Elective Medical Procedures Resume Today - Or Not

May 4, 2020

Credit Robyne / KUAC

Health care facilities can open up for non-emergency procedures today… if they are able to test patients for COVID-19 within two days of treating them. The health facilities must also meet increased, sanitation, social distancing and PPE requirements. The State Health Mandate number 15 allows surgeons and dentists to take cases if “their continued delay will have an adverse medical outcome.” But the testing bottleneck could prevent clinics from reopening.

“Medical needs do not just stop because COVID exists. There are immunizations to be given, screening exams to prevent worsening, and illnesses not related to COVID.”

Dr. Michelle Nace is a pediatrician for Foundation Health Partners. According to the mandate, health facilities who want to provide “elective procedures” need to test patients within 48-hours of the procedure. Dr. Laura Brunner (BROO-ner) says Fairbanks Memorial Hospital has been working toward today’s opening with that in mind.

“Elective procedures are rarely ever truly elective. They probably need to be done, it’s just a matter of whether we can delay them. And so, the work is to try to build our testing capacity, so we are ready for that.”

In the Interior, most COVID-19 tests are processed at the State Virology Lab on the UAF campus. On Sundays, the Anchorage Lab takes the samples. (Some low-priority tests are still sent outside to commercial labs which take 4-5 days to process.) And mostly, results come back in one day. But not always.

“How do we make sure, if test results are not back, or if somebody has a need for a procedure or a delivery that we couldn’t plan in advance, how do we protect our staff and our patients?”

The answer, she says, is more Personal Protective Equipment, with everyone masked, gowned and gloved as before, but now with the assumption that the patient is contagious with COVID-19, the assumption we must make until we know otherwise.

Jacoline Bergstrom from the Tanana Chiefs Conference says their medical services still need more Personal Protective Equipment and more testing, so they are planning to ramp up slowly.

“We’re not anticipating that we’re gonna be 100%, it’s gonna be a phased-in approach. And we’ll be prioritizing our patients who will get elective procedures first.”

TCC has some rapid-testing machines, but they are limited, and TCC does not have enough test kits for everyone waiting for an elective procedure. TCC will receive part of a plane-load of PPE that came to Alaska last week, and Bergstrom says the health provider has a drive to make community PPE, like homemade cloth masks, available to folks in Interior villages.

Elizabeth Hawk-Burton is a Regional Public Health Nurse. She says part of the new normal will be for people who have even mild symptoms to go and get tested. And we need to learn the wider list of symptoms the CDC amended last week for COVID-19:

“Officially they’ve changed their symptom list to include: fever, cough, difficulty with breathing, chills a decreased appetite, losing your sense of smell or taste, and even some things like diarrhea, feeling fatigue, a bad headache, muscle or joint aches, nausea, a rash, sore throat.”

Any clinic that will be resuming non-emergency procedures will probably be taking it slowly, because sanitizing and other precautions that are necessary, even with a negative test result add time to each procedure.