By Mary O’KEEFE

This week USC Verdugo Hills Hospital opened some outpatient services including elective surgical procedures and endoscopies.

“We actually started our first cases on [Monday],” said Dr. Paul Gilbert, chair of surgery for USC-VHH.

It was the middle of March when the pandemic forced hospitals to curtail elective surgeries. This meant that everything from pacemakers to hip replacements was put on hold until deemed safe to schedule. Those who needed life-or-death surgery continued to be treated but for many that knee or hip surgery that had been scheduled was placed on hold.

USC-VHH and other hospitals chose to put these types of elective surgeries on hold as they prepared for a possible surge of COVID-19 cases. That big surge never occurred at USC-VHH and the staff is now confident that many surgeries can move forward.

Verdugo Hills Hospital has spent the last six weeks shifting its focus in terms of care to ICUs and taking care of COVID-19 patients, Gilbert said. Not only are there floors specifically for COVID-19 cases but also isolated rooms to keep those with the novel coronavirus disease separate from the general hospital population.

“We increased our capacity to increase [care of] COVID patients significantly,” he said. “The goal was to flatten the curve.”

At this point at USC-VHH the number of COVID-19 cases are controlled, or are flattening. Staff members, Gilbert said, are now looking to the future and with continued protocols, including social distancing and using masks, feel they will be able to “keep that curve flat.” He adds that there are risks with any surgery and it is important for patients to speak with their doctors about the benefits and the risks of undergoing surgical procedures.

Things are starting off slowly as doctors head back to the surgical theatres.

“Our first week we are [acting] very judiciously [with] not a full surgery schedule. We are at 30% to 40% capacity,” Gilbert said. “We just want to make sure we have all the protocols in place.”

He added returning to elective surgeries after having a long period off is not like flipping a switch but must be done methodically.

“We are ramping up, though,” he said. “I didn’t know [at first] if we would get a flood of requests or get none at all. What we [have gotten] is very manageable.”

Gilbert said some patients who require hip or knee surgery are saying they can stay home for a little longer and would rather have their doctors’ efforts focused on COVID-19 cases, while others are stating they have been in quite a bit of pain and would like the surgery.

He praised the community for its support and understanding as the hospital transitions from focusing all attention to COVID-19 to the new normal. Gilbert did add though that the staff is prepared to change back if the pandemic patient numbers begin to head up again.

Shared decision-making is the process used between doctor and patient as they look at elective surgery. All options, precautions and protocols are discussed then, once the decision is made to proceed, the surgeon and the USC-VHH leadership look at the whole picture to plan the surgery. This includes the patient capacity of the hospital at the time.

Many of the staff at hospitals have noticed the downturn in Emergency Department patients. This may be due to the concern people have of exposure to COVID-19, although hospitals like USC-VHH take every precaution to make certain their patients are safe.

Gilbert said he understands their concerns but also understands that letting a medical issue linger can be dangerous.

“I think the message is to be cautious but don’t be afraid,” Gilbert said. “We have precautions in place, we have the masks [and Personal Protective Equipment] and no one goes into surgery without a COVID test.”

  Mary Okeefe