Under siege with COVID patients, Grady Memorial among hospitals delaying elective procedures

Credit: JOHN SPINK / AJC

Credit: JOHN SPINK / AJC

Piedmont pausing electives at some hospitals; Wellstar anticipates delays of non-urgent procedures

Grady Memorial Hospital on Wednesday resorted to canceling all “non-essential” outpatient surgeries and procedures to deal with the continuing surge of COVID-19 patients that is testing the capacity of hospitals across Georgia.

Grady CEO John Haupert said making changes to the hospital’s operations became necessary after an extraordinarily busy Labor Day weekend. “Seriously ill patients with COVID-19 and other significant health issues inundated the hospital,” Haupert said in an announcement to the Grady staff.

As COVID-19 cases have exploded during August, hospitals in every region of Georgia have been forced to cancel joint replacements, hernia repairs and other procedures that can be safely delayed.

“Hospitals statewide have drastically reduced the number of elective procedures performed on an inpatient basis with the exception of those that must be done for patient safety reasons,” said Anna Adams of the Georgia Hospital Association.

“Hospitals are prioritizing the needs and safety of all patients, including COVID inpatients, and we will continue to allocate staff to areas of the hospital that are experiencing the highest patient volumes,” Adams said.

Patients seriously ill with COVID-19 made up 34% of the state’s hospitalized patients as of Wednesday, according to the Georgia Department of Public Health. The vast majority of the 5,935 COVID-19 patients in Georgia hospitals are unvaccinated.

The current COVID patient loads statewide now exceed the previous pandemic peak reached in January, forcing hospitals back into crisis mode as they try to handle the ongoing flood of patients when their emergency departments and intensive care units are already full.

Grady Memorial Hospital went on a “total diversion” status over the weekend to try to steer ambulance traffic elsewhere because it was so crowded. But every other hospital was full, too, Haupert said, so Grady continued to care for the flood of patients coming in by ambulance, car or on foot.

“Because of the strain this is putting on the health system, our patients, and our staff, we must make some changes to the way we operate,” Haupert said in the announcement.

Grady, one of the nation’s largest safety-net hospitals providing care to low-income and uninsured populations, plans to reschedule the procedures when patient volumes allow. “We are working through this as best we can, all while watching closely for a potential post-holiday COVID-19 surge,” Haupert said. “We realize this is a decision that will inconvenience our patients but is necessary under these extraordinary circumstances to keep our patients and staff safe.”

‘Ripple effect’ of unvaccinated

Phoebe Putney Memorial Hospital in Albany put elective surgeries on hold starting in August as its hospital once again filled up with unvaccinated patients made seriously ill by the highly contagious delta variant.

“Our current situation is untenable,” said Dr. Jason Williams, Phoebe Putney’s Medical Director of Perioperative Services, when he announced the change last month. “By postponing elective cases, we will free up operating room resources to best serve our community in this time of desperate need.”

Wellstar Health System said Wednesday that it’s not yet canceling procedures due to COVID but may shift some operations from its hospitals to outpatient surgery centers. Wellstar’s hospitals study their surgical schedules and staffing daily to make changes if needed, and the system anticipated that more changes may be needed in the coming days.

“As more staffed beds are allocated to COVID patients, we may need to delay certain types of non-urgent procedures, such as cosmetic, bariatric, and spine and orthopedic surgeries in order to provide staffed beds for patients undergoing essential procedures or surgeries,” Wellstar said Wednesday.

Piedmont Healthcare said its hospitals are making a range of changes to deal with the demands of the fourth COVID-19 surge. “At some locations that means pausing elective surgeries, including surgery, endoscopy, and cardiac procedures, so that we can better serve patients in our community and conserve necessary resources to care for them, while also protecting our team,” Piedmont said. “In other cases, we are postponing cases that require an overnight stay or an ICU bed. This is in direct response to the delta variant’s impact as it begins to rival past surges, locally and nationally.”

Emory Healthcare said in a statement the hospital system is postponing some elective surgeries due to an increase in patient volume driven by the COVID-19 surge. Northside Hospital did not respond by deadline to a request for comment on whether it has paused electives.

Dr. Cecil Bennett, medical director of a primary care center in Newnan and an adjunct professor at Morehouse School of Medicine’s Family Medicine Program, said there is a cost to patients when their procedures are delayed.

“When people think about electives, they think it’s something cosmetic or it’s not something you really need to do,” Bennett said. “But we could be talking about a person who may need a knee replacement and has been in severe pain, and they’ve been waiting for a long time for that surgery and now it’s going to be pushed back even longer. This could be a hernia repair surgery and you may think it’s not that big of a deal to delay it but you could have a situation where delaying the surgery leads to serious complications.”

Bennett said the crowded conditions inside the state’s hospitals are creating other challenges for patients, too. One of his patients who recently underwent surgery and was released from the hospital was suffering from symptoms that suggested a serious post-surgery sepsis.

Bennett said the patient needed IV antibiotics and pain management but was turned away at an emergency room after being given some antibiotics, not even examined. “I called multiple hospitals and only one said that maybe they could see him, but that he would likely need to wait a long time, maybe eight hours in the emergency room.”

Bennett said he was livid. ”These are the ripple effects of a population of unvaccinated people ending up in the hospital, filling up our hospitals,” he said. “And what you have are situations where people cannot get the care they need.”