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As COVID-19 cases surge nationwide, healthcare professionals are grappling with tough choices, determining which medical procedures should take priority and which can be deferred. This includes elective surgeries—planned operations that are not urgent or life-threatening.
Revised guidelines: Postpone non-urgent surgeries
The American College of Surgeons recently issued updated guidelines regarding elective surgeries. They emphasized that while some procedures can be delayed indefinitely, most involve conditions like cancer, vascular diseases, and organ failure, which tend to worsen over time at rates specific to each condition.
To understand the implications for patients, we reached out via email to Alan Lumsden, MD, the head of the cardiovascular surgery department at Houston Methodist Hospital.
According to Lumsden, certain conditions like aneurysms, heart attacks, and strokes are urgent and require immediate attention. On the other hand, procedures such as varicose vein removal are purely elective and can be postponed without a set timeline.
Certain surgeries exist in a gray area
There are also scenarios where the decision isn’t black and white. “Many cases fall into this gray zone—they clearly need attention but can be delayed for a short period,” Lumsden explained. For instance, tumor removal might be postponed for a few weeks with minimal risk, though the condition will continue to advance.
“We’re weighing the risks of delaying a procedure against the risks of moving forward with it,” Lumsden stated. Factors include the danger of exposure, such as patients contracting illnesses in the hospital or potentially infecting others. Since COVID-19 can spread asymptomatically, this is a critical concern for doctors. Additionally, the availability of ICU beds in case of post-surgical complications is a significant factor.
In some situations, delaying a procedure by a few weeks or even a month may be acceptable, but postponing it for three to four months could lead to severe complications. These cases present a tougher decision for doctors, as they cannot foresee future circumstances. The concern is that if a patient’s condition worsens, they might require surgery at a time when hospitals are even more overwhelmed.
Balancing risks: immediate versus delayed care
If a patient can afford to wait a few weeks but not several months, doctors must evaluate the risks of performing the surgery now versus potentially needing to operate later, when healthcare resources might be stretched even thinner.
“We truly cannot predict when regular surgical schedules will return,” Lumsden remarked. However, he added that while patients have numerous questions and worries, the majority are understanding of the current challenges.
“Patients often ask how long their procedure will be delayed,” Lumsden shared. “At this point, the honest response is, ‘We simply don’t know.’”
