CORONAVIRUS

Health care providers, dentists scale back elective procedures, surgeries

Policies follow announcement of 'community spread' in Iowa

University of Iowa Health Care complex, which houses University of Iowa Hospitals and Clinics, is seen. (The Gazette)
University of Iowa Health Care complex, which houses University of Iowa Hospitals and Clinics, is seen. (The Gazette)
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As COVID-19 continues to spread, Iowans have been asked to scale back their interactions with the public and to stay home as much as possible — and in some cases, that includes postponing health services.

Across Eastern Iowa, dental clinics are shuttering their offices after the Iowa Dental Board recommended dental providers postpone elective care for the next three weeks.

Hospital officials have suspended elective care and have asked that patients who can delay appointments for four weeks to do so.

“The rule is if the patient would suffer harm by not doing it, it should be done. But if it can be put off for four weeks, that’s what we’re recommending,” said Dr. Dustin Arnold, chief medical officer at UnityPoint Health-St. Luke’s Hospital, during a Wednesday news conference.

However, patients should have a conversation with their provider before delaying care, emphasized Dr. Tony Myers, Mercy Medical Center chief medical officer.

Patients most at risk for complications from the respiratory virus — the elderly, the immunosuppressed and those with chronic medical conditions — in particular have been warned to avoid seeking out these services unless its urgent.

These measures not only are meant to mitigate the risk of spread locally, but also as part of an effort to prepare for a potential COVID-19 outbreak locally by conserving the supply of medical equipment and protective gear.

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Also as important, the measures will help “preserve the function of the hospitals” during a potential patient surge as a result of the pandemic, Arnold said during a separate news conference earlier this week.

Dentists at high risk for Contraction, transmission

According to the Iowa Dental Board, dentists are among the highest risk categories for becoming infected with COVID-19 as the majority of their procedures create “significant aerosols,” or the suspension of liquid droplets in the air, officials said in a statement.

COVID-19 spreads through droplets from an infected person coughing or sneezing, federal officials say.

The dental board’s recommendation, passed down in collaboration with the Iowa Department of Public Health on Tuesday, aims to preserve personal protective gear, such as face masks, and other supplies needed to care for COVID-19 patients.

Elective procedures affected include routine appointments, cosmetic procedures and many orthodontic procedures. However, necessary and emergency dental services should continue in Iowa.

All appointments for high risk patients should be delayed, unless its an emergency, according to a board statement.

Effective on Monday, the University of Iowa College of Dentistry suspended all patient care from its faculty, student and resident clinics, unless it’s an emergency, said Dr. Michael Kanellis, associate dean for patient care.

All emergency patients will be screened to make sure they are healthy, but also to ensure their dental needs are in fact emergent.

“This decision was made out of concern for the health and safety of our patients, providers, students and the community,” Kanellis said in an email.

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The restriction, which is in effect until April 3, applies to the College of Dentistry and Hawkeye Oral Surgery.

Additional University Dental Clinics, including the Institute of Hospital Dentistry, are following the guidance provided by the University of Iowa Hospitals and Clinics, Kanellis said.

‘Non-life threatening’ procedures suspended

Leadership at Physicians’ Clinic of Iowa, the Cedar Rapids-based independent physicians group, has recommended its medical providers only see urgent cases for the next two weeks and proactively reschedule non-urgent and high risk patients. Non-urgent patient appointments, including rechecks and follow-up appointments, should be postponed, according to a statement sent to The Gazette.

Officials hope to scale back the number of patients seen in each clinic to reduce foot traffic through its facilities and “therefore limit the possibility of person-to-person spread.”

Mercy Medical Center, UnityPoint Health-St. Luke’s Hospital, Surgery Center Cedar Rapids and PCI collectively announced Tuesday they were postponing “non-life threatening, non-urgent surgeries and procedures” effective immediately.

“We believe taking this step now, is the best interest of all and will help us protect our valuable resources, which is our health care workers, providers and also will preserve supplies during this challenging period,” a news release stated.

Cedar Rapids resident Cindy Becker, who was scheduled to have a hip replacement operation on Friday, said she was “disappointed” in the decision. Becker, 46, had been preparing for the surgery for several weeks.

“In the big picture, I do understand why they did it,” Becker said. “It’s saving resources and medical material for emergency cases and should anything worse come of this pandemic, I would be glad to have that go to people who need it. But I’m still really disappointed.”

She rescheduled her surgery for May 1.

Mercy Iowa City is not taking similar measures at this time, spokeswoman Margaret Reese said in an email.

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The Iowa City Veterans Affairs center is examining all areas of care to determine what services should be limited or rescheduled in the coming weeks, officials said in a statement.

“We have not canceled or rescheduled patient procedures to date, and patients should contact their VA care team if they have questions about their appointments or care,” the statement continued.

The University of Iowa Health Care put into effect similar measures after state officials first reported evidence of community spread.

According to a Monday email to faculty and staff, UI Health Care officials implemented a number of adjustments that will affect procedures and services until at least April 3.

“Given this and other external factors, we must move forward on activating the clinical contingency plans as we face potential challenges with staffing and in conservation efforts of our medical supplies such as personal protective equipment,” said an email from University of Iowa Hospitals and Clinics Chief Executive Officer Suresh Gunasekaran and Dr. Doug Van Daele, executive director of the University of Iowa Physicians.

The number of surgical cases in the operating rooms were reduced starting Monday. Critical and emergency surgeries will take priority, but “elective and non-urgent surgeries will be postponed,” according to the email.

UIHC also has suspended a number of clinics, including its outreach clinics and the Wendell Johnson Speech and Hearing Center, for the next three weeks.

Cardiac and pulmonary clinics also have been halted, as those patients are most at risk for complications from a respiratory viral infection such as COVID-19.

Gazette Reporter Erin Jordan contributed to this report.

Comments: (319) 368-8536; michaela.ramm@thegazette.com

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