29 Apr Virginia to Resume Elective Surgery
Elective surgery may resume in Virginia. I practice in northern Virginia and have only operated on emergencies for the last month. My patients with non-emergent surgical problems had to cancel or reschedule surgery due to the pandemic.
As recommended by the American Academy of Ophthalmology and the Centers for Disease Control and Prevention, we have not been performing elective eye surgery since the beginning of March due to the pandemic. Cancellation of elective surgery of all kinds was enforced to spare hospital resources and limit uninfected patients’ and staffs’ exposure to the virus.
Late last week, Virginia Governor Northam announced that elective surgical cases could start again May 1, 2020. While the ban was originally set to expire April 24, 2020, Northam extended the ban an additional week citing the need to carefully assess each hospital’s ability to care for non-COVID-19 patients and to provide sufficient PPE (personal protective equipment) for patients and healthcare workers.
What Are Elective Cases?
Elective surgery is not to be confused with “optional” surgery. Cosmetic surgery (face lift, breast augmentation) can be considered both optional and elective.
Elective surgery should be renamed “non-emergency” surgery, where the surgery is necessary, but can be scheduled in advance. Cataract surgery is a great example of elective surgery.
As a retina specialist, I do not perform cataract surgery, but there are still elective eye surgeries. Elective retina surgery includes:
- Epiretinal membranes (macular pucker)
- Macular holes
- Removal of opacities
Emergency surgery, on the other hand, might include surgery to repair a retinal detachment, that is, if we wait too long, the prognosis gets worse.
Redistribution of Resources
In Virginia, the actual patients needing critical care and hospitalization, according to the state authorities, has started to level off though local infection numbers continue to rise.
Hospitals with ample resources (staff and PPE) may start to schedule elective cases. If we are able to successfully take care of these additional patients without compromising our capabilities, we will continue to expand our services.
What Does this Mean?
Restarting elective procedures does NOT mean we have returned to normal. Social distancing and other mitigation must continue as we are increasing exposure and person to person contact by providing elective surgical care.
Taking care of patients who need elective surgery, for example, cataract surgery and hip replacement surgery, is just the first step to slowly redistribute our healthcare resources and is a tiny step towards “normal.” It’s a test of each hospital’s infrastructure.
Scheduling elective surgery also means that our offices will be soon opening…our patients considering elective surgery need pre-operative and post-operative care.
If you are anticipating elective surgery, call your doctor. This is not a national mandate, but the return to elective surgery will be decided by each state, or in some cases, by the city mayor.