Throughout the pandemic, many hospitals have had to delay some surgeries amid Covid-19 surges—a move that has resulted in a substantial backlog of surgical procedures that hospitals must now catch up on.

How omicron impacts our provider volume outlook

The pandemic delayed millions of surgeries

Throughout the pandemic, many hospitals have had to delay elective surgeries and other non-urgent procedures amid overwhelming caseloads from Covid-19 surges, including the most recent omicron surge. This deferral of care has resulted in a substantial backlog of surgeries for many hospitals, with some research suggesting that the United States could face millions of cumulative delayed cases by 2022.

The term "elective" is used to describe a surgery that doesn't need to be done immediately "to maintain life or limb," said Brian Cole, chair of surgery at Rush Oak Park Hospital. "But it's a very nebulous term to call something elective."

These delayed surgeries have had a significant financial impact on hospitals, particularly during the early days of the pandemic and subsequent case surges. According to a study published in the Annals of Surgery, hospitals lost an estimated $22.3 billion in revenue between March and May 2020.

"The impact [of the pandemic] on surgery is incredibly broad," said Patricia Turner, executive director of the American College of Surgeons. "It's going to be felt for a long time."

How 7 health systems are tackling their surgical backlogs

Many health systems are currently tackling backlogs that may extend as far as the beginning of the pandemic.

For example, UW Medicine in Seattle postponed more than 18,000 procedures between April 2020 and December 2021. The system is currently prioritizing the most time-sensitive cases and expanding its operating hours to tackle the delayed surgeries.

Similarly, IU Health in Indiana has identified at least 5,000 to 6,000 surgical cases in its backlog and is trying to reduce the number while also performing other ongoing care.

"There's still ongoing care that develops every day, so if we even went back to 100 percent of our pre-pandemic production, we still couldn't catch up our backlog because that's just ongoing care we're still providing," said Paul Calkins, IU Health's VP and associate chief medical executive. "So, we need to come up with a strategy to increase above our normal surgical capacity, and like every other hospital probably in the U.S., we've taken losses in staffing—both physician and nonphysician, so it's going to be difficult for us to make up all of those losses."

At University of Utah Hospital, around 500 surgeries were delayed during the pandemic, and the hospital is bringing in a U.S. Navy medical team to help workers provide the needed care. According to Michael Good, the hospital's CEO, the Navy has deployed around 20 medical staffers, including physicians, nurses, respiratory therapists, and administrators to the hospital.

"We're going to be able to open hospital beds that have been closed because of staffing," Good said.  "We're certainly not back to normal, but we’re trying to shift and get headed in that direction. Our colleagues from the Navy help us accelerate that pivot, that transition."

According to Good, the Navy medical team will stay for around 30 days, which will help the hospital "make a good start" on its backlog, even if it is not completely cleared.

Hospitals in Michigan are also working to address surgical backlogs from the omicron surge. For example, Brian Brasser, COO of Spectrum Health Grand Rapids, said the hospital is currently working to get its surgical scheduling back to normal.

"Our hope is that within the next week or two to be back at baseline. We recognize that we're going to have to go above that baseline to work through some cases that have been delayed," Brasser said. "The teams are working very hard to get to that point."

Steve Polega, the chief nursing officer at the University of Michigan Health West, said his organization is similarly working to get through their deferred cases. "We've pushed out just over 200 cases that we've had to adjust or move," he said. "It felt like we went right from the delta surge to the omicron surge and just recently the last couple weeks is when we've started to see our numbers come down, our numbers under 40 and now under 30."

In New York, Gov. Kathy Hochul (D) recently ended a mandate pausing elective surgeries in the state, allowing hospitals to begin tackling surgical care that was previously delayed.

At the University of Rochester Medical Center, many procedures have been delayed since the start of the pandemic, and the hospital is currently working to expand patients' access to surgical care, according to Matthew Miller, the organization's senior director of perioperative services.

"We have been creating access to every surgery that needs to happen now[;] we have been creative in expanding our access," Miller said.

Similarly, UR Thompson Health is also working to expand access to elective procedures. According to CEO Michael Stapleton Jr., the hospital now has five out of six operating rooms up and running again and is working to get enough beds and staff.

"We need to build that back," Stapleton said. "Still have a lot of patients in hospital beds who don't need to be, they need to be in a nursing home but there's not enough nursing home capacity in our region, so that backs us up." (Alberty, Salt Lake Tribune, 3/2; Mitchell, Wood TV, 2/14; Gooch/Gonzalez, Becker's Hospital Review, 3/3; Cost, ABC News 10, 2/25; Berlin et al., McKinsey, 10/2/20; Lloreda, STAT News, 8/13)