Hospitals Cut Back On Elective Surgery Amid Coronavirus Surge

CHICAGO — Hospital administrators in the Chicago area are reducing non-emergency and elective procedures, re-implementing strict limits on visitors and expanding surge capacity to confront rising numbers of coronavirus patients.

Advocate Aurora Health Monday announced plans to postpone half of the elective surgeries it had scheduled to ensure it has sufficient staff and capacity to handle increasing numbers of new COVID-19 hospitalizations at its hospitals in Illinois and Wisconsin.

Out of the 5,581 hospitalized COVID-19 patients across Illinois Monday, 655 of them were in Advocate's 10 hospitals in the state.

"We will be looking at broad-scale, across our system, reducing admissions — those procedures or elective surgeries that would result in even a short hospital stay — by 50 percent," Dr. Jeff Bahr, chief Aurora Medical Group officer, said at a news conference Monday.

Meanwhile, NorthShore University HealthSystem has converted Glenbrook Hospital in Glenview to a primary hospital for coronavirus patients and is evaluating all elective procedures on "a case-by-case basis." Northwestern Medicine has reportedly increased its capacity and put strict limits on visitors in place at its hospitals in Chicago and Lake Forest. Vista Health in Waukegan has also restricted visits. On Monday, all four hospital groups issued a joint statement warning that the north suburban region was due for increased restrictions on gatherings.

"As healthcare providers, we know how deadly this virus is and how serious the situation has become. We also know that without immediate action, it could become much worse," it said. "Please take preventative precautions like getting a flu shot and reconsidering plans that may put you and your family at increased risk."

Dr. Robert Citronberg, executive medical director of infectious disease and prevention for Advocate Aurora Health, said Thanksgiving dinners have the potential to be "superspreader" events.

"The numbers are devastating right now, our health care system cannot absorb doubling or tripling of those numbers that might happen if we have many superspreader events arising out of Thanksgiving," Citronberg told reporters. "The next two to three months are going to be very difficult. Lots of hospitalizations, lots of deaths, unfortunately. We just need one more big push to get through it."

Citronberg said it is likely that the pandemic will be in the rear-view mirror within months. He advised the public to take a "mulligan" on the 2020 holiday season and look forward to next year — or risk the unimaginable.

"Even if we don't have a surge after Thanksgiving it's still going to be very taxing on our health care system — the sheer number of people that are infected. If Thanksgiving turns out to be superspreader events, if Christmas turns out to be superspreader events, we're going to see numbers that we couldn't even possibly imagine," he added.

"So [I'm] pretty confident, unfortunately, that the next couple of months are going to be bad no matter what, it's just a question of how bad."

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RELATED: COVID-19 Hospitalizations In Illinois Reach All-Time High

Across NorthShore's five-hospital system, most units were above 90 percent full, according to spokesperson Colette Urban. She said all five hospitals still have surgical and ICU bed capacity for both COVID-19 and non-COVID-19 patients.

On Friday, Evanston Hospital President Doug Silverstein told Evanston's COVID-19 task force that elective surgeries had been temporarily suspended, with in-patient beds filled for the prior eight days, according to city staff.

As of Tuesday morning, Glenbrook Hospital had 132 COVID-positive patients, while Evanston Hospital had 10. There were 19 coronavirus patients in intensive care units, mostly at Glenbrook, Urban said in an email.

Glenbrook has a total of 21 ICU beds and 152 surgical beds, according to the Illinois Department of Public Health.

Urban said all emergency and urgent procedures will continue as planned. In the past week, she said, volume at the hospital group's emergency rooms is down by about 19 percent.

"NorthShore has manageable staffing resources system-wide and is integrating our Labor Pool strategies to provide clinical and non-clinical assistance where needed," Urban said.

Putting off elective surgeries and medical procedures can hurt patients' health and leave hospitals with significant revenue shortfalls. Many hospital systems rely on elective surgeries to make money, and because the spring's suspension of elective surgeries was costly, hospital administrators are expected to continue performing them as long as possible.

Limits on elective surgeries were removed from the Tier 3 of the "menu of mitigation options" included in Gov. J.B. Pritzker's regional Restore Illinois coronavirus plan Tuesday — the same day the governor announced Tier 3 would apply to the entire state.

RELATED: Entire State Moving To Tier 3: 'This Is Not A Stay-At-Home Order'

Mary Beth Kingston, chief nursing officer at Advocate Aurora, said Advocate is redeploying staff from within the system, as well as calling in travel nurses, mobilizing medical students and training volunteers to assist.

"From my perspective, the most important thing everyone can do to support our efforts and keep everyone safe, including our team members who are essential is to follow the guidelines," Kingston said at Monday's news conference. "Masks. Distancing. Handwashing. Avoiding large gatherings."

Kingston said the hospital group is offering accommodations and support to its health care workers who are choosing not to go home to avoid the risk of infecting family or household members. She suggested the current surge could result from a kind of pandemic fatigue among members of the public.

"People thought this was going to be over and done with, and they had this feeling that things were letting up," she said. "Now that we see resurgence in this way, they're tired of the way their life has changed, and I think that behavior issue is a prime contributor."

Denial is also a factor, Bahr said. According to the chief medical officer, people tell themselves it affects someone else, whether they be less healthy, older or from another region, rather than taking on the shared social responsibility for each other's neighbors, families and friends.

"I think we need to get our minds around the fact that this is going to take all of us to get through it — not just somebody else's problem," Bahr said.

"One of the cruelties of the pandemic has been the experience of the front-line clinical team member taking care of patients in the throes of the disease, dying. And then these same team members are going to their homes, their communities and interacting with friends, family members, other individuals who don't believe the pandemic is a serious threat," he said. "So that dichotomy of experiences is extremely taxing on the psyche of our clinical employees."