Stopping Elective Cases

[GassYous]

Same with us. We just need to tough it out. Omicron, with its more contagiousness and less deadliness, is a godsend at this point. Once everyone has seen it, these ‘brownouts’ in health care won’t be an issue anymore. between the vaccine, monoclonals, paxlovid, molnupiravir, along with fluvoxamine, the vast majority of us will do just fine as we march toward endemic status.

Weird how people keep talking about the virus becoming endemic and how we have to live with it but it's been over two years and it still hasn't happened

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[Status Sciaticus]

Still going strong with elective cases, albeit with decreased volume. A-Fib ablations, EGDs, Colonoscopies, Gastric sleeves/bands, total joints, spines. This is an academic center with a large residency program with half of the anesthesia department who is out with COVID. Seems legit

 

[chocomorsel]

This is only true if we don’t spin off some other mutant variant in the process that combines delta virulence with omicron contagiousness and evasiveness. Giving the virus maximum mutational opportunity is not a godsend.

Michael Crichton 2.0 anyone?

 

[dpmd]

Weird how people keep talking about the virus becoming endemic and how we have to live with it but it's been over two years and it still hasn't happened

Actually some have been proclaiming it is already endemic despite the continued surges.

 

[DrZzZz]

We've seen a huge spike, almost doubled our inpatients since Christmas. Now about 2/3 of the way to our all time peak a year ago. We've had a bunch of recent cancellations purely because more people are testing positive prior to their elective cases. And the hospital is now once again talking about OR slowdowns, though it hasn't yet kicked in.

 

[jwk]

Still going strong with elective cases, albeit with decreased volume. A-Fib ablations, EGDs, Colonoscopies, Gastric sleeves/bands, total joints, spines. This is an academic center with a large residency program with half of the anesthesia department who is out with COVID. Seems legit

We're still business as usual with absolutely no discussions about discontinuing elective cases of any sort. I think the staff shortages we have are balanced out by having fewer cases because of 1) Covid surge and 2) it's JANUARY!

 

[Guillemot]

We are not running at full capacity in the OR due to staffing shortages and COVID.

May as well proceed with elective stuff as logistics permit IMO. There is no clear end in sight to the pandemic & at this point the vast majority of COVID hospitalizations are also elective.

 

[PTPoeny]

We started cancelling certain cases even before the COVID surge because of the blood shortage. There was one day we had 5 units of platelets in the blood bank for two hospitals. Led to some interesting discussions regarding priority between CICU and heme/once...

 

[dpmd]

We started cancelling certain cases even before the COVID surge because of the blood shortage. There was one day we had 5 units of platelets in the blood bank for two hospitals. Led to some interesting discussions regarding priority between CICU and heme/once...

I tried to prevent a cirrhotic patient bleeding from portal hypertensive gastropathy and too unstable to move anywhere for tips or transplant from using up precious blood supplies (she was on three pressors and had a pH of 6.9 when I had the discussion with family recommending comfort care) but sadly they did not go for it. So we wasted a few units of platelets and a lot of ffp and prbcs because the patient was stubborn enough to not code for a few days (I think maybe she wanted to wait until after Christmas)

 

[ethilo]

We are a level 2 trauma center. Currently our PACU and pre-op holding areas are converted to inpatient wards. We are only doing urgent/emergent cases. Our ambulatory centers are moving along with business as usual however COVID test turnaround times are much longer than before.

 

[Twiggidy]

The testing bottleneck is bothering me the most. A month ago I was able to drive right up to a testing site and get a test with no wait. A friend of mine a couple days ago had to wait 4 hours and he was able to get the last test in the facility.

 

[GravelRider]

We haven’t stopped electives yet, but I think some surgeons see the writing on the wall. Staffing is an issue as a lot of OR staff is out sick. We’re running less rooms later in the day. There are some other ominous signs, though. A couple weeks ago we would get the occasional asymptomatic person that incidentally tested positive. Then it was someone who had a known exposure. Then it was people with some mild symptoms. Now it seems like every single patient is testing positive and is at least moderately symptomatic with fever and productive cough. I’ve noticed a lot more “rapid responses” called overhead the past few days as well. I would be surprised if we don’t get an official OR slowdown in the next week or two. I doubt we will be talking about running out of ventilators, but with the sheer numbers that are getting sick, a significant proportion of them will need acute care.

 

[DoctwoB]

I’m in a super high Vax rate area, so admissions and ICU have barely budged (also early in our omicron peak). Bigger issue by far is OR staff, was running tight at baseline and already getting a decent number off for COVID.

 

[nimbus]

New York is also a high vac area. What’s coming down the pike.

 

[<(^_^)>]

New York is also a high vac area. What’s coming down the pike.






View attachment 347863

And for reference there are roughly 250 beds per 100k people, so if everyone were unvaccinated you would only need literally a couple of days at 70 per 100k to cause >50% of beds to be occupied by covid patients.