Fresno hospitals putting ‘nonessential’ surgeries on hold, due to flood of COVID patients
Several Fresno area hospitals have canceled or postponed non-emergency surgeries that would require an inpatient stay because they need the beds – and the attendant staff – to deal with more seriously ill patients, including those admitted for treatment of COVID-19.
Fresno County hospitals including Community Medical Centers, Saint Agnes Medical Center, Kaiser Permanente and others collectively reported more than 400 patients with confirmed and suspected coronavirus cases receiving inpatient care as of Tuesday.
That’s more than triple the number of patients hospitalized on Aug. 1. Of those hospitalized, 85 were sick enough to require treatment in intensive-care units.
Across Fresno, Kings, Madera, Mariposa, Merced and Tulare counties, hospitals in the central San Joaquin Valley had almost 750 of their inpatient beds occupied by COVID-19 cases, including 141 in ICUs.
Community Health System, which as the region’s largest health system operates Community Regional Medical Center in downtown Fresno and Clovis Community Hospital, reported Wednesday it had 249 inpatients with confirmed coronavirus cases — plus 13 more with symptoms but awaiting confirmation through testing.
Among Community’s staff of doctors, nurses and others, 200 were in self-isolation because of COVID-19 exposure, including 93 who have tested positive for the virus.
Limits being placed on surgeries
The rising number of inpatient beds needed for coronavirus patients, as well as other illnesses or conditions that require hospitalization including heart attacks, strokes, trauma and more, continues to put a strain on hospital staffing and the capacity of the facilities.
Dr. Tom Utecht, chief medical officer for Community Health System, said the organization notified doctors last Friday about steps that the Fresno and Clovis hospitals, as well as the Fresno Heart & Surgical Hospital in north Fresno, are taking to manage hospital capacity and resources, including evaluating surgical procedures.
While not detailing particular limits, delays or suspension of elective surgeries, “we view each surgery/procedure from the overall impact it has on our capacity and staffing resources,” Utecht said, “while simultaneously considering … acuity of condition, length of stay and consequences of delaying the procedure.”
Utecht added that doctors and nurses assess operating room schedules on a daily basis and work with physicians to prioritize cases.
Saint Agnes Medical Center in northeast Fresno last month asked doctors to reduce the number of surgeries and other procedures requiring an inpatient stay by 50%. The hospital also announced a cap of 12 patients per day for elective procedures for which patients need to be admitted.
Since that mid-August memo, however, Saint Agnes has stopped “non-essential” surgical cases, based on guidance from the American College of Surgeons, said Kelley Sanchez, communications director at the hospital.
Sanchez added that Saint Agnes is in Phase II of the ACS guidance limiting surgeries and procedures to patients whose lives would be endangered if the surgery is not performed within a few days.
“If delaying a surgery would put the patient’s survivorship at risk, then it considered essential,” Sanchez said. “For example, a bariatric surgery would not be considered essential.” Endoscopic procedures for screening purposes are temporarily suspended, but doctors are still performing endoscopies to diagnose patient illnesses or conditions.
At Kaiser Permanente’s Fresno medical center, where treatment is limited to the health-maintenance organization’s members, some procedures have been postponed, but not to the degree that some other hospitals have done.
“We are doing what we can to avoid postponing any procedures and will reach out to members should it become necessary,” the organization said in a statement released by spokesman Jordan Scott. “We have rescheduled a small number of non-urgent procedures and have already reached out to those members.”
Kaweah Health, which last month declared an “internal disaster” for two days when the emergency room at the Visalia hospital was overwhelmed with patients and no beds to admit them for inpatient treatment, began limiting outpatient surgeries requiring admission to three per day starting on Aug. 23, spokesperson Laura Florez-McCusker said.
“We evaluate weekly to determine further reductions and/or steps for increasing surgeries,” McCusker said.
The Visalia hospital reported 114 people in inpatient beds as of Tuesday, including 15 in intensive care units.
At Adventist Health, which operates hospitals in Hanford, Tulare, Selma and Reedley, “no changes have been made to elective surgeries at this time,” spokesperson Amanda Jaurigui told The Bee. “However, we review (the situation) daily.”
This story was originally published September 1, 2021 at 3:16 PM with the headline "Fresno hospitals putting ‘nonessential’ surgeries on hold, due to flood of COVID patients."
