The global pandemic known as COVID-19 has already affected over 280,000 people worldwide. As of March 20, the Centers for Disease Control and Prevention (CDC) reported 15,219 cases and 201 deaths in 54 jurisdictions in the United States due to COVID-19.

In a New York Times article, researchers from Columbia University estimate that the coronavirus has infected far more people in the United States than testing has shown so far. They have given a stark warning: Some 650,000 people might become infected in the next two months even if the country cut its rate of transmission in half.

As coronavirus continues its spread across the US, hospitals, and health systems are bracing for the influx of patients with COVID-19. Healthcare providers nationwide are now making adjustments and new protocols to ensure patient safety.

Here’s how the situation is affecting hospitals and surgery centers across the US:

  1. Non-essential elective surgeries and other procedures (including dental) are being postponed

The CDC has given healthcare facilities and clinicians some directives in order to preserve staff, personal protective equipment (PPE), and patient care supplies:

  • Delay all elective ambulatory provider visits
  • Reschedule elective and non-urgent admissions
  • Delay inpatient and outpatient elective surgical and procedural cases
  • Postpone routine dental and eye care visits

Following the actions above can also help ensure staff and patient safety, and expand available hospital capacity during the COVID-19 pandemic.

The Centers for Medicare and Medicaid Services (CMS) has also released its recommendations Wednesday night March 18, 2020, to limit all non-essential planned surgeries and procedures, including dental, until further notice. CMS recommends low to intermediate acuity surgery to be postponed if possible, this includes cataracts, elective angioplasty, colonoscopy, low-risk cancer, etc.

The Ambulatory Surgery Center Association (ASCA) has also asked surgery centers to postpone elective surgeries for six to eight weeks unless the delay will significantly compromise patient safety.

Some hospitals in the U.S. are already canceling or postponing elective medical appointments and procedures as they prepare for the possibility of a surge in COVID-19 patients:

  • UCSF Health hospital system in San Francisco is postponing up to 7,000 appointments a day.
  • Seattle-based Proliance Surgeons canceled elective procedures at its 90 clinical care centers and 20 ASCs on March 17. The practice has made its ASCs available to local hospitals for elective procedures to free up capacity at the hospitals.
  1. Ambulatory surgery centers (ASCs) and other outpatient care facilities will play a key role 

As hospitals brace for an influx of patients with COVID-19, ASCs and other outpatient care facilities are taking on urgent cases to provide patients with much-needed inpatient care.

Hospitals are already delaying or canceling elective procedures to create capacity for those impacted by the novel coronavirus. When rescheduling is not an option, the CDC is recommending that hospitals shift urgent inpatient care to the outpatient setting.

There are 5,800 ASCs across the United States. These facilities can provide additional space, personnel, and equipment to help expand surge capacity and provider care services by expanding outpatient care for urgent elective procedures.

According to the Denver Post, Kaiser-Permanente is looking into using ASCs and critical-care hospitals to add beds for patients for the surge of COVID-19 patients in Colorado.

A special report by MSNBC’s “Morning Joe” mentioned how ASCs can play a key role in combating COVID-19:

  • Medicare, Medicaid, and private insurers can move additional elective procedures to ASCs. If the payers allow these surgeries to migrate to the ASC setting, it’ll free up additional beds in hospitals to handle the coronavirus cases.
  • Up to 1,000 elective procedures can be authorized to be performed in an ASC setting.
  • ASCs could also be turned into triage stations if the situation calls for it.
  • ASCs also have equipment that could help alleviate concerns (e.g anesthesia machines in ASCs could act as long-term respirators once modified)
  1. While other ASCs are opening their doors, some are closing theirs

Surgery centers nationwide are closing or restricting access across because of the coronavirus pandemic:

  • Waverly Lake Surgery Center in Albany, Oregon, closed last week after a staff member may have been exposed to COVID-19.
  • Tri-County Center for Endoscopy in Clinton Township, Michigan has closed proactively due to COVID-19.
  • The Riverside Surgery Center of Rutherford (N.J.) is open for urgent surgeries only and has reduced staff.

Several ASCs have already canceled or postponed procedures in response to the COVID-19 pandemic.

ASCA recommends that ASCs shut down based on any of these conditions:

  • If a patient, employee or physician that has been in the center has a confirmed case of COVID-19.
  • Or if there is a significant shortage of masks, gowns, gloves or other PPE in the area.

At the same time, patients are also canceling or deferring procedures in light of the coronavirus outbreak, according to a survey by investment bank Jefferies. As the coronavirus is increasingly altering American life, almost a quarter of doctors surveyed said patients are canceling elective procedures because of the outbreak.