Overwhelmed by latest surge, hospitals again delay elective surgeries

Registered nurse Emily Hiatt checks on a patient in the COVID ICU of Franciscan Health’s Indianapolis hospital. (IBJ photo/Eric Learned)

Hospitals across Indiana are once again delaying elective surgeries and procedures, and some warn they are operating near full capacity due to the latest COVID-19 surge.

Indiana University Health, the state’s largest hospital system, said it has delayed thousands of elective surgeries in recent weeks, although it is continuing to take urgent and emergency cases.

“People are in line to get surgery who can’t be operated on right now because of our COVID numbers, and our record-high census as well,” Dr. Paul Calkins, associate chief medical executive, said during a press briefing Thursday afternoon.

The latest surge of patients is beginning to overwhelm IU Health’s doctors, nurses and other members of the patient-care team. On Thursday morning, the hospital system said it had enlisted the Indiana National Guard to help.

“Our people are incredibly tired,” Calkins said. “We were watching the numbers go down, and to have them turn back around and start going up again is just about the most disheartening thing I can imagine. People are really, really, really tired of this. You can only do this so long before it just becomes draining.”

The Indiana Hospital Association said hospitals across the state have been delaying non-urgent procedures for some time, but that has “increased significantly due to the surge.” Spokeswoman Laura McCaffrey said all hospitals are prioritizing the most medically urgent procedures and are evaluating capacity daily, “and in some cases, even hour by hour.”

Dr. Christopher Weaver, IU Health’s chief clinical officer, said most of the COVID-19 patients are unvaccinated, although up to 20% are vaccinated, including some who are now in the intensive care unit.

“It’s really hard work, taking care of a whole lot of people right now,” Weaver said. “It’s a big emotional strain to take care of people who are really, really sick, many of whom are dying.”

Eskenazi Health is delaying elective procedures through mid-January, “so people can plan around it, rather than hearing about it week to week,” said Dr. David Crabb, chief medical officer.

He said the hospital, which has 327 beds, had 376 inpatients on Monday, about 50 of them with COVID-19. The hospital has created other temporary sites for patients while waiting for beds to open on the nursing floors, including in clinical areas and in the emergency room.

Franciscan Health said it has begun using a priority scoring system to determine which cases are safe to defer and which need to proceed as soon as possible.

“This approach allows us to match our caseload, both inpatients and outpatients, with available beds and staff on a daily basis,” Franciscan said in a statement on Thursday.

Since mid-November, the number of COVID hospitalizations at Franciscan’s main campus on the south side has increased nearly threefold from the low 20s to the mid-60s. The system’s Mooresville hospital has set new records in the past few days with more than 20 COVID inpatients, many of whom are critically ill.

Community Health Network said it is determining on a day-to-day basis whether it needs to reschedule elective surgeries to make sure all patients who need them have beds available to them. It did not say how many surgeries it has delayed.

“We monitor staffing and are working with staff to make sure they don’t face burnout,” the system said in a statement.

Reid Health, based in Richmond, said Wednesday it has paused all elective inpatient surgeries and that it remains on “critical bed status.” It said all scheduled surgeries will be reviewed for urgency, and the surgeon’s office will reach out to those patients who need to be rescheduled.

A spokeswoman for Ascension St. Vincent said Thursday that none of its Indiana hospitals were delaying surgeries at present.

IU Health said its emergency rooms are backing up, as many of the 16 hospitals in its system are filling to capacity because there are no spare rooms or beds in the nursing units.

Hospital officials are trying to get people through the system and discharged to free up beds, Calkins said.

On Wednesday, the system was caring for more than 440 COVID-19 patients. Based on the rate that cases are climbing, it predicted it could have 575 COVID-19 patients by the end of the year. That would surpass the system’s census peak of 517 COVID patients on Dec. 14 of last year.

