Mar 24, 2020 9:01 AM

Most KC-area hospitals put off elective surgeries to prepare for COVID-19

Posted Mar 24, 2020 9:01 AM
The University of Kansas Health System has postponed elective surgeries to prepare for an influx of coronavirus patients. KU Hospital
The University of Kansas Health System has postponed elective surgeries to prepare for an influx of coronavirus patients. KU Hospital

By DAN MARGOLIES
Kansas News Service

As the coronavirus continues its relentless spread, hospitals are making tough decisions about postponing or canceling elective procedures.

Earlier this week, the Centers for Medicare and Medicaid Services recommended that providers consider a range of factors in determining whether to postpone surgery or other procedures. They include patient risk, urgency of the procedure, bed availability, staffing and the availability of personal protective equipment.

“The reality is clear and the stakes are high: we need to preserve personal protective equipment for those on the front lines of this fight,” CMS Administrator Seema Verma said in a statement Wednesday.

The University of Kansas Health System, which operates the area’s largest hospital, has indefinitely postponed all elective procedures.

“It’s part of our conservation efforts to make sure that we have enough supplies,” said spokeswoman Jill Chadwick. “And it's to help protect patients whose annual check-up, etc., can wait. We know social distancing works and we are assessing everyday how to do our part.”  

In a conference call with reporters Friday, Steve Stites, KU’s chief medical officer, said the hospital’s operating rooms were currently operating at about 25% capacity because most elective procedures had been canceled or deferred.

He said KU had prioritized cases into three tiers: ones that can readily be postponed, such as cosmetic surgery; ones with a risk of harm, where the physician and patient need to make an informed decision about what the relative harm and risk may be; and ones that can't be postponed.

“So cases that you have to do are cancer surgery,” Stites said. “You can’t let the tumor grow.”

Stites said the measures were being taken to conserve personal protective equipment in the expectation of an influx of COVID-19 patients in coming weeks.

“We're trying to conserve as much as we can right now for the eventual rapid increase in the number of COVID-19 patients inside the hospital,” Stites said. “And that’s the reason we've been holding back surgery, in order to preserve our personal protective equipment.”

At Saint Luke’s Health System, another large hospital network, elective procedures are being deferred, although what constitutes “elective” in some cases is being left to physicians’ discretion.

“We are deferring all cases that can be safely deferred,” spokeswoman Laurel Gifford said. “Some technically elective procedures are still medically necessary so our physicians and surgeons are reviewing them on a case-by-case basis. But I think it’s safe to say that all cases that are not required at this point and where it’s in the best interests of the patient, are being rescheduled and deferred to a later date.”

HCA Midwest Health, the largest hospital operator in the Kansas City area, said it’s following CMS’ guidelines but also deferring to the clinical judgment of its physicians.

“Our COVID-19 preparedness efforts include reinforcing infection prevention protocols and guidance from the CDC, sourcing necessary supplies and equipment, and emergency planning, so our hospitals are prepared to safely meet the needs of all of our patients and protect the health and well-being of our colleagues,” HCA spokeswoman Christine Hamele said.

Safety-net hospital Truman Medical Centers is postponing “anything that’s true elective surgery,” according to spokeswoman Leslie Carto.

“There are some, like a malignancy that can possibly wait but they have the diagnosis, those are being done. But anything truly elective – those are being canceled,” Carto said.

At least one local healthcare provider, AdventHealth System, which operates AdventHealth Shawnee Mission (formerly known Shawnee Mission Medical Center), has not postponed elective procedures.

“We haven’t told (physicians) that they need to cancel things. I will tell you that’s something that’s being reviewed daily and that position can change,” Adventist spokeswoman Morgan Shandler said.

At the top of its website, AdventHealth posted this notice: “While preventing the spread of COVID-19 and treating COVID-19 patients is of highest priority in our community, we recognize that we have many patients with medical needs unrelated to COVID-19 that still need addressed. At this time, AdventHealth Shawnee Mission has not cancelled or delayed scheduled procedures. However, individual physicians are reviewing their scheduled cases and may opt to postpone elective cases that are not time sensitive. If your case will be postponed, your physician’s office will contact you directly. We will continue to update this policy as the situation with COVID-19 evolves.”

Dan Margolies is a senior reporter and editor at KCUR. You can reach him on Twitter @DanMargolies.

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Mar 24, 2020 9:01 AM
Virus outbreak poses massive challenges for US charities
The pandemic stopped the annual Girl Scout cookie sale. Above is Alliance, NE councilwomen Annora Bentley with Girl Scouts in Box Butte County. 

NEW YORK (AP)— With its global scope and its staying power, the coronavirus outbreak poses unprecedented challenges for charities and nonprofit groups that rely on donations.

