Philly hospitals react to COVID-19 surge by canceling procedures, tightening

Health care staff shortages and near-capacity COVID-19 units are straining Philadelphia area hospitals even as they prepare for a bigger wave of cases following the holiday season.

Some hospitals have begun canceling non-urgent procedures to reserve their depleted staff for critically ill patients, while others have tightened visiting policies that had loosened during the summer.

Inside hospitals, workers described scenes dramatically different from just a few weeks ago. Most hospitalized patients are unvaccinated. But workers are also seeing people who were vaccinated against COVID-19 — but not boosted — filling beds faster than the hospital can discharge patients who’ve recovered.

While the vaccines and a variant that seems to make people less sick offer some hope, hospital workers said they are bracing for things to get worse before they get better.

Last week, Temple University Hospital began reviewing its upcoming planned surgeries and rescheduling some, “if the case is one that can be safely postponed and frees up necessary resources for a burgeoning inpatient population,” said Tony Reed, executive vice president and chief medical officer at Temple University Health System.

“I anticipate we’re going to be having the conversation about electives for the next few weeks,” he said.

Temple is currently rescheduling no more than five procedures a day. Meanwhile, Main Line Health announced Sunday that it is “pausing” all elective surgeries for the next two weeks.

Temple’s emergency department — already one of the busiest in Philadelphia — has been especially hectic with the influx of COVID-19 patients.

“We’re in a crisis within the crisis,” said Carlos Aviles, a pharmacy technician and the president of the union representing technicians at Temple University Hospital. “We weren’t ready for the first wave of COVID, and we’re dealing with a dam with a lot of cracks and leaks right now. If this dam bursts through, how many lives are we going to lose?”

Aviles and his colleague, nurse Mary Adamson, the president of the Pennsylvania Association of Staff Nurses and Allied Professionals chapter at Temple, say staff shortages have demoralized nurses and spurred worries that they can’t care appropriately for the number of patients they’re being assigned. Adamson, an ICU nurse, said the hospital had about 150 to 200 COVID-positive patients on campus.

“The industry standard is two ICU patients to one nurse, unless the patient has a more serious condition” — like many COVID patients, Adamson said. “Now we’re at three patients to one nurse, and patients that should require a single nurse are being paired up. In the medical-surgical units, nurses are taking five, six, seven patients apiece.”

“The thing about nursing is,” she continued, “it’s all about surveillance. It may not look like you’re busy, but you’re watching everything. When someone has a heart attack or a blood clot, it happens fast, but the symptoms leading up to that are there. They’re subtle, but they’re there. And that’s what we’re missing in health care right now. Those subtle signs that prevent those bad outcomes.”

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