Daily new Covid-19 cases and hospitalizations hit records in Texas this week, state data show.
Photo: callaghan o'hare/ReutersTexas has ordered hospitals in four counties to stop some surgeries as the pandemic gains traction across Western and Southern states and hospitals fill with critical coronavirus patients.
Hospitals in Bexar, Dallas, Harris and Travis counties must halt nonessential procedures as of Saturday to make sure beds are available for coronavirus patients, under an executive order issued by Texas Gov. Greg Abbott Thursday.
The governor stopped short of a statewide shutdown, as Texas and other states previously ordered when the pandemic first hit. Hospitals nationwide emptied out in late March under the state orders, which governors began to roll back in late April as economies tentatively reopened. The order also allows surgeries that wouldn’t deplete hospital capacity.
“As Texas faces a rise in Covid-19 cases, we are focused on both slowing the spread of this virus and maintaining sufficient hospital capacity for Covid-19 patients,” Mr. Abbott said in a written statement.
The governor also announced a pause to the next steps to reopen Texas. But he said he wouldn’t clamp down where the state already relaxed restrictions. Texas has allowed most businesses to reopen with at least 50% capacity. “The last thing we want to do as a state is go backwards and close down businesses,” he said in announcing the decision.
Mr. Abbott’s decision not to further limit public life drew criticism from some health-care experts. Without a curb to activity, hospitalizations will continue to climb, said Nahid Bhadelia, an infectious-diseases physician and medical director of the Special Pathogens Unit at Boston Medical Center. “It’s avoidable,” she said.
Texas has seen its percentage of positive tests rise along with an increase in hospitalizations, two indicators the virus is spreading widely, said Taison Bell, an infectious-disease and critical-care physician and assistant professor at the University of Virginia. “It’s time to take decisive action,” he said.
The governor’s office didn’t respond to requests for comment.
Some states have delayed reopening plans and national tracking shows a fresh wave of infections in a growing number of states. Thirty-three states are seeing cases accelerate, a Wall Street Journal analysis of Johns Hopkins University data found.
Daily new Covid-19 cases and hospitalizations hit records in Texas this week, state data show. It has pushed some hospitals to near capacity for the most critical patients. The Texas Medical Center, a complex of hospitals in Houston, reported it had reached 98% of its normal intensive-care beds as of Tuesday.
The new order comes at a tough time for Texas hospitals, which said they were just starting to recover from the first shutdown. Doctors said their patients suffered anxiety, pain and deteriorating health during the prior suspension, and administrators said hospital revenue plunged.
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Houston-area hospital executives told reporters Thursday they had adequate capacity for all patients who needed care and hospitals regularly operate with full intensive-care units, even outside the pandemic. “It’s a little bit more complex than absolute numbers of beds,” said David Callender, chief executive of Memorial Herman, a Texas-based nonprofit hospital system.
Hospitals can add intensive-care capacity by bringing in more workers and are better prepared to care for Covid-19 patients than they were earlier in the pandemic, said Marc Boom, CEO of Houston Methodist.
In a written statement, the executives said they hoped the order would be short-lived.
Revenue at hospitals plunged an estimated 30% to 40%, on average, during the hiatus, according to Moody’s Investors Service. Hospitals raced to preserve cash with job and pay cuts, though many also benefited from a $175 billion federal health-care relief fund.
Many whose procedures were postponed before can no longer wait, hospital executives said in recent interviews before Mr. Abbott’s announcement.
“We’ve reached a point where a routine elective case—something as trivial as a hernia—has to be treated like an emergency because of the complications associated with delays,” said Todd Rosengart, a cardiothoracic surgeon at Houston-based Baylor St. Luke’s Medical Center and the chair of surgery at Baylor College of Medicine.
Health workers at Banner University Medical Center in Phoenix. Intensive-care units in Arizona were nearly 90% full as of Tuesday, data show.
Photo: Caitlin O'Hara/Bloomberg NewsA spokeswoman for CommonSpirit Health, a national hospital system that includes St. Luke’s, said it is too soon for Dr. Rosengart to comment on the governor’s order, as the system decides on its next steps.
In recent days, Memorial Hermann had no plans to stop non-Covid surgeries across its 11 Houston-area facilities. “The focus on Covid patients created a very detrimental effect all across our community, and we don’t want that to happen again,” Dr. Callender said in an interview before the governor’s order.
In other states with rising Covid-19 cases, hospitals continue to perform nonessential surgery.
In Arizona, hospitals cannot perform nonessential procedures once 80% of their beds are occupied, under a state order. Hospitals report capacity to the state daily.
Intensive-care units across Arizona were nearly 90% full as of Tuesday, data from the state show.
Cara Christ, director of Arizona’s Department of Health Services, said Tuesday the agency planned to start contacting hospitals whose occupancy has exceeded 80%. State officials will press hospitals for how they will lower occupancy and could require hospitals to halt electives, she said.
Banner Health, which is based in Phoenix and has 28 hospitals in six states, reports one occupancy rate across its 17 Arizona hospitals. No one hospital with more than 80% must halt procedures as long as overall occupancy remains below the cap, said Marjorie Bessel, chief clinical officer.
In addition to bed space, hospitals must also preserve the availability of staff and personal protective equipment such as gowns and masks. Yuma Regional Medical Center last week postponed four surgeries to remain below Arizona’s occupancy threshold, said Robert Trenschel, chief executive. This week, the hospital has beds, but not enough nurses for Covid-19 patients who need intensive care. Yuma Regional is now postponing three to four surgeries daily to redeploy nurses.
The hospital may voluntarily cancel electives soon, Dr. Trenschel said Tuesday. He said he appreciates the state has allowed hospitals to remain open and manage occupancy to avoid halting surgery again, which will help avoid a further financial hit from postponed procedures. Yuma Regional lost $400,000 a day in revenue during the eight weeks it postponed nonessential surgery, he said.
Staying open now is also less risky than was the case a few months ago, when critical supplies were scarce, testing was limited and the virus was a greater mystery, hospital executives said. “We have learned a lot,” said Dr. Bessel.
Hospitals have developed protocols to prevent spread of the infection, separating uninfected patients from those who have or might have Covid-19, she said.
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More delays could harm patients. Mayo Clinic scientists forecast some 21,000 deaths in the U.S. from colorectal cancer over the next five years. In research published this month, those scientists said an additional 10,043 Americans are expected to die over that period because of surgical delays associated with the Covid-19 shutdown.
Kate Dobyanski, a 48-year-old mother of two, suffered collapsed hips because of avascular necrosis. Doctors at Memorial Hermann replaced her right hip days before surgeries shut down in early March, leaving her in a “tremendous amount of pain” because her left side had yet to be operated on.
“I couldn’t walk, shower, dress, I couldn’t do anything for myself,” said Ms. Dobyanski.
Ms. Dobyanski was operated on as soon as her hospital resumed non-Covid surgeries on April 30, but has yet to fully recover because her muscles weakened while she was bedridden.
Write to Melanie Evans at Melanie.Evans@wsj.com and Preetika Rana at preetika.rana@wsj.com
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