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Coronavirus in Texas

Patients face canceled appointments and delayed surgeries as doctors respond to coronavirus. They're worried about the wait.

On Friday, several major health care providers announced they would postpone elective surgeries and other non-urgent procedures and appointments.

Exterior of St. David's Medical Center in Austin on March 19, 2020.

Linda Gabriel was looking forward to her surgery, even though she was nervous about it.

“They say it is a life-changer for someone who has this condition,” said Gabriel, a retired nurse who lives in Montgomery and was diagnosed with adult degenerative scoliosis in 2018. “It has caused me to lose almost 4 inches in height, and I am in pretty much constant pain.”

But on Friday morning, Gabriel’s surgeon at Houston Methodist called to tell her the two-day procedure, which had been scheduled for next week, was canceled.

It would be too risky to operate amid the rapid spread of the new coronavirus, he said.

In an effort to protect their staff and patients from COVID-19 during a time when people are being encouraged to stay 6 feet away from each other, health care providers across the state have postponed check-ups, elective surgeries and other non-urgent medical appointments that must be conducted in person. Likewise, some patients who need regular medical care are putting it off, afraid of contracting the virus in crowded waiting rooms or from health care workers who may not have access to adequate personal protective equipment.

But there are certain procedures and other in-person visits that can only be delayed so long. That has patients and health care providers alike asking the same question: How long is the coronavirus pandemic going to last and demand social isolation?

That is an “unanswerable question” at this point, said Dr. Jim McDeavitt, senior vice president of operations and dean of clinical affairs at Baylor College of Medicine in Houston.

“We don’t know, and there’s no one who can tell you,” he said. As with the economy, education and beyond, “the longer this goes on, the more challenging it’s going to get.”

A spokeswoman for Houston Methodist confirmed that starting Friday, “all elective, non-urgent procedures are canceled,” while noting that “all elective, urgent procedures will continue as scheduled.”

Memorial Hermann, another Houston hospital, made the same announcement Friday.

“As you all know, the spread of COVID-19 has created an unprecedented situation for people across the country — especially within healthcare communities,” Dr. David Callender, Memorial Hermann Health System CEO, said in a statement. “Memorial Hermann is taking immediate and proactive actions to protect the health of all of our patients and our workforce.”

While it means her chronic pain will continue, Gabriel says she’s OK with her surgery being delayed for now — though she’s “a little worried that it may take a while, because I had finally felt confident about having it done.”

“But I'd rather wait, no matter how long it takes, for everything to be safe and for all the medical personnel to be present and taking care of me, without other issues affecting the care I get,” she said. “I'm 69 years old, so I'm also cautious because I do not want to get the virus at my age.”

For now, McDeavitt said, health care providers have to focus on managing the situation at hand. At Baylor, that has meant a daily examination of all scheduled appointments and procedures over the next two weeks to determine whether they are mandatory or could be conducted online. Those that don’t fit into either category have been postponed for at least six weeks.

Now is not the time to get your annual physical, McDeavitt said, noting that can safely be delayed for several months.

Some decisions are more nuanced, though, he acknowledged, giving mammograms as an example. While most women are advised to get them only every two years, they are more urgent for those at higher risk of breast cancer.

Dr. Douglas Curran, former president of the Texas Medical Association, added that immunizations shouldn’t be delayed for too long either.

For now, Curran, who practices family medicine in Athens, is still seeing patients in person, though he is also practicing more telemedicine. When would he stop seeing patients altogether?

It’s hard to say because things are changing fast, he said, adding that “I could tell you something today that could change tomorrow.”

Pregnant women pose a particularly difficult quandary for health care providers as it’s still not clear what impact the virus may have on expectant mothers or unborn children, but they still must go in for most check-ups — and deliveries.

Baylor and the Texas Children’s Hospital urged pregnant women Friday to keep medical appointments unless otherwise advised.

“While we are working every day to limit non-essential visits, unless you are notified by your obstetrician or midwife of changes in your scheduled visits, please do keep them,” Dr. Kjersti Aagaard, professor of obstetrics and gynecology at Baylor and Texas Children’s and an expert in maternal-fetal health, said in a statement.

With hospitals in Texas and around the country expected to fill up quickly with COVID-19 patients, some mothers are considering delivering at home.

Courtney Erickson, a student midwife in Allen, said that “a lot of women have been reaching out about home birth options, and if they are great candidates for out-of-hospital birth, local midwives are scrambling to make it work.”

Ajay Michalek, of Dripping Springs, is due in April and said her doctor still wants her to come in for check-ups but that she’s worried about delivering in a hospital.

“They have a birthing wing, but I am still concerned and will be speaking to my doctor at length about this next Friday,” she said.

Naomi Andu contributed reporting.

Disclosure: The Texas Medical Association and Texas Children's Hospital have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.

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