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Ducey: Elective surgeries could be back on table shortly

From the April's Tucson-area coronavirus coverage: 1,200+ Pima County cases, stay-home order extended series
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PHOENIX — Gov. Doug Ducey said Wednesday that he is looking to restore the ability of Arizona hospitals — which are reporting financial losses of 30% to 40% a month — to again do elective surgeries.

Ducey said he issued his directive last month halting elective surgeries to ensure there is an adequate supply of personal protective equipment — masks, gowns and gloves — to handle what is expected to be a surge in the number of people hospitalized with COVID-19.

That peak is not expected until the end of this month, and possibly into May.

But in the meantime, hospitals are hemorrhaging money because they have lost that business, said Holly Ward, spokeswoman for the Arizona Hospital and Healthcare Association.

She said there needs to be financial relief — and soon — to keep the doors open.

Ducey said he understands the problem.

“We’ve been working for the past 45 days to make sure we’ve got appropriate hospital capacity, ICU beds, personal protective equipment, ventilators, etc.,” he said.

Now, Ducey said he is reevaluating the situation.

“If we’re in a position where we’ve got enough supply that we have available inventory and we have product on the way as well, I am open-minded to resuming elective surgery,” he told Capitol Media Services.

But when it occurs, it won’t be all at once.

“I would think this would be something where we would start with our rural hospitals first, and then, over a period of time, we would extend it into the urban core,” Ducey said. “It would be as soon as I have data that gives me the confidence to make a decision.”

Ward said the hospitals agreed with Ducey’s original order. “However, it is having dire financial consequences,” she said.

“That’s a lot of financial bleeding that’s happening,” she said, citing the reported monthly losses .

She said loosening the restrictions on elective procedures, such knee surgeries and hip replacements, would help. “We aren’t suggesting that elective surgeries are the be-all, end-all,” she added.

Ward said hospitals are just seeing fewer patients overall, including in emergency rooms.

The cause appears to be Ducey’s directive to Arizonans to remain at home unless they need to be out to work at essential jobs or to participate in essential services like shopping for groceries.

“People are staying home,” Ward said. “They’re not having car accidents like they used to to go into the hospital,” for example. “It’s not that day-in, day-out traffic that we would normally see.”

Ducey’s response: “You want me to apologize for people not getting into car accidents?”

Policy issues aside, Ward said hospitals need some immediate and direct cash relief.

The governor provided some last week in the form of an additional $5.3 million in supplemental payments to “critical access hospitals,” those in rural areas more than a 35-mile drive from any other hospital.

The state is also advancing $50 million to hospitals in advance Medicaid payments, essentially fronting them money for services they have yet to provide.

Ward said more is needed, whether from the state or the federal government.

How quickly an easing of Ducey’s ban on elective surgery could happen is dependent on several factors.

One is when the number of hospitalizations peaks.

Last month, Ducey directed hospitals to find another 13,000 beds by the end of this month on top of the 15,000 they already have. He also is working to reopen the closed St. Luke’s Hospital in Phoenix.

For the moment, there seems to be plenty of space. New information released this week shows total inpatient bed use in Arizona at less than 70 percent.

But there are indications the worst is yet to come, said Holly Poynter of the Arizona Department of Health Services.

She noted that healthdata.org, which produces models for states and countries, predicts Arizona will hit its peak hospital need April 30. But other models, Poynter said, have the peak in May.

“Worst-case scenario models are still predicting up to 13,000 (additional) hospital beds may be needed,” she said.


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