In the meantime, IU Health, like many other hospitals, is trying to cope with a severe nursing shortage, as nurses quit, retire or take new assignments. The system has spent millions of dollars hiring short-term “traveling nurses” to fill in but is concerned the latest surge will take its toll.

“One of the huge problems we’re concerned about is whether this is going to lead to more staff losses,” Calkins said, “because people just get to the end of their rope.”

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27 thoughts on “Overwhelmed by latest surge, hospitals again delay elective surgeries

  1. Let me change some words to see if this resonates with some of the unvaccinated:

    Dr. Christopher Weaver, IU Health’s chief clinical officer, said most of the car crash patients weren’t wearing their seatbelts, although up to 20% of them were wearing seatbelts, including some who are now in the intensive care unit.

    Now, would you stop using your seatbelt because there’s a 20% chance you still might end up in the hospital?

    GET. THE. VACCINE.

    1. As in, maybe 20% of the people hospitalized with COVID were vaccinated – but the CHANCE of getting COVID (or into a car crash) to begin with is much lower with the vaccine.

      Seatbelts don’t prevent accidents, but the COVID vaccine can prevent infections.

    2. WHY. DO. YOU. CARE. WHAT. OTHERS. DO. ???

      Besides, what a false comparison. Your chances of needing a hospital if you are in accident w/o a seat belt are faaaaaar higher than needing a hospital if you get COVID (vaxxed or unvaxxed)!!!!!

    3. M.G. See the head line. This means that benign tumor that uncle harold has, that only makes it uncomfortable for him to do what he wants, get delayed.

      This also means that the nurse that treats you for a heart attack might have already worked a double shift. Do you want a stressed and tired caregiver that just worked a double shift administering medicine that could kill you if they get it wrong.

      Real people suffer the consequences of an overloaded heath system when the solution is so simple. Get vaccinated.

    4. MG, I do care what other people do because I work in a hospital and do have to deal with people like you that don’t make the wise decision to worry about how their behavior actually DOES impact other people!

  2. Auto insurers increase premiums for high-risk individuals. They sometimes cancel coverage for high-risk drivers or those with lengthy claim records. Can health care insurers institute a policy that will exclude coverage to those that are not vaccinated if they become ill with COVID and require medical care? It’s all about risk management, and the costs associated with managing the risks. We would all be better served if we removed the emotions and politics from the vaccination issue and treat it like any other situation, as a business matter that prices products according to risk factors. Show up at the hospital needing medical care without being vaccinated, and put up a bond or prepay for services in order to be admitted. For anything. No vaccination, no coverage. This is not a mandate. It’s each individuals choice to qualify for insurance coverage.

    1. And for the flu vaccine and on and on – every treatment and/or vaccine for everything out there – you cannot be insured unless you take them all. Sure.

    2. Mark, some companies have already started passing those costs on to their unvaccinated workers.

      And it’s 100% legal.

    3. Fortunately, Obamacare prevents health insurers from denying coverage or charging different rates – a program I am sure many anti-vaxxers despise. However, businesses, many of whom are self insured, can force employees to pay a greater share of their company subsidized health insurance or they can just fire them since at-will employment laws pretty much allow companies to let you go for any reason, or no reason at all, except for race, religion, gender, or age. Businesses free from government constraint or regulation, something I am sure many anti-vaxxers support strongly.

  3. WHY. DO. YOU. CARE. WHAT. OTHERS. DO. ???

    Besides, what a false comparison. Your chances of needing a hospital if you are in accident w/o a seat belt are faaaaaar higher than needing a hospital if you get COVID (vaxxed or unvaxxed)!!!!!

    1. M.G. If hospitals were overloaded with crash victims because suddenly it was patriotic to NOT wear a seatbelt, we would be having this same conversation.

      See the head line. This means that benign tumor that uncle harold has, that only makes it uncomfortable for him to do what he wants, get delayed.

      This also means that the nurse that treats you for a heart attack might have already worked a double shift. Do you want a stressed and tired caregiver that just worked a double shift administering medicine that could kill you if they get it wrong.

