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The Coronavirus Spikes In St. Louis, But Only Some Hospitals Cancel Elective Surgeries

Erin Jones
Barnes-Jewish Hospital
A health care worker works in the Barnes-Jewish Hospital intensive care unit earlier this year. The hospital has postponed some elective procedures as coronavirus admissions swell, but other local hospitals have not followed suit.

St. Louis hospitals are seeing record numbers of daily coronavirus admissions, but some local health systems are holding off on canceling elective procedures as they did in the spring.

In March, the region’s four largest hospital systems canceled colonoscopies, mammograms and nonessential surgeries to make room for coronavirus patients and preserve personal protective equipment.

But another freeze on those procedures could be financially destructive for hospitals during a time when they need more staff than ever before, hospital officials said.

“In the short run, by reducing elective surgeries that are done, it frees up a lot of staff,” said Sean Hogan, president of Mercy South Hospital. “But shutting everything down was really financially devastating to the entire health care community back in those days. That’s where we’re trying to balance the short term versus the long term and what people really need.”

Hospitals in the region are at about 90% capacity, according to the St. Louis Metropolitan Pandemic Task Force. On Tuesday, hospitals admitted 126 patients with the coronavirus.

Early in the pandemic, hospitals were concerned about preserving supplies of masks, gowns and other protective equipment.

Hospital officials are now largely concerned about staffing levels, he said. Health care workers are burning out, quitting or getting sick and unable to come to work. SSM, BJC HealthCare, St. Luke’s and Mercy all laid off or furloughed people after they canceled the lucrative procedures in the spring.

“Quite honestly, you need revenue to pay for the supplies that you need to take care of these patients,” said Dr. Michael Boland, St. Luke’s surgery chief. “You need revenue to pay the nurses overtime for working extra shifts, double shifts, longer shifts.”

Even though some procedures are deemed “elective,” it doesn’t mean they’re not vital to patients who need them, Boland said.

“We’re taking care of the people that need to be cared for, but at the same time, as long as we have the capacity, we’re still doing our best to take care of the community that we serve,” he said.

Many people save those appointments for late in the year after they’ve reached their insurance deductible. Patients might not be able to wait another year and will need to pay significantly more out of pocket if those surgeries are canceled, said Dr. Clay Dunagan, chief clinical officer at BJC HealthCare.

BJC officials have already decided to cancel certain procedures that require overnight stays at some hospitals in the region, Dungan said.

“We’re just running at full capacity … we have caregivers who are really burning out because of the relentless activity, and we have to create the capacity somewhere,” he said. “We feel like we have little choice … sometimes the economic consequences are things we don’t want to see.”

SSM health has also postponed some surgeries.

Unlike Barnes-Jewish Hospital, St. Luke’s and other local hospitals are smaller facilities that don’t take as many transfers, Boland said. As of now, they still have a little wiggle room to take non-coronavirus patients, but if things don’t change, they’ll likely need to cancel some or all procedures and take the financial hit.

“There is a misconception that we’re making money off of COVID patients, and this very noxious theory that health care is in some way promoting COVID because it makes money,” Dunagan said. “That’s really not at all the case.”

Follow Sarah on Twitter: @petit_smudge

Sarah is the health reporter at St. Louis Public Radio.

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