opinion

Surgeon General: Delay elective medical, dental procedures to help us fight coronavirus

If you are having a heart attack or have been in a car accident, there is a chance you will need to have a medical or surgical procedure right away. Many procedures are urgent and must be done even in the midst of a global pandemic. Elective procedures are those that are often scheduled days to weeks in advance and often could be postponed without causing great harm. For example, most total joint replacements are elective, but transplants and cancer surgery are not.

As a member of the president’s Coronavirus Task Force — and a practicing physician — I am calling on all hospital systems to heed federal recommendations and cancel or delay nonessential elective procedures in a way that minimizes potential harm to patients. These include dental procedures as well. As both Vice President Mike Pence and Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, have said, this move is imperative for our national COVID-19 response for several reasons:

Why these delays are needed

►First, nonessential planned procedures consume personal protective equipment such as masks, gloves and gowns. At a time when health providers in the hardest-hit areas are concerned about having enough PPE to take care of COVID-19 patients, it is imprudent to pull PPE from regional and national pools to do procedures that could be postponed.

►Second, a person rarely comes in alone for a medical procedure. Each additional person, whether a loved one or caregiver, might have an undiagnosed case of COVID-19 that could be transmitted to the medical staff and facility. The president and his task force’s guidelines around social distancing mean avoiding unnecessary interactions, which include those we can eliminate by postponing elective procedures.

►Third, as we are in the midst of a whole-of-government effort to fight COVID-19, we need all our health care workforce and more to meet the demands of this challenge. Every non-urgent case takes precious staff time and energy, straining a workforce already going above and beyond in this fight.

►Finally, elective cases occasionally require prolonged hospital stays, ventilators and other resources that might soon be necessary to respond to community spread of COVID-19. While the Trump administration and the Department of Health and Human Services are facilitating innovative approaches to repurpose buildings, beds and equipment, we also can increase existing capacity through judicious postponement of elective procedures.

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Many health providers and facilities have already started acting to preserve these vital resources, like the American Societye of Plastic Surgeons who are coordinating the donation of unused PPE to be part of our response. The American Hospital Association and American College of Surgeons have urged their members to delay cases when possible to help with the COVID-19 effort. I applaud those who have already stepped forward to help ensure we have adequate materials during this time, and I urge all health providers and facilities to heed this advice.

This is a temporary response

Deferring elective procedures does not mean they cannot or will not be done in the future once we see our COVID-19 response needs decrease. We are at a critical point in our global and national response to an unprecedented pandemic, and it will take sacrifice and an all-of-America effort.

Ultimately, the decision about proceeding or postponing a procedure belongs to clinicians and patients, and I would encourage both to consult new guidance from the Centers for Medicare & Medicaid Services.

I recognize that many hospitals, especially those in small and rural settings, depend on the revenue generated by elective procedures to support salaries, benefits and operations. Our federal and state leaders must — and will — find ways to support them during and after this crisis. But the best way to ensure our long-term success is to act decisively now to conserve resources for the COVID-19 response.

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Stopping the spread of COVID-19 will be hard, but we should not make it harder by using vital health care resources for services that could wait. As the president said, “We are at war with an invisible enemy.” The lives of many — especially our most vulnerable — are at stake. We can win this war if we all commit to taking the right and timely actions for our country. My plea to all health care systems, hospitals, clinics and patients: Until we can flatten the COVID-19 curve in the United States — please consider delaying your elective procedures.

Vice Adm. Jerome M. Adams, MD, is the 20th Surgeon General of the United States. He is a board-certified anesthesiologist with a master's degree in public health and a member of the president's Coronavirus Task Force. Follow him on Twitter: @Surgeon_General