Outpatient and emergency procedures are still going on as scheduled
BY CHUCK VANDENBERG
LEE COUNTY – Dr. Michael McCoy, the top doctor at Southeast Iowa Regional Medical Center, confirmed this morning that some surgeries are being postponed effective today to relieve pressure on facilities and staffing as a result of surging inpatient numbers due to COVID.
McCoy, chief of medicine at SIRMC, said only elective in-patient surgeries are being postponed effective Monday because of a reduction in the number of staffed-care beds for patients with emergency situations whether COVID-related or not.
“The emergency and outpatient, or day surgeries where patients can go home the same day, we’re still doing those, but there are a few cases that we know a patient is going to need to stay in the hospital following the surgery,” McCoy said.
“If waiting two weeks or a month might cause some pain or be a hassle, but won’t affect their overall health, those are the cases we’re delaying.
“I would say 80-90% of the surgeries, the supermajority, are outpatient. Those surgeries are still being done as normal.”
McCoy said the top reason for the change is the number of staffed beds the system has is being challenged by breakthrough COVID infections and infections from those who are not vaccinated.
“Our hospitals are full every day,” he said. “We’re trying to make sure we have staffed beds to take care of the patients that need to be in the hospital.”
During COVID, the federal government under Medicaid and Medicare were giving 3-day waivers to long-term care facilities for patients that needed some additional care following a procedure, in order to free up critical staffed-bed space.
McCoy said those waiver guidelines are changing at the state and federal level, but he said the biggest concern is that now the long-term care facilities don’t have any more skilled care beds open than the hospitals do.
He said people need to make the choice to get vaccinated to help get the viral outbreaks under control. With data being reported in different ways with different values, McCoy said people need to pay attention to the hospitalization rates, especially for pediatric patients.
He said confusion on reporting is even prevalent at the hospital level where decisions on care are very fluid and constantly changing.
“I totally get how the public must feel,” he said. “The hard part is the state was putting out data weekly, but now they are doing it twice or three times a week, but a lot of these home test kits aren’t being reported in the state’s data.” he said.
Iowa’s reporting database at coronavirus.iowa.gov has Lee County currently at an 8% positivity rate for nasal swab (PCR) and antigen testing, with PCR testing being the “gold standard” for COVID testing. However, the Centers for Disease Control, which doesn’t include antigen testing, is showing Lee County at 19.5% as of Monday at 2 p.m. The CDC tracker also shows 52% of Lee County residents with at least one vaccine dose.
LCHD officials said today that number was 48%, which is fairly close, comparatively.
But McCoy said the top three pediatric hospitals in the state are basically full and the number of pediatric ICU beds are very limited, similar now to adult cases.
“Doctors are now saying they are seeing sicker and sicker young kids. Early on you had some breakthrough infections, but now you’re seeing some of those are less mild as some of the immunities and antibodies are wearing off.”
He said he thinks the FDA will go back to offering boosters in the same way they rolled out vaccines – to the most vulnerable first. Boosters are available for those over 65 and those immuno-compromised now.
He also said supplies are running low at hospitals, including monoclonal antibodies. McCoy said the system used to be able to request those from pharmacies. Then it went to state control and now is back under federal distribution because of the reduction in supplies.
“This is a result of more people getting sicker,” he said. “But I’m going back to the number of patients hospitalized. That number has crept up and continues to creep up. We’re at 24 hospitalized right now in our three hospitals. 23 of those as of yesterday were (in Burlington). Until that number comes down and we have staffed beds to take care of those people and those who need emergent care, I’m not going to feel better until that happens.”
McCoy said people need to be careful about where they go for care. He said emergency rooms are for emergency situations, but he said data shows people are flooding emergency rooms looking for a rapid test, which is overwhelming those staffs and resources.
“Think about choosing the location of your care as carefully as you can. Emergency Rooms are for emergencies. Going there for a rapid test is just making it harder for an already-stressed staff,” he said.
He added that urgent care clinics and walk-in clinics are overwhelmed as well, so people need to be “patient patients”.
“We’ve got providers taking care of patients, especially in ERs and in hospitals, differently than they normally would because we don’t have those other choices, and you may be waiting longer,” he said. “If you sense that and are frustrated, trust me, it’s no more frustrated than we are.”