Hospitals curtail non-emergency surgeries

All major hospitals in the Buffalo area have canceled elective surgeries to conserve dwindling supplies of blood and protective gear, such as face masks, that are needed to treat victims of the COVID-19 pandemic.

Surgeons at Catholic Health and the Erie County Medical Center began canceling elective surgeries earlier in the week. Kaleida Health followed suit with a decision Thursday to cancel non-emergency surgeries effective today. Niagara Falls Memorial Medical Center announced it would take the same measure, effective Friday evening.

The embargo on all non-essential procedures comes as hospitals seek to limit staff and patient exposure to coronavirus and brace for an influx of COVID-19 patients. Blood for transfusions and protective gear for healthcare providers, including face masks, are in critically short supply. These consumable supplies, like tests for COVID-19, have become difficult to obtain.

Pressure has been building for hospitals to stop performing non-emergency surgeries. Last Friday, the American College of Surgeons advised hospitals to reschedule elective surgeries. New York City hospitals have done so, as have hospitals in Ohio, under an order from that state’s health department.

ECMC and Catholic Health, which operates four hospitals in the Buffalo area, followed suit earlier this week. Kaleida Health, the region’s largest healthcare provider, continued to perform elective surgeries at Buffalo General, Millard Fillmore Suburban and Gates Vascular Institute. 

The operating rooms at Millard Fillmore Suburban were the busiest of the three hospitals, Kaleida employees told Investigative Post. They were booked at full capacity all week, mostly performing elective procedures, employees said. Staff members said some of these cases originated at ECMC and Catholic Health, which had already stopped booking non-emergency operations.

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Investigative Post interviewed 10 doctors, nurses and other employees at Kaleida for this story. All requested anonymity in order to speak freely about their discomfort with Kaleida’s policy. 

Nurses at Kaleida told Investigative Post that, in the last week, they received changing dictates from administrators about the use of protective gear — when to wear a mask, for example, and what kind — as supplies dwindle. Doctors and other employees at Kaleida described deep divisions among staff about the wisdom of continuing to perform elective surgeries. They expressed concern about the depletion of resources, the allocation of staff time, and the risk of infection posed to staff, patients and their families. 

It’s unclear whether staff dissent contributed to Kaleida’s decision to cancel elective surgeries effective today. Regardless, management communicated the new policy to staff by email Thursday:

At this time, we are further limiting surgery to those cases considered urgent, which we are defining as immediate threat to life and limb, unstable cardiac, severe or progressive neurological deficit, and the timely diagnosis and treatment of cancer.

Chronic pain, despite severity, is not considered urgent. Therefore almost all inpatient joint replacements are restricted. And bariatric surgery, which has significant long-term health benefits, will be on hold. Spinal surgery will be restricted based on degree of deficit and instability.

Vascular and cardiac surgery will continue, with the consideration of whether the procedure can safely be delayed three months.

The anticipated shortage of ICU units and ventilators to treat COVID-19 patients is a concern in Western New York and across the state, as Investigative Post reported earlier this week. Gov. Andrew Cuomo has expressed concern that the state’s health care system could be overwhelmed with patients diagnosed with the virus, citing, among other factors, an anticipated shortfall of hospital beds and ventilators. 

Of equal concern, however, is the limited supply of consumable necessities such as blood and face-masks. One surgeon who spoke to Investigative Post estimated that local hospitals have four days’ supply of blood on hand, and two days’ supply of face masks.

On Thursday, Catholic Health’s St. Joseph’s Campus for Sister of Charity Hospital, in Cheektowaga, became the first regional health facility committed solely to treatment of COVID-19 patients.