Six weeks after hospitals and outpatient centers in Chattanooga suspended elective surgeries to help preserve personal protective equipment and medical facilities for a possible influx of coronavirus victims, such surgeries are resuming Friday at Chattanooga's biggest hospital and on Monday at most other local hospitals and surgery centers.
Chattanooga's hospitals, which have suffered major losses in business due to the drop in surgeries and other hospital admissions since mid March, are reopening surgical suites for non-urgent surgeries that were put off since the COVID-19 virus began infecting residents in Chattanooga. Tennessee doctors and nurses sidelined by the COVID-19 pandemic are returning to hospital surgery rooms for knee and hip replacements, exploratory surgeries, plastic surgery and other non-urgent procedures.
"There has been a certain amount of pent up demand so I think we're going to see more surgeries than normal in May and June," said Bill Taylor, founder and CEO of Physician Practice Resources, a billing and management service for about 50 local health care providers.
Tennessee Gov. Bill Lee announced Monday that he would lift the ban on elective surgeries, starting May 1, after determining that there is adequate hospital capacity and equipment to handle the expected number of COVID-19 cases and determining that hospitals can safely perform other surgeries without risks of spreading the virus.
"With the suspension of elective procedures set to expire at the end of the week, THA has worked with Tennessee hospitals and the state's Unified Command on a plan for resuming elective surgeries," said Dr. Wendy Love, the former TennCare director who now serves as CEO of the Tennessee Hospital Association (THA). "The result has been the development of guidelines for a responsible, phased restart of elective procedures that allows hospitals to approach re-entry in a manner that is most appropriate for their community."
THA reported last week that hospitals across the state are losing about $1 billion a month because of the pandemic and the loss of much of its traditional surgical business. CHI Memorial Hospital operated at only about 50% or less of its capacity during the last week of March and most of April, due in part to the deferral of elective procedures.
Pat Charles, corporate communications director for Erlanger Medical Center, said the hospital has been preparing this week to resume elective surgeries "in a very thoughtful and deliberate manner.
"Patients now undergoing elective surgeries at Erlanger will be following the same pre-screening protocols as all those entering our hospitals, with restricted visitation policies still in place in order to assure their safety and protection, as well as healthcare workers," she said.
Erlanger has a wide variety of elective surgery cases scheduled at its various campuses starting this Friday, including general surgery, orthopedics, urology, ENT and gynecology procedures. Other healthcare services postponed at the onset of the COVID-19 pandemic, such as G.I. procedures and mammograms, have also been re-scheduled and occurring in the coming weeks throughout the Erlanger Health System.
Local hospitals said they will continue to screen everyone who enters their buildings, using face masks and other personal protective equipment and restrict visitors except for unique situations, such as labor and delivery or end of life.
Chattanooga's hospitals stopped performing elective procedures after March 21 in order to preserve supplies and capacity for a possible surge in COVID-19 patients. At one point, the Army Corps of Engineers and the Tennessee Emergency Management Agency began preparing plans to possibly build a temporary 1,500 bed hospital on the former Alstom property on the Westside of downtown to house COVID-19 patients. But those plans were scrapped when there was no surge in coronavirus cases and existing hospital capacity appeared to be adequate.
This week, the Hamilton County Health Department reported that Chattanooga hospitals had 232 vacant hospital beds, including 51 intensive care unit beds, and 357 ventilators not in use. As of Thursday, Hamilton County reported 156 persons who tested positive for the COVID-19 virus, but 88 of those have recovered and most of those who are still sick with the virus are not hospitalized.
Although not urgent, many of the delayed medical procedures and surgeries are important to the health of local patients, officials said.
"As we continue to monitor the trajectory of this pandemic as well as state and federal policies, we have begun to thoughtfully re-introduce scheduled procedures and surgeries to ensure that those who have been waiting for important care have access to treatment," Parkridge Health System spokesman Michael Ferguson said. "Many people in our community have medical needs unrelated to COVID-19 that should not be ignored."
CHI Memorial is reopening its physician offices on Monday and resuming elective surgeries next week.
"As we resume surgery, patients will be screened and vetted for any potential signs or symptoms of COVID-19 or who may have exposure to others with COVID-19," Memorial Hospital spokeswoman Karen Long said. "The scheduling surgeon will evaluate each case based on surgical and medical risk, and then in consultation with our surgical review committee comprised of surgeons, anesthesia, pathology and infectious disease specialists, will guide the decision to proceed to surgery."
Contact Dave Flessner at dflessner@timesfreepress.com or 423-757-6340.