GUIDANCE TO FLORIDA RESIDENTS ABOUT SURGICAL PROCEDURES DURING THE CORVID-19 PANDEMIC

Many Florida residents are unclear as to whether or not their surgical procedure will have to be postponed during the CORVID-19 pandemic.

Florida, a state with a large population or residents over the age of 65 and therefore vulnerable to complications from CORVID-19, is prudently preparing for a predicted overwhelming intake of hospitalizations of patients suffering from CORVID-19 while further anticipating a shortage of both medical supplies for patients and personal protective equipment needed to protect medical care providers from contracting this contagious virus.

President Donald J. Trump and the Centers for Medicare and Medicaid Services have also recognized the shortage of medical supples and have recommended that health care providers limit “non-essential” elective surgical procedures and dental procedures during the CORVID-19 pandemic.

The Surgeon General for the State of Florida and the Agency of Health Care Administration recommended that medical supplies and personal protective equipment only be used to respond to the CORVID-19 emergency and other urgent medical events thereby impliedly precluding non urgent medical procedures unelated to CORIVID-19 as they can not be performed without medical supplies and personal protective equipment.

In response to these recommendations, on March 20, 2020, Florida’s Governor, Ronald DeSantis, responded to the recommendations to conserve medical supplies and personal protective equipment while balancing the medical needs of Florida residents by executing Executive Order Number 20-72 (EO 20-72).

EO 20-72 provides that all hospitals, ambulatory surgical centers, office surgery centers, dental, orthodontic, endodontic offices, and other health care practitioner’s offices in the State of Florida cease providing any medically unnecessary, non urgent or non emergency surgeries which would not place the patient at risk if delayed or would not contribute to the worsening of a serious or life threatening medical condition.

EO 20-72 provides guidance as to what constitutes a non essential medical procedures that should be delayed by providing examples such as endoscopy, cataract and lens surgeries, non-urgent spine and orthopedic procedures and cosmetic procedures.   These types of elective surgical procedures will be postponed until after the CORVID-19 pandemic passes thereby allowing medical supplies and personal protective equipment to be utilized for more urgent patients.

Examples of permissible essential medical procedures expressly enumerated in EO 20-72 include the removal of cancerous tumors, transplants, limb-threatening vascular surgeries, trauma-related procedures, and dental procedures to relieve pain and management infection. These essential surgical procedures will continue to be performed during the CORVID-19 pandemic.

Florida residents should be assured that Florida’s talented health care providers will continue to treat non CORVID-19 patients who would be placed at risk by a delayed surgical procedure or if a serious or life threatening medical condition could be worsened by a delay and that Florida’s health care providers will only postpone non-essential elective surgeries and procedures during the CORVID-19 pandemic.  Florida health care providers will resume treatment on non-essential elective surgical procedures after the CORVID-19 pandemic ends and/or when additional medical supplies become available.

UNDERSTANDING THE NEED FOR RESTRICTIONS IN NURSING HOMES DURING THE COVID-19 PANDEMIC

While nursing home residents typically have a statutory right to receive visitors, the grave risk that the rampant spread of COVID-19 poses on the frail and vulnerable residents in nursing homes has led to strict, but necessary, restrictions on not only visits from family and friends but also from routine visits from non-essential health care personnel.  Additionally, social distancing within the nursing home has led to changes in daily activities leaving the compassionate nursing staff to find new ways to keep nursing home residents entertained. While these changes are understandably concerning to the family and friends of nursing home residents, the restrictions are deemed necessary in the effort to reduce exposure to COVID-19 in the nursing home setting.

In response to the recommendations from both the Center for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS) that all visitation to nursing home residents be restricted except for certain compassionate care situations, such as end of life situations, nursing homes have been creative in finding alternative ways for residents to safely “visit” with their loved ones through video communication and window visits while asking community volunteers from schools, scouts, and church groups to postpone their usual visits.

The CDC and CMS have also recommended that non-essential healthcare personnel (HCP) be restricted thereby causing routine visits from the dentist and eye doctor to be postponed.  Similarly, visits from the hairdresser and barber have also been restricted as infection control understandably trumps a set and style.

In response to recommendations restricting group activities within nursing homes as part of social distancing measures, nursing home staff have again shown creativity by providing alternative means of entertainment (at a 6 foot distance) with games of hallway BINGO and other no touch activities.

Communal dining has also been restricted leaving the dining rooms empty as residents dine at a safe distance from other residents as part of safe social distancing.

While visitation and activities of daily living in the nursing home setting have changed during the COVID-19 pandemic, loved ones of nursing home residents should understand that these precautions are necessary to reduce the risk of infection to those at the highest risk of developing life threatening complications from COVID-19.  Nursing homes look forward to the day that COVID-19 is behind us the doors can safely reopen to accept visitors, but in the interim, nursing homes ask for understanding and patience so that they can devote their time to what is most important – taking care of their treasured residents.