The American Red Cross faces a severe blood shortage due to the cancellation of nearly 2,700 blood drives. The Girl Scouts' annual cookie sale — vital to the group's finances — has been disrupted by a top-level plea to halt in-person sales.

And a 21-member coalition of major nonprofits is pleading with Congress to allocate $60 billion so charities can keep their staff on the job and ramp up assistance programs.

The CEO of one of those groups, Brian Gallagher of United Way Worldwide, has worked with the charity since 1981, engaging in its response to the 9/11 attacks, the Ebola threat, Hurricane Katrina and other disasters.

He said the COVID-19 outbreak has no parallel: "It's as if a natural disaster is hitting in slow motion just about every country on Earth."

Already, foundations and other major donors have contributed more than $1.9 billion to combat the outbreak, according to Candid, a New York-based nonprofit that tracks philanthropic giving.

The overall total, including donations from individuals, is surely far higher. Yet nonprofit leaders fear that the needs arising from the outbreak will outstrip even the possibility of massive future giving, let alone a possible drop in giving if a recession takes hold.

“Even if we get this virus under control, there will be several months of recovery for many people,” said Patricia McIlreavy, president of the Center for Disaster Philanthropy. “Business will have closed, many families will have exhausted every reserve.”

Among the major charities bracing for future challenges is the Salvation Army, which says it annually receives about $2 billion in public support to serve about 23 million people living in poverty.

“We expect that service number to rise exponentially in the coming months," requiring "tens, if not hundreds, of millions of dollars to support our most vulnerable neighbors,” said Dale Bannon, the faith-based organization’s community relations and development secretary.”

He said the Salvation Army, like many other charities, has been forced to cancel numerous fundraising events because of the outbreak. It is now focusing on online fundraising operations.

Canceled blood drives have been devastating to the American Red Cross, which provides about 40% of the nation’s blood supply.

In a statement Wednesday, the organization estimated that there have been 86,000 fewer blood donations in recent weeks because of the wave of blood drive cancellations at workplaces, colleges and other venues as people were told to work or study from home and practice social distancing.

Patients being treated in hospitals for the coronavirus do not generally need blood transfusions, but the worsening blood shortage could affect surgery and cancer patients and victims of car accidents.

Anticipating that blood drive cancellations will continue, the Red Cross pleaded for potential donors to support drives that do take place or for donors to visit its blood-donation facilities.

The group outlined additional safety precautions being taken, including checking the temperature of staff and donors before they enter locations and requiring staff to change gloves each time they interact with a different donor.

For the Girl Scouts of the USA, calling for a halt to in-person cookie sales was momentous, given that the sales net roughly $800 million annually and are the core of the organization’s fundraising.

Girls who had been selling cookies at booths outside stores and other locations were asked to focus on online sales instead.

“The risk of interaction with large crowds is just too great,” said the Girl Scouts’ CEO, Sylvia Acevedo.

The Girl Scouts are asking their corporate supporters to consider making bulk cookie purchases. A spokeswoman, Valerie Geiss, said it would be several months before the financial outcome of the sales campaign is known.

Many local Girl Scout gatherings across the country have been suspended, though some units are meeting online. The Washington-based Girl Scouts of Nation’s Capital said it will be hosting more than 40 “virtual troop meetings” next week, potentially serving about 5,000 girls.

The Girl Scouts were among the 21 nonprofits appealing to congress on Thursday for the $60 billion infusion of support for charitable organizations.

Their appeal said America’s charities employ 12 million workers, many of them working on the front lines of the coronavirus response.

“The financial impact of the crisis has put the very survival of many essential service providers at risk,” said Steven C. Preston, president and CEO of Goodwill Industries International. “Charities are our society’s shock absorber when crisis hits.”

At the Center for Disaster Philanthropy, McIlreavy says there has been a surge of requests from would-be donors seeking guidance on how to give effectively in response to the pandemic.

‘‘Folks just want to know the money is going somewhere where it's actually going to help someone,” she said.

Her center urges donors to be wary of misinformation and do thorough research of charities before making gifts. It identifies key areas that could interest donors: urgent medical response needs, long-term medical research and assistance to vulnerable people in the U.S. or abroad.

For most people, the coronavirus causes only mild or moderate symptoms, such as fever and cough. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia.

For the United Way, a current priority is to strengthen and expand the 211 network that helps people who call the number to connect with providers of urgently needed social services.

Gallagher said 211 specialists have answered about 12 million requests annually, and he predicts there will be an additional 200,000 calls per day in coming weeks because of the outbreak.

Looking broadly, Gallagher believes there will be a surge in charitable giving for the next few months, and then a downturn as a weak economy takes a toll.

Big charities like United Way will get through it, Gallagher said. “The smaller nonprofits — houses of worship, soup kitchens — they will struggle."