut our total OR schedule by about 50%,” he said.
The entire WVU Medicine system is responding, he said, though it varies from facility to facility on how much they are scaling back based on various factors.
They try to titrate or prioritize what they reduce based on need, Pellegrino said. They’ve asked surgical departments to help with the triage process, and a multidisciplinary group is working to vet cases.
They understand this is hard on patients, he said. “Just because their surgery is considered nonemergent or elective doesn’t mean it’s not important.” The people are experiencing pain and uncertainty and genuinely need care. So the providers have to weigh whether deferring a surgery is manageable for the patient.
He urged people to do their best to avoid acquiring COVID by exercising all the precautions: Wear your mask, social distance, wash your hands, avoid large gatherings.
Mon Health
Gilliam said that Mon Health Medical Center has been monitoring the numbers since the pandemic began. Even after they ramped back up in June they have screened employees and visitors and screened and pre-tested patients before surgeries.
They daily monitor state and county metrics and internally monitor staff, beds, and available PPE, he said.
At the time of Justice’s November announcement, staff exposures were small and Mon Health had capacity and was managing well, Gilliam said.
“What we’ve seen in the last two weeks, every day we’ve seen that inch up,” he said. “We’re still in a good position in terms of managing what we have but we have recently met with our surgical committee and have just sent a memo out today.”
Now, “any elective, non-urgent procedures that require an overnight stay, we’re asking those to be deferred out for a month or so,” he said. The measure is to make sure Mon Health remains aligned for capacity in ICUs, for COVID patients and for or other things they need to take care of.
Goldberg said they want to ensure capacity for emergency room cases moving to the floors and for transfers from other hospitals in the system that need higher level care for COVID.
“We’ve been doing that,” he said. “Right now we’re going to the next level and reducing a little bit more to make sure that our nursing staff and our support staff have the capacity for those that we’re seeing with more COVID.”
He noted that they haven’t seen flu caes yet, but expect flu cases to pick up as people are getting together. And the gastrointestinal bug comes around this time of year, and that all requires hospital capacity, so they’re being prudent.
“But we also know there are patients who waited for procedures they thought would be done late spring, summer, early fall that need to be done,” he said. “So we’re working with our doctors to assess clinically do they need to be done more timely or can they be deferred.”
Most of the cutbacks are occurring at Mon Health in Morgantown, he said. But other facilities are taking some measure. The bariatric surgeon at Preston memorial has deferred many of those electives.
Eelective joint replacements have been push off a little further, along with screening colonoscopies and other types of procedures that can go a little longer.
Mon Health has to keep in mind, he said, protecting its patients and staff from acquiring COVID.
Goldberg offered some parting encouragement.
“People should be blessed to be living in north-central West Virginia for the quality of the health care,” he said. “They should know the caliber of medical staff, the first responders are second to none. And everybody’s doing what we believe is in the best public health interest to provide capacity for those that are really sick.”
While exercising proper precautions, he urged people to keep in contact with their providers and continue their health care.
Tweet David Beard@dbeardtdp Email dbeard@dominionpost.com
