Indiana ban on elective medical procedures could be lifted next week

Indiana hospitals and clinics could resume elective procedures as soon as next week if they have enough personal protective equipment so as not to detract from their ability to treat patients with COVID-19.

Gov. Eric Holcomb issued an executive order on Monday afternoon that said the state would re-evaluate whether to allow hospitals, surgery centers, abortion clinics, dermatology offices, dental facilities and plastic surgery centers to resume services at 11:59 p.m. Sunday, “as warranted by the circumstances.”

“If our supply of inventory [of personal protective equipment] holds up, we will open up these elective procedures and other medical and clinical practices around Indiana,” Holcomb said during a press briefing.

The move comes more than a month after Holcomb directed hospitals and ambulatory surgical centers on March 16 to cancel or postpone elective and non-urgent surgical procedures to help the health care system to conserve resources and personnel necessary to handle the expected surge in COVID-19 cases.

The surge has been lighter than expected, Holcomb said, due to Hoosiers practicing social distancing.

“You are, for the most part, practicing good physical distances practices,” he said. “You are slowing the surge and flattening the curve.”

He also credited hospitals for collaborating with information and supplies.

Hospitals make most of their money on elective procedures, such as hip replacements and nose reconstructions. In response to the massive drop in revenue, more than 100 hospitals around the country have furloughed or laid off staff. The Indiana Hospital Association said it was unaware of any hospitals in central Indiana that have done so.

Holcomb said that the current inventories of personal protective equipment look sufficient, but it needs to be monitored on an ongoing basis. The restrictions on elective medical procedures will be re-evaluated every seven days.

The Indiana Hospital Association said hospitals have been “nimble in expanding their capacity and redeploying staff to care for patients with COVID-19.”

“Hoosiers must know that they should seek treatment today not only in emergency situations, but also to diagnose serious conditions, address underlying chronic illnesses, relieve significant pain, and more,” the association said in a statement. “Of course, our member hospitals will continue to carefully monitor the supply of personal protective equipment and other trends related to COVID-19 in the weeks ahead.”

Holcomb’s executive order also permits immediately allowing hospitals to conduct “clinically indicated procedures” to diagnose, screen and treat serious medical conditions, including cancer, heart disease and respiratory procedures, “as well as those procedures meant to reduce significant pain or symptoms.

However, Indiana hospitals were always permitted to those procedures during the pandemic.

Indiana’s move comes two days after the Centers for Medicare and Medicaid Services announced new guidelines on how hospitals can provide non-emergency care in states and regions where COVID-19 outbreaks are under control.

The guidance says hospitals must have plans to conserve supplies, maintain capacity for surges and ensure appropriate cleaning and protections for patients.

“This isn’t going to be like a light switch,” Verma said. “It’s more like a sunrise where it’s going to be a gradual process.”