HOST INTRO (LAUREN PEACE): Starting next week, elective surgeries will be allowed to resume in hospitals in the state of New York. Many patients with issues - from rashes to sprained ankles to cancer have been waiting weeks for treatment. Dr. Adrian Diaz is a research fellow at the Institute for Healthcare Policy and innovation at the University of Michigan. I asked him how hospitals are prioritizing when COVID-19 is still a risk for patients and staff. And, what elective procedures are?
ADRIAN DIAZ: Yeah, so it's something that to be completely frank with you, we hadn't really thought much about in the surgical literature. So, you know, I think that historically, we really thought of elective as anything that was not an emergency. So anything that was not a trauma or anything that was not,, life or limb critical. But what this pandemic has really caused us to think hard about is that there are some procedures that we historically used to consider as elective, for example, any operation for a cancer. But we know that, you know, for certain diseases like cancer time is of an essence.
PEACE: Yeah. And so when the decision was made to cancel elective surgeries, was that a decision that was made because the thought was that doctors who were doing these surgeries would have to shift their focus and aid with Coronavirus treatment? Or was it more that they were worried about the risk factors of having already compromised patients coming in to a hospital where this highly contagious disease existed?
DIAZ: We certainly were concerned at many hospitals about workforce so we we knew that, you know, many surgeons were likely going to be asked to to cover some shifts in ICU’s
But the other concern was also that we weren't going to have enough personal protective equipment. This is things like and N95 masks that we heard a lot about in the media as well as surgical gowns, eye protection, etc. These are all equipment that are not only used in ICU where we're treating patients with Coronavirus, but also in the operating rooms.
And then, you know, the third component to that that was obviously exposing uninfected patients to, to a healthcare environment where we knew there was patients who were infected. And we know that there's a number of asymptomatic carriers.
PEACE: As we resume elective surgeries in New York City in New York state what sort of decisions are going to be made about prioritizing which types of surgeries take place?
DIAZ: Yeah, it's a it's an excellent question. And and I think the the answer is going you know, come down to local resources, local disease burden, both from COVID. And as well as how many surgeries have essentially been postponed.
The other thing that I think a lot of hospitals have to take into account is their supply. It's not just not having any COVID cases, but it's also having the the surgical equipment, the personal protective equipment available so that your staff is feels protected and they are protected against being exposed to potentially an asymptomatic patient.
And then finally, there, there's certainly some ethical implications to consider, we we are bringing you into to a healthcare environment where we were not certain if we may be exposing you to some asymptomatic carriers of Coronavirus and we we don't have all the information available at the time to to realistically say that 100% certain that you may not contract the Coronavirus in the healthcare facility.
PEACE: So that was Dr. Adrian Diaz, a research fellow at the Institute for Healthcare Policy and innovation at the University of Michigan and a general surgery resident at Ohio State University. Adrian, thank you so much for speaking with me today.
DIAZ: Thank you for making the time to talk about these really important issues.
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