Just as patients started returning for care they delayed throughout the COVID-19 pandemic, hospitals are again having to put non-emergency procedures on hold to free up resources for patients hospitalized with the delta variant of the coronavirus.
Salt Lake City-based Intermountain Healthcare is the latest system to announce it's postponing elective procedures starting Wednesday at 13 of its hospitals, and expects the pause to last several weeks, CEO Marc Harrison said during a Friday press conference.
The system's ICUs are at more than 100% capacity and among those hospitalized with the virus, 87% are unvaccinated, Harrison said.
Intermountain follows other systems in pockets of the country like Advent Health in Florida that have chosen to cut off some of their most lucrative services in order to care for surges of COVID-19 patients. Hospitals took a major financial hit when they delayed procedures early in the pandemic, either by orders from CMS or local officials, and now some are doing so voluntarily.
A study published in the Annals of Surgery estimated that hospitals lost nearly $22.3 billion in revenue nationally from March through May of 2020, when the most stringent shutdowns and widespread procedure delays occurred.
This time, non-emergency procedure delays appear much more scattered and dependent on hospitals' current volumes of non-COVID-19 patients, Matthew Bates, managing director at Kaufman Hall, said.
"It has a lot to do with where you're starting from. Not everybody is starting with their bucket already being full, some people have a lot more bandwidth," Bates said.
Intermountain had about 350 patients with COVID-19 across its hospitals on Friday and already postponed about 150 procedures last week, Harrison said.
Staffing shortages are dire, too, amid widespread burnout, with some systems dangling steep sign-on bonuses and other incentives to attract needed staff.
"They've been at this for 18 months, they have served and are serving heroically and things keep getting worse," Harrison said.
Many of the procedures delayed at Intermountain are deemed elective, though they aren't minor or trivial, Harrison said.
He noted a patient experiencing stroke symptoms has been unable to get a needed procedure, and if they experience a major stroke, "we don't have an ICU bed to put that patient in," he said.
More than a year and a half has passed since the first procedure delays and cancellations, and many patients have been waiting, though hesitantly, to return to medical settings. Hospitals, too, are waiting anxiously to go through backlogs of delayed care and recoup lost revenues.
Elective procedures normally fall into two buckets: those that have surgical alternatives and can be delayed and worked through, and those that really are essential and the delays have true health implications, Bates with Kaufman Hall said.
Someone with end stage renal disease needing a kidney transplant would fall into the second bucket, while someone with joint issues might fall in the first.
"If you're a patient and you've been delayed for six or 12 months, you might have just learned to work with it or found an alternate solution," he said.