Postponement of elective surgeries one reason Chicago area hospitals not overwhelmed during COVID-19 pandemic

ByChuck Goudie and Barb Markoff, Christine Tressel and Ross Weidner WLS logo
Friday, April 24, 2020
Postponing elective surgeries helped prevent Chicago area hospitals from being overwhelmed
The agonizing wait for people forced to put off elective surgeries because of the pandemic.

CHICAGO (WLS) -- When the Surgeon General recommended elective surgeries be halted in mid-March so hospitals could save precious medical protective gear, and hospital beds, for the surge of coronavirus patients, thousands scheduled for procedures were told to wait. Most are still waiting, although Governor JB Pritzker announced Thursday some elective surgeries can start up again on May 1.

"I had polio when I was a child, my left leg is pretty much paralyzed, so I depend on my right leg. I have a pinched nerve that causes a great deal of pain in my right leg, it affects everything I do," said U.S. District Judge Robert Gettleman, who was forced to put off his March 26 spinal surgery.

"Everything came to a halt. And as a result of that, I'm still in a lot of pain. This was my last real hope," he said.

Experts say the term "elective" is a misnomer.

"I think people misinterpret the term elective surgery to mean uninsured surgery or unnecessary surgery or cosmetic surgery. But we're treating conditions that are very painful for patients are, very limiting for patients," said Dr. Eric Chehab, an orthopedic surgeon at Illinois Bone & Joint Institute.

Dr. Chehab is also Judge Gettleman's son-in-law. Seeing his father-in-law suffer inspired him to write an essay about these difficult side effects of the pandemic.

"I feel like these people should be recognized. They're sort of unsung heroes of this pandemic," said Dr. Chehab.

His partner, Dr. Gary Shapiro, will do Gettleman's surgery once elective procedures start up again. The backlog for re-scheduling will mean more waiting. That may be especially tough on cancer patients.

"Postponement for them is really an emotional issue. The delay that occurs is likely not to negatively impact them in terms of their cancer outcome or their surgical outcome," said Dr. Mitchell Posner, a surgical oncologist at University of Chicago Medicine.

Dr. Eric Chehab said they will have to start prioritizing one patient over the other depending on their condition.

Doctors say it was challenging to switch from a patient-centered approach to a public health focus when COVID-19 started to spread.

"This is not something most practicing physicians in the U.S. are used to doing," explained Dr. Peter Angelos, a medical ethicist at University of Chicago Medicine, "I really think it's, it's creating a lot of a lot of concern and raising the potential for lots of additional ethical questions down the road."

"I think the idea of postponing surgeries in the current environment, to be able to ensure the resources are there for the influx of COVID-19 positive patients, was exactly correct," said Dr. Posner.

Experts say this approach preserved scarce protective gear for medical staff, prevented non-COVID patients from being exposed to the virus and kept hospital beds open for those with coronavirus.

On March 23, of the 28,000 plus hospital beds in Illinois, 52 percent were full. Governor Pritzker warned without protective measures, beds would run out within a week. Now, nearly two-thirds are full; 23 percent of those, with COVID-19 patients.

Hospitals are hemorrhaging money. Nearly $1.5 billion per month is being lost statewide according to the Illinois Health and Hospital Association. This is due to elective surgeries being canceled and fewer patients coming in for regular appointments.

Judge Gettleman said these current restrictions are affecting everyone.

"It's just amazing that a country as rich and vibrant as our country, finds itself in this position," he said. "I think we're all going to suffer as a result of that."

Medical facilities such as the University of Chicago have implemented new scoring systems to prioritize which patients will go first when elective surgeries begin again next Friday.