Too many empty beds
Before COVID-19 became a major issue in the United States, we witnessed how hospitals and health systems in China, Italy and Spain were overrun with patients. Then when the first surge occurred in the New York City area, many states and communities were expecting the worst, too.

Since we had never faced anything like COVID-19 before, many hospitals and health systems were ordered to stop elective surgeries and other types of non-emergency care to conserve PPE and to prepare for anticipated surges of patients. However, in many states, that hasn’t happened yet. For example, a field hospital that was scheduled to be built in a suburban Detroit convention center was scaled from 1,100 beds to 250 due to fewer than anticipated cases. Such outcomes are likely evidence that stay-at-home orders and social distancing practices have been effective.

At the same time, however, due to the elective procedure restriction, hospitals and health systems are expected to lose nearly $51 billion a month through June 30, according to the American Hospital Association.

These organizations were already cash-strapped before COVID-19 and cannot afford to incur such losses, even with financial assistance from the federal government—which, by the way, may not cover the cost of care for the COVID-19 patients.

At the same time, while many clinicians worked seemingly endless shifts, others were laid off. The healthcare industry, consistently a job-creating sector, lost 448,000 jobs in April, not including dentists, and particularly hard hit were ambulatory services. Health systems in some states were waiting several weeks for a possible surge in COVID-19 cases and were unable to deliver most care unrelated to the pandemic.

What should have been done
The state mandates to discontinue elective surgeries may have been prudent in some cases (and still are where surges are occurring)—but likely not across entire states at the same time. Some states issued the restrictions well before they were necessary. Here’s how we could have maintained access to non-COVID procedures—and still can—while delivering safe and effective care to patients with COVID-19.

1. Shift resources
Cohorting COVID-19 patients to a designated facility, department or temporary setting certainly protects other patients and clinicians. Health systems often have many facilities across large geographic areas. A network-wide perspective of vacant beds, surgical suites and provider availability can give health systems the critical information they need to create dedicated facilities for elective procedures, separate from patients with suspected or confirmed COVID-19. Granted, some procedures can only be performed in a designated facility for safety and compliance reasons, but real-time network-wide visibility into resources can give health systems the information they needed to be nimble and adjust operations as the conditions demand.

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