      Real people suffer the consequences of an overloaded heath system when the solution is so simple. Get vaccinated.

  4. Put the unvaccinated to the back of the line. Love to know how many of these politicians who are prattling on about no vaccine mandates and my body my choice, chose to get the vaccine as soon as it was available.

    1. That would be most all of them. Even Trump got the vaccine, but he refuses to encourage people to take the fruit of his greatest accomplishment in office because he’d rather have their adulation. So he lies to them and tells them what they want to hear, not what they need to hear.

      How messed up is that?

    2. Well, Donald actually did tell a crowd once a few months ago that they needed to get vaccinated and they all booed & hissed at him. I remember seeing it on TV. Here’s the online references (take your pick): https://www.google.com/search?channel=nus5&q=trump+tells+a+crowd+to+get+vaccinated
      .
      That said, I have no doubt that if Trump had won (legitimately) in 2020, he would have been the Covid vaccine poster child and made anyone who didn’t get vaccinated feel like a 2nd class citizen.

    3. It would be fascinating given how his base voters are the ones refusing to get vaccinated or take the antibody treatments.

      If anything, the current Republican strategy is all about making sure their unvaccinated base voters can’t be made second class citizens. No vaccine mandates, no passports, no masks. The snowflakes must be protected at all costs.

  5. My spouse just found out that he needs bypass surgery, asap. His dr does NOT want to wait until Jan. His surgeon is at Methodist Hospital, part of IU Hospitals. If he can’t get a bed due to unvaxxed “Covidiots”, kick them out. We are triple vaxxed…

    1. If I needed bypass surgery, and my doctor had to delay it due to Covid restrictions it their hospital I would definitely find a great heart surgeon at a hospital without Covid restrictions. There are too many great heart surgeons. I would not hesitate. Prayers for your husband.

  6. M G. Sayeth:

    WHY. DO. YOU. CARE. WHAT. OTHERS. DO. ???

    ======================================

    It’s not what you do that we care – it’s what you DON’T do which matters.

    Where do you think the variants come from? Right now, we don’t know for certain that a vaccinated person can’t create a variant. But YOU, unvaccinated, stand the risk of creating a variant…potentially a variant which is highly contagious AND virulent…potentially nasty enough that current vaccines which seem to be doing a good job would end up being as though no one received a vaccine — it could be as if something worse than the Delphi variant were as contagious as the common cold.

    If your lacking as a human being would only affect you, I’d have no qualms about saying, “you’re only hurting yourself and anyone else you infect, not to mention you’d be selfish by getting a hospital bed when someone else is more deserving of it”.

  7. I’d appreciate local health reporters getting quotes or soundbites from hospitalized, unvaccinated Covid patients, and/or their family members, about how they feel taking hospital resources from cancer patients who are worried about their upcoming surgeries being postponed. The choices of most hospitalized Covid patients are resulting in very real consequences for others. I’d appreciate knowing what’s going through their minds.

  8. Bad time to do anything that would put any obstacle in the way of getting vaccinated. From Becker’s Hospital Review 12/10/21:

    Six states in the Midwest and East Coast account for more than half of the nation’s total COVID-19 hospitalizations confirmed in recent weeks, NBC News reported Dec. 7.

    Federal data shows 35 states and the District of Columbia have seen hospitalization rates increase in the last two weeks.

    Michigan, Ohio, Indiana, Pennsylvania, New York and Illinois are mostly driving this increase. These states make up 35 percent of the population among states with increasing hospitalizations, but comprise 60 percent of new hospital beds filled between Nov. 10 and Dec. 5, according to an NBC News analysis of HHS data. Michigan topped the list, accounting for 13.2 percent of new hospitalizations over this time period.

    As of Dec. 5, the nation’s seven-day hospitalization average was 7,176, a 14.6 percent increase from the previous week’s average of 6,260, CDC data shows.

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