Butler Health System and UPMC both plan to continue some previously scheduled elective, but medically necessary procedures, following guidance from the state Department of Health.

While a list of life-sustaining businesses permitted to remain open noted elective procedures were prohibited, the Department of Health issued guidance that hospitals review all scheduled elective admissions, surgeries and procedures and develop a plan to postpone or cancel them if they are not medically necessary.

BHS announced last week its plan to honor these necessary appointments, and UPMC has steadfastly maintained its plan to do the same at all locations, including UPMC Passavant-Cranberry.

“Procedures and surgeries that are not necessary for the health and well-being of patients are being postponed indefinitely,” Jana Panther, a BHS spokeswoman, explained Friday, adding the regional health system was in compliance with the governor's order. “Procedures and surgeries which are necessary, because a patient will suffer without it, are proceeding at the discretion of the patient's physician.”

BHS announced Sunday that physicians would review scheduled surgical procedures during the next two weeks and postpone those which were “non-emergent and may be postponed.” They said they would contact patients prior to the date of their scheduled procedure to inform them of the postponement.

Sunday's move by BHS followed the recommendation of U.S. Surgeon General Jerome Adams and the American College of Surgeons, who both urged hospitals to manage elective procedures during the outbreak, prior to the governor's mandate.

UPMC said Monday that they would continue with all procedures and appointments as scheduled. On Tuesday, the hospital network said it “recommended” the postponement of elective procedures for those at a higher risk due to COVID-19 when it was clinically safe to do so.

Although elective care can include procedures that may not be necessary to prolong life or improve quality of life, it often means care for cancer patients or surgeries like heart valve replacement, said Dr. Donald Yealy, chairman of emergency medicine at UPMC.

“Scheduled does not mean unnecessary, and the governor and the CMS (Centers for Medicare & Medicaid Services) did not request necessary care be canceled,” he added.

Yealy said hospitals that are “declaring” their intention to cancel elective procedures are in reality following the same guidelines UPMC is following.

“Our goal is that we meet the needs of our patients and that we keep our staff safe while providing that care,” he said.

UPMC doctors also said they would screen patients for the coronavirus symptoms, but said they would not test asymptomatic individuals. That is in line with public health guidelines, said Dr. Graham Snyder, medical director of infection prevention and hospital epidemiology at UPMC.

“It's going to be difficult to identify asymptomatic COVID-19 carriers,” he said.

The Health Department asked all hospitals in the state to cancel potentially unnecessary elective appointments to increase capacity in preparation for a surge of COVID-19 patients who may need critical care.

Contingency plans

While Dr. John Williams, UPMC chief of pediatric infectious diseases, said Western Pennsylvania has not yet seen mass community spread of COVID-19, the health system is working on plans to mitigate the effects of widespread cases in the region.

There are currently 5,500 hospital beds in the UPMC network in the region, according to Yeager, and 750 of them can be used for intensive care patients. But, he added, it's possible that UPMC could increase its capacity between 25 and 40 percent if necessary, upping those numbers to approximately 6,875 to 7,700 beds and 935 to 1,050 intensive-care beds.

Additionally, Yeager said they are looking for ways to deploy personal protective equipment to medical personnel “smartly.”

“We're trying to be smart about this on day one and that's what we're preparing for right now,” he said.

While UPMC plans to expand testing centers to various facilities throughout its network in Pennsylvania, Snyder did not say whether UPMC Passavant-Cranberry would soon have testing facilities.

The health system's current test is “extremely sensitive and extremely specific,” the doctors said. Its facilities are able to process 80 tests each day, with a turnaround of one day though patients typically get results within 8 to 12 hours.