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Non-emergency surgeries to resume in Virginia

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RICHMOND, Va. -- Gov. Ralph Northam announced Wednesday non-emergency surgeries and dental procedures can resume when his executive order expires at midnight Thursday.

“We did this to preserve our PPE for our frontline workers in our hospitals and prepare for a surge if that were to occur,” said Northam. “Our efforts (social distancing) to slow the spread of this virus are showing success.”

Because of those successes, Northam says hospitals are prepared to start non-emergency procedures safely.

“They have worked for weeks to prepare to reopen and they are ready,” Northam added.

Northam says the procedures will resume with guidelines in place to ensure safety for healthcare workers and patients and to maintain an adequate supply of PPE.

Additionally, veterinarians will be allowed to see pets for non-emergencies.

VCU Health responded to the governor’s decision Wednesday and said they are prepared to resume elective surgeries and procedures for both pediatric and adult patients on May 1.

“We never stopped providing life-saving care at our hospitals, such as transplants, trauma surgeries or cancer care,” said Dr. Ron Clark, Interim CEO of VCU Hospitals and Clinics. “For weeks, we have worked on a roadmap to resume elective surgeries and postponed procedures, with safety as our top priority. This plan is now activated, and we are in the process of re-introducing services gradually.”

VCU Health says they are putting extra safety and infection prevention measures in place to resume elective surgeries and procedures.

• We are testing every patient for COVID-19 before undergoing surgery, so our teams can take the proper safety measures to care for them and keep others safe. In addition, we are testing all patients before admission to the hospital.

• We continue using telehealth for patient appointments and to communicate with patients both before and after their surgery.

• We are piloting drive-thru pre-operative testing for surgery patients next week to reduce the amount of time spent in public waiting areas.

• We screen everyone for coronavirus symptoms at our entrances and encourage everyone who enters our facilities to wear a mask. If you do not have one, we will provide one.

• We have extra hand-washing stations, robust cleaning and disinfecting protocols for our rooms and equipment, and protocols for treating patients with coronavirus symptoms in designated areas to minimize the spread of COVID-19.

The governor’s decision comes a week after the Virginia Hospital & Healthcare Association sent Northam a letter saying state hospitals have enough capacity now to treat both coronavirus patients and elective surgery patients.

One hospital official at Wednesday's news conference said the pause of elective surgeries has cost Virginia's hospitals over $200-million, but said that was insiginifcant.

"The more important thing to do was to build the capacity within our hospitals to make sure that we were able to care for Virginians if they needed it do this COVID-19 crisis," added Dr. Michael McDermott, the President & CEO of Mary Washington Healthcare in Fredericksburg, Va.

Impact on Beginning the Reopening Process

In Northam's "Blueprint for Easing Public Health Restrictions" that he released last Friday, adequate hospital bed and instensive care capacity, plus an increasing and sustainable PPE supply were among the metrics Virginia needed to meet in order to begin phase one of the reopening process.

With enough of both of those to resume elective surgeries, Northam said Wednesday that those two metrics have been met.

"Hospitalizations and ICU admissions and need for ventilators, which is what we were really focused on with COVID-19, have remained essentially flat throughout this," said Northam. "I think what Virginians have done and certainly what the hospitals and healthcare providers and dentists and veterinarians have all done has allowed us to keep that curve flat and and not get to a point where our capacity was overburdened."

Northam was also asked about how his administration is gauging one of the metrics on that list, a downward trend in the percentage of positive tests over 14 days. He was asked if that meant a consistent 14-day decline in that percentage and if, for example, an increase on day 13 would cause the countdown to restart.

Northam said his administration was following trends rather than a strict 14-day decline.

"Not to get into a lesson on statistics, but it's not quite as straightforward as the average person might think that 'Well, we're just going to follow the number of positive cases each day.' So, we're looking at all these trends, as you know, we're looking at different models and I think the answer to your question is that there's nothing set in stone, but we're really focusing on the trends," said Northam.

When asked if that meant Virginia was could still potentially begin reopening on May 8, as Northam mentioned last week (and is when his executive order that temporarily closed many businesses is set to expire), he would not recommit to that date.

"Our numbers haven't flattened out yet," said Northam. "Now, a follow up question that I might anticipate is 'What about in some other areas of Virginia" Because, it's not the same, I mean, there's certain counties, for example, that don't have any cases right now. And so, that's why we're really trying to think through this with with thoughtfulness and reason and and fairness and, at the end of the day doing everything that we can to keep Virginians safe."