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Anne Arundel Medical Center to delay elective surgeries due to surge in COVID-19 delta variant, increase in emergency room admissions

Anne Arundel Medical Center is delaying some elective surgeries that require overnight care to free up occupied beds, the hospital announced Friday.

AAMC, owned by Luminis Health, is experiencing a daily influx of patients in its emergency room in addition to an average of 40 COVID-19 patients per day that require longer term care in hospital beds. The hospital is pausing some elective surgeries so patients with emergency medical needs can receive treatment.

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Starting Monday, patients that need to recover in the hospital after intensive surgeries for medical conditions that are not life-threatening, such as spine surgery, could have their procedure postponed. Surgeries that allow for a patient to be discharged the same day will continue.

Dr. Stephen Selinger, chief medical officer at AAMC, said the hospital will evaluate the temporary pause on a weekly basis. The hospital is still determining whether surgeries will be delayed indefinitely or rescheduled to a later date. All elective surgeries will eventually resume. Visitor policies will not be affected.

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“We don’t want to delay anybody’s surgery but we felt as we looked at our emergency department volumes this week that we had no real alternative but to do this,” Selinger said.

“Any surgery where we think somebody’s health would be negatively impacted in any way, we’ll have their surgery done,” he added.

Around 60 elective surgeries are performed at the Annapolis hospital daily. Selinger expects a small portion, at most 10 procedures, will be affected by the temporary pause.

Cathy Copertino, vice president of cancer services at AAMC, said cancer procedures are considered emergency surgeries and will not be postponed.

Patient volumes in the emergency room rapidly declined during the first surge of the coronavirus pandemic when much about the disease was unknown. Elective surgeries were halted in Maryland and elsewhere in the country from March to May 2020 in anticipation of demands COVID-19 would place on the health care system, a decision that hurt the financial health of hospitals that often operate on thin margins.

AAMC’s emergency room is currently experiencing a 4% increase in patient volumes compared to 2019. Around 230 people in an emergency seek treatment at the hospital every day. Patients who are admitted to the hospital from the ER may need a bed that another patient recovering from an elective surgery might otherwise take.

That influx stretches an already stressed hospital staff tasked with treating COVID-19 patients who are hospitalized on average for over five days. The daily average stay of non-COVID patients is about four days. Hospital leaders at AAMC expect are anticipating a peak of 55 patients hospitalized with COVID-19 at one time. As of Friday, 328 people were hospitalized for non-COVID aliments.

As of Friday, the hospital was treating 42 COVID-19 patients, four of whom were in the ICU.

“Not only are we taking care of the patients who have COVID pneumonia and other complications of COVID, we have very high emergency department volumes. And so we need this capacity (from elective surgeries) to take care of our community, and particularly the patients who are coming to our emergency department,” Selinger said.

“We don’t have extra staff to open additional beds within the facility, but the beds that we use on a day-to-day basis for our patients are all staffed,” he added.

Selinger said hospital leaders do not know why more people are coming to the emergency room compared to a pre-pandemic period.

Anne Arundel County is currently considered an area at high risk of transmission when a more contagious delta variant of the virus pushed the county’s transmission rate over 14 cases per 100,000 residents in August. That rate has since risen and slightly declined. On Friday, the county had 16.4 COVID-19 cases per 100,000 residents, a level last seen in April.

Several Baltimore-area hospitals said Friday they did not have plans to suspend elective surgeries.

At the start of the pandemic, the University of Maryland Medical System put in place an incident command structure that monitors patient volumes across the hospital network. UMMS spokeswoman Tiffani Washington said no restrictions on elective procedures are in place at this time.

“ICS routinely reviews both current volumes and patient forecasts and will make recommendations and decisions as circumstances require,” Washington said in an email.

Representatives from LifeBridge Health and MedStar Health also said they also had sufficient bed space, at least for now.

“This is something we access daily and make changes as necessary as we continuously monitor updates from medical organizations, federal, state and local governments about the COVID-19 virus,” said Leslie Simmons, LifeBridge’s executive vice president and chief operating officer, in a statement. “At the present time, we have enough staffed capacity at all our hospitals.”

Baltimore Sun reporters Hallie Miller and Meredith Cohn contributed to this report.

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