New York City hospitals have begun eliminating elective surgeries to prepare for an expected onslaught of coronavirus cases — amid concerns the move could put other patients at risk.
The NewYork-Presbyterian, NYU Langone Health, Mount Sinai and Northwell Health hospital systems all said Wednesday that they’d postponed or canceled elective procedures, as ordered by Mayor Bill de Blasio on Sunday.
Exact numbers weren’t available, but nurse Anthony Ciampa, a union official who works at NewYork-Presbyterian/Columbia University Medical Center in Upper Manhattan, said the operating-room schedule there was about 75 percent lighter than usual.
At Montefiore Medical Center in the Bronx, elective procedures — which comprise 80 percent of all surgeries — will be canceled as of Thursday, a spokeswoman said.
A similar move is underway in Britain, where the National Health Service on Wednesday announced plans to cancel all elective surgeries for three months.
Although there’s no official definition of “elective surgery” under state law, NYU Langone said the term covered procedures that aren’t “medically necessary” and that “both the physician and the patient agree can be safely delayed for up to three months.”
The chief medical officer of Northwell Health, Dr. David Battinelli, said physicians at its facilities — including Lenox Hill Hospital on the Upper East Side — were entrusted to make decisions on a case-by-case basis.
“It’s not a master list. It’s a master plan, I guess you can call it,” he said.
“What can be postponed safely will be postponed. And what needs to occur, needs to occur.”
Battinelli estimated that total surgeries had been scaled back by at least 30 percent since Northwell began postponing elective procedures last week.
Dr. Patrick Borgen, chairman of the surgery department at Maimonides Medical Center in Brooklyn, said elective procedures were ones that “could be postponed for eight to 12 weeks with no harm to the patient.”
“You’ll read different definitions of that. We believe the definition of that is no harm to the patient, not minimal harm to the patient,” he said.
The American College of Surgeons cautioned that it’s “not possible to define the medical urgency of a case solely on whether a case is on an elective surgery schedule.”
“While some cases can be postponed indefinitely, the vast majority of the cases performed are associated with progressive disease (such as cancer, vascular disease and organ failure) that will continue to progress at variable, disease-specific rates,” the group said in a statement Tuesday.
“Indeed, given the uncertainty regarding the impact of COVID-19 over the next many months, delaying some cases risks having them reappear as more severe emergencies at a time when they will be less easily handled.”
Several medical-industry groups, led by the American Hospital Association, also sent a letter to US Surgeon General Jerome Adams on Sunday in which they expressed concern that government officials were “recommending that hospitals immediately stop performing ‘elective’ surgeries without clear agreement on how we classify various levels of necessary care.”
“We agree that the crisis as it develops may require the curtailment of the least critical or time-sensitive hospital services, but any curtailment must be nuanced to meet the needs of all severely ill patients,” the letter said.
“Our patients will be best served by carefully evaluating and prioritizing gradients of ‘elective’ care to ensure that the most time-sensitive medically necessary care can be delivered by physicians and hospitals.”
During a Monday night appearance on MSNBC’s “The Rachel Maddow Show,” de Blasio acknowledged that “elective surgeries are still very serious things in many cases.”
“And we did say if a doctor believes something might have bigger, profound health ramifications they can figure that out this week. But we want them cleared out,” he said.
On Tuesday evening, Hizzoner told NY1’s “Inside City Hall” that his order would “clear the way to focus on coronavirus.”
“It also frees up personnel, it frees up beds and surgical rooms, it frees up the equipment as well,” he added.
Additional reporting by Julia Marsh