Officials to provide guidance on eligible medical facilities, priority procedures, and protocols for keeping COVID-19 at bay

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By Lilo H. Stainton

New Jersey health officials are expected today to spell out additional details of Gov. Phil Murphy’s order to allow elective surgeries to resume next week, including which medical facilities are eligible, what procedures must be prioritized and additional protocols for reducing the spread of COVID-19.

Murphy signed an executive order made public late Friday night that reversed the temporary ban he placed on elective procedures — both medical and dental — two months ago, at the onset of the major health crisis brought on by the novel coronavirus. The new order set a restart for May 26 at 5 a.m., subject to the policies pending from the state Department of Health.

“With the strain on hospital capacity and resources declining and a significant decrease in the number of patients presenting with coronavirus symptoms, we are allowing a phased-in reopening of elective surgeries beginning with urgent surgical procedures at hospitals. Safety and protection of patients and staff will be paramount,” DOH Commissioner Judy Persichilli said Friday. Facilities will need to test potential patients for COVID-19 three days in advance and any found positive would not be eligible for an operation.

Elective procedures — which have been banned in many states in response to the pandemic — were defined in New Jersey as anything that could be delayed without causing the patient undue risk. (While the order applies to both medical and dental procedures, it is not clear if the order also allows for the resumption of preventive oral health care, like teeth cleanings.) Medical procedures range from cosmetic surgeries to the operation Murphy himself underwent in New York City in early March to remove a tumor from his kidney that turned out to be cancerous — just days before it would have been delayed under a similar suspension in that state.

New York state is now phasing this work back in, with about two-thirds of the counties now permitting elective surgeries; Pennsylvania allowed elective procedures to resume earlier this month.

Delaying care for serious health conditions

Health care providers have also grown concerned by a stark decline in traditional emergency cases, like heart attacks and strokes. Individuals appear to be delaying care when they notice symptoms out of fear of contracting the virus if they go to the hospital and in many cases are in greater medical distress when they do seek care, experts note.

The situation prompted Persichilli and Cathy Bennett, president and CEO of the New Jersey Hospital Association, to produce a public service announcement encouraging people not to avoid treatment. On Friday, Bennett — who previously served as state health commissioner — praised Murphy’s decision and stressed that hospitals are safe and ready to provide care.

“Gov. Murphy’s action today is necessary for the health of the people of our state. People awaiting a scheduled surgery, or living with pain or chronic conditions, or in need of a procedure to diagnose an illness, have been in limbo for eight weeks,” Bennett said in a release.

“It is essential that New Jersey residents receive medically necessary care before their conditions grow worse,” she added. “The COVID-19 crisis will be compounded if we have ongoing harm to people’s health and well-being by delays in needed care.”

The suspension has also had an enormous impact on the balance sheet of New Jersey’s 71 acute-care hospitals and hundreds of ambulatory surgical centers, which were largely shuttered under the state order. Persichilli, a nurse and former hospital administrator, said weeks ago that hospitals seek to generate roughly half their revenue from these procedures and acknowledged that facilities are losing tens if not hundreds of millions of dollars during the pandemic. (Hospitals have been granted $723 million in federal stimulus money so far to help offset some of these losses.)

Murphy’s order was also welcome news to Brian Finestein, president and CEO of Saint Clare’s Health, a network of community hospitals based in Morris County and owned by Prime Healthcare Services, which operates facilities in more than a dozen states. “It is vital for not only our patients but our organizations to resume surgical cases that many have put off during this pandemic,” he said. “I am hopeful these actions by the governor will be the impetus for people to seek out necessary treatment.”

Mid-April peak for COVID-19

With COVID-19 cases rising quickly earlier this year, Murphy decided it was necessary to suspend these procedures — starting March 27 — to ensure there were sufficient staff, equipment and supplies to care for those infected by the coronavirus. The impact of the virus continued to climb for several weeks but peaked in mid-April. On Friday, Murphy pointed to a marked decline in hospitalizations for COVID-19 and other positive trends and said it means elective surgeries “can be reasonably resumed.”

More than 146,000 New Jerseyans have tested positive for COVID-19, including nearly 10,400 who have died. Just over 3,400 patients were hospitalized with the disease, and there were around 1,000 in critical care and some 800 on ventilators —  these figures are all roughly half what they were in  mid-April, when the impact of the virus peaked on the statewide health care system.

“Our collective efforts to flatten the curve in New Jersey has alleviated the crisis burden on our health care systems and hospitals across the state,” Murphy said, the same day he announced plans to allow municipalities to reopen beaches in the coming weeks.

“While still focusing on the importance of our COVID-19 response, our health care systems now have the capacity and resources to resume the critical role of serving their patients and ensuring the health of our communities,” the governor added.

Header: Photo by Paul Felberbauer on Unsplash