Advocate Health system starts reducing elective surgeries amid COVID-19 crush

Advocate Aurora Health will defer half of its elective procedures that would result in even a short hospital stay as COVID-19 admissions surge to new highs.

The 28-hospital system in Illinois and Wisconsin will start curtailing inpatient elective surgeries on a broad scale later this week.

Advocate Aurora reported treating 1,118 patients for the virus Monday, with nearly 630 in its 10 Illinois hospitals. Patient numbers for the entire system reached the mid-800s during the worst of the spring surge.

"With the recent rise, we've started to look more stringently at electives," said Dr. Jeff Bahr, chief Aurora Medical Group officer.

The rollback comes as soaring caseloads put new strain on staffing levels. While system leaders say they have a "robust supply" of protective gear, hospitals are redeploying employees where needed and hiring travel nurses to prepare for a crush of COVID-19 patients heading into the holiday season.

"As the COVID volumes in our communities continue to really break new records every day, we are acknowledging it's becoming more difficult for our team members, including clinicians, because they are also being exposed and may be unable to work if ill themselves," Chief Nursing Officer Mary Beth Kingston said.

While earlier surges were concentrated in different regions at different times, the new wave is filling up hospital beds across the country, limiting the availability of health care workers.

Advocate Aurora is reaching out to retired nurses and has requested travel nurses, Kingston said during a briefing with reporters Monday.

"We are expecting individuals to start the end of November and also into December," Kingston said, "but we also know we're competing with the rest of our region and the rest of our country for that resource."

Surgeons will prioritize elective procedures based on need and resources. Anything related to the diagnosis or treatment of cancer will not be delayed, Bahr said.

"24/7 urgent and emergency care is available," Bahr said. "That's not what we're talking about here. We're really talking about lower-acuity procedures and surgeries that can be delayed."

In the Chicago area, Advocate Lutheran General Hospital in Park Ridge logged 100 COVID-19 patients Monday. Advocate Sherman Hospital in Elgin had 66 virus patients, Advocate Condell Medical Center in Libertyville reported 92, Advocate Good Samaritan Hospital in Downers Grove had 42, and Advocate Good Shepherd Hospital in Barrington posted 38.

Illinois hospitals are still within state public health guidelines for occupancy levels in both intensive-care beds and medical or surgical beds, Bahr said.

His colleagues see signs for hope in Moderna's announcement that its COVID-19 vaccine appears to be 94.5% effective. But it will still take months before a vaccine is widely distributed.

"The way I look at this vaccine news, the next two to three months are going to be very difficult no matter what, but there clearly is light at the end of the tunnel," said Dr. Robert Citronberg, executive medical director of infectious disease and prevention.

Experts are urging families to cancel Thanksgiving dinners except for those people who already live in their households. Recommendations for Christmas will "probably be about the same," Citronberg said.

Hospitals are now in the midst of "an absolutely abysmal second wave" that could only get worse if gatherings turn into super-spreader events, Citronberg said.

"We need to get through this winter," he said. "It's going to be difficult."

"We're in the midst of an absolutely abysmal second wave of this pandemic," Advocate Aurora's Dr. Robert Citronberg said. "We're seeing numbers that were not even imaginable just a few weeks ago."
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