Lourdes, General postponing elective procedures

UPDATE: On March 21, the Louisiana Department of Health issued an update to the March 18 directive noted in this story. All non-emergency or elective procedures are now postponed until "further notice."

The gist: Both Our Lady of Lourdes and Lafayette General were still doing elective surgeries this week, despite widespread concerns about pending equipment, supply and bed shortages and the potential for spreading the coronavirus from asymptomatic patients to health care providers. 

The state ended that yesterday. In an updated notice to all of the state’s health care facilities, the Department of Health said it was “directing and requiring” hospitals to use their judgment in determining which medical procedures can be safely postponed for 30 days. The state gave the hospitals one day to implement the directive. Elective procedures can include everything from scans to hip replacements and plastic surgery. We’re not talking here about removing cancerous tumors or replacing faulty heart valves. 

Dire warning from the governor. On Thursday, Gov. John Bel Edwards warned that the state’s hospitals could be over capacity in the next seven to 10 days, according to worst-case scenario modeling. 

LDH’s notice came on the heels of sweeping calls all week from various members of the Trump Administration’s coronavirus task force to curtail elective procedures, along with guidelines Tuesday from the American College of Surgeons about how to implement changes

Both hospitals confirmed they are abiding by the state’s requirement. “Our Lady of Lourdes is postponing surgeries for 30 days for patients who the physician believes it is safe to postpone,” said Dr. Matt Boudreaux, chief of surgery at Lourdes, in a statement. “With collaboration by our surgeons and health system COVID-19 physician leadership, we are putting processes in place to comply with this rule effective immediately.” 

Lourdes is asking patients with scheduled surgeries to contact their surgeon’s office to discuss whether their procedure will be postponed.

Lafayette General said its physicians “will work directly with their patients to determine whether or not a surgery or procedure is emergent or elective.”

Both hospitals had confirmed earlier this week that they had not instituted a system-wide canceling or postponing of elective procedures. 

Spokeswoman Patricia Parks Thompson said Tuesday that Lafayette General was taking its cues from New Orleans-based Ochsner Health System (in September the two entities announced their plans to merge), calling it “a very fluid situation” at the time.

Some employees question the wisdom in waiting. “Don’t put me in a position where I might be exposed when I don’t have to be,” one employee who asked not to be identified by hospital or name told me earlier this week. The employee, who thinks the rescheduling process should have started weeks ago to conserve personal protective equipment, said health care workers have been particularly concerned about treating patients who may be positive for coronavirus and not showing symptoms. “I should not be doing elective cases, especially ENT or dental,” the employee said, “anything involving the mouth.” 

Patients and docs took matters into their own hands. Thompson said patients and doctors were free to make their own decisions and had already been canceling and/or postponing elective procedures.