Oregon Gov. Kate Brown Lifts Ban on Elective Surgeries. Some Frontline Workers Wonder If It’s Too Soon.

The decision is related in part to the economic well-being of rural hospitals and clinics.

Providence Portland Medical Center and a drive-thru COVID-19 testing site. (Henry Cromett)

Oregon Gov. Kate Brown announced Thursday she is lifting a ban on elective medical procedures, beginning May 1. Brown's decision immediately drew pushback from some health care workers who say major shortages of personal protective equipment continue to plague hospitals across the state.

Brown issued the ban on nonessential surgeries and other elective procedures March 18 to maintain hospitals' resources during the COVID-19 pandemic.

"By lifting this order, we're giving our hospitals, our clinics and medical offices the green light to move forward with non-urgent procedures. But let me be very, very clear: We still need to proceed with this step very carefully," Brown said Thursday. "Lifting this executive order will also have a real impact on many of our hospitals and clinics, especially in rural Oregon, where these procedures play an important role in the financial stability of our health care system and our workforce."

Dr. Dana Hargunani, chief medical officer of the Oregon Health Authority, outlined the specific criteria facilities will need to follow to conduct elective procedures: Hospitals must have a bed capacity at or above 20 percent, they can be at no more than 50 percent of their pre-COVID-19 procedure volume, and all facilities must have a plan to stop elective surgeries if a resurgence occurs.

"The framework we are putting into place is a balanced and safe way to get our health care workforce back to work and address the important health care needs while being prepared to slow down as needed," Hargunani said.

Thursday's decision appears to  be motivated in part by economics. After Brown halted non-urgent procedures, hospitals and clinics statewide—particularly in rural regions—experienced plunges in revenue, WW previously reported. Oregon House Republican leader Rep. Christine Drazan (R-Canby) issued a statement Thursday regarding the economics of Brown's decision.

"Our rural [hospitals] made a huge sacrifice when they had their doors closed to nonessential procedures and donated their stock of personal protective equipment in order to prepare the state for a surge of COVID-19 cases," Drazan said. "We saw a spike in unemployment claims in the medical field, and countless Oregonians were not able to receive treatment. Now, those facilities can get back to work and Oregonians will once again have access to necessary medical procedures. While this is just a small step toward getting Oregon back to work, it is an important one."

Dr. Sharon Meieran, a Multnomah County commissioner and emergency room doctor, told WW she understands why it's important to resume elective surgeries, but she questions the transparency around the state's decision to lift the executive order at this time: She said she's heard from health care workers statewide who still do not have sufficient personal protective equipment they need to do their jobs.

"The hospitals are telling the state that apparently their supplies are fine," Meieran said. "[Yet] these supplies across the state are reported as being inadequate by providers at all different levels in all different hospital systems."

Brown said during a call with reporters Thursday morning that the state is expecting a large shipment of personal protective equipment—particularly coveted N95 masks—in the next few days. She added that the state will also receive a Battelle machine, which can clean thousands of surgical masks a day.

Meieran remains skeptical.

"My feeling is, sure that's great, but show me," Meieran said. "Show me that our frontline providers are, across the state, experiencing this improvement in our PPE supply and I will be thrilled. But to continue to put out that we are getting this supply or that supply when I know people who are working aren't getting it—it's hard to reconcile those things."

Kevin Mealy, spokesman for the Oregon Nurses Association, says he's aware of some facilities across the state that still lack personal protective equipment.

"There are certainly facilities that don't have enough PPE now, so it's not safe for them to resume non-urgent surgeries," Mealy said. "Before we rush into elective surgeries, we need to go back to basic infection control practices. There are facilities claiming they can do that; we have not seen facilities be able to implement that yet."

The concern in the bigger picture, Meieran said, is that ramping up elective surgeries too fast and too soon could exacerbate COVID-19 in the state.

"It could result in a surge of cases," Meieran said. "It seems we're putting the cart way before the horse. It all boils down to transparency. If we're doing it, we need to think it through and we have to be transparent."

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