Maryland hospitals directed to delay some surgeries

Gov. Larry Hogan ordered hospitals to postpone non-urgent procedures when COVID-19 hospitalizations exceeded 1,200. Maryland joins other states taking similar steps and struggling to contain the latest surge.

Faced with a rise in COVID-19 patients, Maryland hospitals are now postponing some surgical procedures.

On Friday, Maryland Gov. Larry Hogan’s administration directed hospitals to delay non-urgent procedures. Hogan issued an order earlier in the week setting the benchmark of 1,200 hospitalizations for the postponement of some procedures. Maryland surpassed that number Friday.

Other states, such as New York and Massachusetts, have imposed orders directing hospitals to delay elective procedures amid another spike of COVID-19 cases. Hospitals across the country are struggling to manage the rise in COVID-19 cases, along with staffing shortages and people coming to hospitals for other health issues. Some healthcare systems are acting on their own to postpone non-urgent surgeries and procedures.

Earlier this week, Hogan also ordered Maryland hospitals to activate pandemic plans if the state surpasses 1,500 COVID-19 hospitalizations.

Currently, about 94% of Maryland’s staffed hospital beds are filled, said Bob Atlas, president and CEO of the Maryland Hospital Association.

“Our hospitals are committed to providing necessary appropriate care for everyone who needs us,” Atlas said in a phone interview Friday. “We are doing it now. The threat of being unable to do it is considerable.”

Under Hogan’s order, hospitals are directed to make available all staffed bed capacity and delay non-urgent surgeries requiring an overnight stay.

In a statement Friday, Maryland’s governor cited the rapidly spreading Omicron variant, which has been projected to be more transmissible than other variants. Hogan also noted the vast majority of the COVID-19 patients in hospitals are unvaccinated, and he urged Maryland residents to get the shot.

With the order, Maryland hospitals are having to make difficult decisions.

“At this point, because beds are full, as the governor’s order indicated, we are making choices where we will prioritize care,” Atlas said. “We’re having to push off some procedures.”

Hospitals are going to make choices on scheduling surgeries based on the acuity of patients. But delaying procedures for weeks also can create other challenges.

“Some patients may be in severe pain or the longer they wait, the greater the chances of complications perhaps,” Atlas said.

About 1 in 6 of the patients in Maryland’s hospitals are being treated for COVID-19.

“That may not sound like a lot but it’s the thing that’s putting the system into the difficulty that we’re in,” Atlas said. “We have all these other patients who need our care.”

At the peak in January 2021, Maryland had 1,952 COVID-19 patients in hospitals.

“That’s a lot more than we have now. But at the time, we had fewer non-COVID patients,” Atlas said.

In addition to seeing more patients with other health issues beyond COVID-19, the staffing shortages are testing Maryland’s hospitals, and hospitals around the country.

Last year, “We had a situation with staff where we were able to bear up,” Atlas said. “Now we’re dealing with a depleted staff situation.”

Hospitals are struggling to fill vacancies in nursing staff. Maryland’s healthcare systems are also seeing shortages of respiratory therapists and radiation technologists, but the nursing shortage is the biggest problem, Atlas said.

Hospitals are turning to traveling nurses, but rates for those nurses have soared, adding to the financial strain of healthcare systems, Atlas said.

Earlier this week, Calvert County, which sits in southern Maryland, notified its residents the county’s only hospital is at capacity. In a series of messages on Twitter, county officials said nearly all patients were unvaccinated and urged residents to get their COVID-19 shots.

The full picture of COVID-19 infections in Maryland has been unclear in recent days following a cybersecurity incident affecting state government systems. State officials have said there is no evidence data was compromised but they are still working to restore surveillance data.

The network security incident has hampered health occupation boards in processing license applications and renewals, dealing another setback to hospitals.

“We do have hospitals that have new graduates they want to put to work,” Atlas said. “They need to process the paperwork for the licensing.”

The Maryland Department of Health is reporting COVID-19 vaccinations, hospitalizations and outbreaks in schools and congregate care settings. The department is aiming to begin reporting more COVID-19 data as soon as possible, Andy Owen, an agency spokesman, said Friday.

“Due to the recent network security incident, it is not currently feasible for our systems to provide additional data,” Owen said via email Friday afternoon. “Our IT and cybersecurity teams are working around the clock to restore the full level of reporting, but we do not have a timeline to share right now.”

The health department has set up a webpage to update Maryland residents on the status of the net

More states are struggling to control COVID-19. Most states have seen increased hospitalizations over the last two weeks. Nearly 69,000 COVID-19 patients are being treated in hospitals nationwide, compared to about 50,000 just a month ago. Some states have tapped military medical teams for assistance.

This week, nine Minnesota hospital systems joined together urging the public to get vaccinated. A full-page ad in newspapers was headlined with a stark message: “We’re heartbroken. We’re overwhelmed.”