Abbott halts elective surgeries amid concerned health officials’ call for autonomy

EDINBURG — In response to the coronavirus pandemic, Gov. Greg Abbott issued a proclamation Tuesday suspending unnecessary medical procedures in Hidalgo, Cameron, Nueces and Webb counties, a move that contradicts opinions expressed by several high-ranking hospital CEOs at a news conference held Monday.

Abbott said the measure was an attempt to ensure hospital bed availability.

“As these counties experience a surge in COVID-19 cases and hospitalizations, we are committed to working alongside hospitals to help ensure that every COVID-19 patient who needs a bed will have access to one,” Abbott said in a news release Tuesday. “We are constantly monitoring the data at the local level and will continue to take precautionary action where it is necessary. I want to remind all Texans that each of us have a responsibility to help slow the spread of this virus, and I urge everyone to wear a mask, wash their hands regularly, practice social distancing, and stay home if possible.”

Hospitalization rates in Hidalgo County have continued to soar. As of Tuesday evening, the county reported 274 people hospitalized with complications from the virus, 19 of whom are being treated in intensive care units.

The administrators at Monday’s press conference acknowledged that those cases were spreading staff and supplies thin, particularly with regard to staffing, but none of them advocated for halting elective surgeries.

Speaking Monday, Rio Grande Regional Hospital CEO Cris Rivera said that it was important for hospitals to establish processes to determine whether elective surgeries need to be done.

“We need to be allowed to have that autonomy in order for each of us to be able to make those decisions,” she said.

According to Rivera, those processes were in place at Rio Grande Regional. She described a surgical advisory group that contained several of the institution’s highest-ranking doctors and met daily to determine whether elective surgery was necessary or not.

“Those individuals know what is best for their patients, and we assess whether that patient’s condition can hold off and do that surgery at a later date or if it’s something that needs to be done…” she said.

Rio Grande Regional responded to a request for comment on the governor’s proclamation in an email Tuesday afternoon.

“We have well established protocols in place to care for patients with infectious diseases. Our responsibility during this pandemic includes balancing our readiness to care for patients with COVID-19 while continuing to make sure the many other patients who depend on our hospitals receive needed and timely care,” the email read. “After reviewing the order and the implications to our patients, it is important to know that at this time our hospital has the bed capacity, supplies and equipment we need to continue serving patients, meeting the requirements under Governor Abbott’s executive order. Beyond our hospital, we have a freestanding surgery center, which also factors into our decision to schedule a surgery.”

Several of the administrators at Monday’s news conference said that elective surgeries can often be important, even life-saving in the long run.

“We need to be able to deliver regular health care. I mean, strokes, heart attacks, cancers that have had to wait when there’s been complete bans on procedures,” DHR Chief Medical Officer Robert Martinez said Monday. “That’s a real risk, because all of the concomitant diseases that we see, diabetes, hypertension, heart disease, those have endpoints and they come, and we need to be able to deal with those endpoints. And so sometimes it may not be an emergency, but it’s very, very urgent that that patient have that procedure, and it can save a life or determine your five-year mortality rate.”

Lance Ames, South Texas Health Systems CEO, echoed those sentiments Monday, saying that resources for elective surgeries aren’t necessarily the same resources needed in emergency rooms.

“We’ve been focusing on still being able to provide those elective procedures for conditions that are still urgent and that are needed. When you look at the resources that are required for elective surgeries, or for just surgeries in general, it is different than what we need in the ERs and in the in-patient medical telemetry units,” he said.

According to Ames, halting elective surgeries likely won’t be the silver bullet for the staffing shortages being faced by Valley hospitals. He said that in many cases, healthcare workers aren’t cross-trained for other jobs. Operating room nurses, Ames said, aren’t necessarily trained to work in the emergency room.

“Allowing them to maintain their function for the community is actually a great benefit for everyone, and so far with the PPE we’ve had sufficient PPE to continue with those surgeries and maintain them at this point, as well as our ER and medical services,” he said.

Ames oversees McAllen Medical Center, which recently dedicated an entire wing, 36 new beds, to treating COVID-19 patients.

Manny Vela, CEO for Valley Baptist Health System, said Monday that many local hospitals have expanded their capacity to care for patients infected with the coronavirus, referencing the governor’s expectation that hospitals reserve 15% of their beds for COVID-19 cases.

“In regards to the 15% carve out, I’ve been on calls with this group. I’ve been on calls with a group from Cameron County, and I can tell you we’ve not seen that as some kind of a ceiling,” he said. “People in this room, people in Cameron County, have opened new wings, have created new COVID beds to try to meet the demand…”

mwilson@themonitor.com