Gov. Jay Inslee announced new guidance Wednesday that gives health care providers more leeway to resume some nonurgent medical procedures that he had halted in response to the coronavirus pandemic. He also said he will extend his “stay home” order beyond May 4, when it is set to expire.
Inslee’s actions don’t materially change his order on medical procedures, originally announced March 19, which stopped all nonurgent medical and dental procedures. Instead, he is issuing new guidance in how his initial order should be interpreted.
The governor said he would outline on Friday how a broader reopening of Washington’s economy will proceed when he believes it is safe to do so.
The medical order was an effort to conserve both hospital space and personal protective equipment, like gowns and face masks, for the flood of COVID-19 patients that experts were predicting. It applied to all procedures not expected to “cause harm to the patient” if delayed for three months. It did not define “harm.”
“The governor leaves assessment of harm up to the individual clinician,” the new guidance says, saying providers should consider how a patient’s illness or injury is causing pain and dysfunction in daily life.
It’s the latest small step in the governor’s slow, phased reopening of Washington’s economy. Inslee allowed residential construction to resume last week and on Monday he announced that golf, fishing and hunting could soon resume and many state parks and public lands would reopen their gates. Other states, including Oregon and Texas, have recently relaxed their bans on elective medical procedures.
The decision to perform any surgeries or procedures, according to the guidance, should be weighed against factors like a patient’s health, how the condition is progressing, the consequences of further delay and whether leaving the patient untreated could make them more vulnerable to COVID-19, the illness caused by the novel coronavirus.
“There are some much-needed procedures that aren’t being performed that should be, and we need to make sure that everyone gets the care they need during this time,” Inslee said in a prepared statement. “We are clarifying that some procedures should go forward while still ensuring there is adequate capacity to deal with COVID-19 and other emergency situations.”
In order to perform any procedures, hospitals must comply with state regulations on personal protective equipment (PPE), including reporting how much they have available, not reusing equipment that is soiled or damaged and having at least a seven-day supply of equipment on hand.
Also on Wednesday, Inslee showed the data he is looking at as he considers when to allow reopening of the economy. It includes: the growth and activity of the virus, availability of testing, the state’s ability to do contact tracing, the risk to vulnerable populations and the status of the state’s health care system.
While some data has markedly improved since early April, the governor said he will again extend the current stay-at-home order, scheduled to lift at the end of the day on May 4. The state’s testing capacity still remains far below what experts say is needed. Washington labs have the ability to run more than 22,000 COVID-19 tests a day, Inslee said, but we only have enough swabs and test kits to do about 4,600 tests a day.
Meanwhile, officials are considering whether Washington can reopen by region, with areas that have seen fewer cases potentially moving first, Inslee said, but no decisions have been made yet.
Washington’s hospitals have mostly dodged the most dire forecasts, as the stay-home order and strict social-distancing measures have helped slow the spread of the virus, even as they’ve wreaked havoc on the economy.
The state’s hospitals, as of Tuesday, had 1,058 available hospital beds, including 153 in intensive care units, according to state data Inslee displayed Wednesday.
“Washingtonians ought to be proud that we have kept people out of the hospital,” he said, calling it a testament to social distancing.
But the state is falling far short in acquiring the PPE it seeks. Washington has ordered more than 284 million gloves, gowns and masks, but has received fewer than 20 million, according to state data.
Health care industry groups have been lobbying Inslee to allow procedures to resume. Not only have some patients had their lives put on hold, but the cancellation has inflicted a major economic blow on hospitals and health care workers. In a letter to Inslee earlier this month, the Washington State Hospital Association (WSHA), the Washington State Medical Association and the Association of Washington Healthcare Plans said hospitals around the state have lost 50% of their revenue and at least three have contacted WSHA about starting closure proceedings.
In March, Congress approved $100 billion in aid to hospitals, as part of its economic stimulus package. The latest package, passed last week, includes, at the insistence of Democrats, an additional $75 billion in aid for hospitals.
WSHA surveys found that the statewide average for hospital capacity is at 70%, meaning facilities have room to care for more patients. The new guidance says that hospitals may not exceed 80% capacity.
Seattle Times staff writer Joseph O’Sullivan contributed to this report.