Defer or continue electives during a COVID-19 surge? 3 physicians weigh benefits of each approach

Three physicians offered their rationales for handling elective surgeries amid a COVID-19 surge in a recent case vignette published in The New England Journal of Medicine. 

The article presents the following hypothetical scenario amid a COVID-19 surge: 

  • The hospital has been at 90 percent capacity for the last week.
  • More than half of ICU beds are filled with COVID-19 patients. 
  • The hospital is using 10 percent of the hospital's ICU surge capacity.
  • Personal protective equipment supplies are limited.
  • The seven-day average for daily new COVID-19 cases in the area is 30 cases per 100,000 people. 
  • This rate has fluctuated in the last week but is still rising.
  • Nearby hospitals are facing similar capacity challenges.

Based on this information, the article asks readers to decide which of three approaches the hospital should take: Continue to schedule elective surgical procedures; defer all elective surgical procedures; or proceed with scheduled procedures but defer new cases.

The article also includes a short essay supporting each decision written by one of the following physician leaders:  

  • Craig Smith, MD, chair of the surgery department at Columbia University Irving Medical Center in New York City
  • Bradley Lembcke, MD, senior vice president and CMO of Englewood, Colo.-based Catholic Health Initiatives' Texas division 
  • Tanira B.D. Ferreira, MD, associate professor in the division of pulmonary, critical care medicine and sleep medicine at University of Miami's Miller School of Medicine

To read each leaders' rationale and vote on which approach you would take, click here.

More articles on patient flow:
10 hospitals closing departments, ending services
Ballad Health to postpone elective procedures at some Tennessee hospitals
Texas to set up makeshift hospital amid COVID-19 surge

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