Abbott: Texans, Stay Home

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docaggie
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In reply to agforlife97 • 10:45a, 6/25/20
AG
agforlife97 said:
Player To Be Named Later said:
AggieMPH2005 said:
This is ridiculous, that elective procedures are banned and restaurants, bars and gyms are allowed 75% capacity.

Completely backwards.
Chips and salsa are way more important to Texans than medical procedures.

My God we are stupid
Lock them down another 6 weeks and those restaurants, bars and gyms will be all gone permanently. That's the issue. Abbot is only freeing up space in major hospital systems in the state on a temporary basis. Obviously this is not ideal, but he's having to make choices to manage the crisis while doing the least harm overall.
Lock down elective procedures for another 6 weeks and you'll see hospitals permanently close.

The previous ban hit even the biggest hospital system finances in a way that will take a long time to recover.

I'd have preferred seeing a continuance of the previous order stating that 15% of beds need to be available in case of a COVID surge, with the addition of demanding a plan from each individual hospital as to at what census level of COVID patients they would cease elective surgeries on their own. If COVID admissions continued to rise, the previous order of 25% availability for hospital beds could be reenacted.

We don't have quite the same PPE concerns as we did before, and could continue a large percentage of surgeries without depleting hospital resources while maintaining an adequate footing for a COVID surge.
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InternetFan02
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11:22a, 6/25/20
AG
My young son had "elective" open heart surgery years ago that obviously required an ICU stay. It was elective in that it was correcting a birth defect and we got to choose a summer date so that he wouldn't miss any school time. He needed the surgery and the sooner it was done the better but wasn't urgent. Not sure what we would have done if it was this year - tough times.
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Player To Be Named Later
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In reply to InternetFan02 • 11:25a, 6/25/20
AG
Unfortunately I think a lot of people read "elective surgeries" and just figure these are all cosmetic surgeries, etc that nobody really needs.

Elective surgery covers a pretty wide range of things, many of which are pretty serious and make people pretty miserable if they can't have performed.
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11:27a, 6/25/20
Proposition Joe
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In reply to [removed post] • 11:37a, 6/25/20
SoupNazi2001 said:
If hospitals are going to go out of business because of this order it means they aren't really at capacity otherwise they would still be making money.

It's been well documented that "elective" surgeries are the profit centers for hospitals.
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AggieMPH2005
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12:07p, 6/25/20
Soup that's not how any of this works.
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Cyp0111
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12:08p, 6/25/20
[We don't want the disrespect here. - Staff]
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In reply to docaggie • 12:15p, 6/25/20
AG
docaggie said:
agforlife97 said:
Player To Be Named Later said:
AggieMPH2005 said:
This is ridiculous, that elective procedures are banned and restaurants, bars and gyms are allowed 75% capacity.

Completely backwards.
Chips and salsa are way more important to Texans than medical procedures.

My God we are stupid
Lock them down another 6 weeks and those restaurants, bars and gyms will be all gone permanently. That's the issue. Abbot is only freeing up space in major hospital systems in the state on a temporary basis. Obviously this is not ideal, but he's having to make choices to manage the crisis while doing the least harm overall.
Lock down elective procedures for another 6 weeks and you'll see hospitals permanently close.

The previous ban hit even the biggest hospital system finances in a way that will take a long time to recover.

I'd have preferred seeing a continuance of the previous order stating that 15% of beds need to be available in case of a COVID surge, with the addition of demanding a plan from each individual hospital as to at what census level of COVID patients they would cease elective surgeries on their own. If COVID admissions continued to rise, the previous order of 25% availability for hospital beds could be reenacted.

We don't have quite the same PPE concerns as we did before, and could continue a large percentage of surgeries without depleting hospital resources while maintaining an adequate footing for a COVID surge.
The executive order appears to leave some room for interpretation

Quote:
Every hospital that is licensed under Chapter 241 of the Texas Health and Safety Code, and is also located in Bexar, Dallas, Harris, or Travis counties, shall postpone all surgeries and procedures that are not medically necessary to diagnose or correct a serious medical condition of, or to preserve the life of, a patient who without timely performance of the surgery or procedure would be at risk for serious adverse medical consequences or death, as determined by the patient's physician; provided, however, that this prohibition shall not apply to any surgery or procedure that, if performed in accordance with the commonly accepted standard of clinical practice, would not deplete any hospital capacity needed to cope with the COVID-19 disaster.

Maybe I am reading this wrong but it seems to allow some wiggle room to still do elective procedures as long as more COVID capacity is not needed.
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In reply to Proposition Joe • 12:20p, 6/25/20
Knucklesammich
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In reply to Forum Troll • 12:21p, 6/25/20
I'm not a doctor but I read that as, "patient a is having a heart attack and needs a bypass to live get it done"

"patient b needs a hear procedure but is more than likely not going to die in the next few weeks so they can walk around with say one of those Zoll defib vests don't they wait"

Is that about right? No opinion on if it should or shouldn't be just curious.
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docaggie
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In reply to Forum Troll • 12:27p, 6/25/20
AG
As with every executive order, we have to spend a day with legal parsing through to see what might be allowed and what won't.
Then, a day or two later, we'll get a clarifying announcement from the Texas Medical Board.
Class of 1998;
Husband of an Aggie, Class of 1999;
Father to future Class of 2029 and 2031
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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docaggie
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In reply to Knucklesammich • 12:29p, 6/25/20
AG
Patients get arranged into tiers.
Tier 3 - needs surgery within 72 hours.
Tier 2 - needs surgery within 2-4 weeks
Tier 1 - no timetable for when surgery needs to occur.

During the last shutdown, we started off with Tier 3 surgeries only, plus surgery for cancer.
As things opened up a bit, we moved to Tier 2. Then on May 1st, to Tier 1 patients.
Class of 1998;
Husband of an Aggie, Class of 1999;
Father to future Class of 2029 and 2031
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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HowdyTexasAggies
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In reply to docaggie • 12:37p, 6/25/20
AG
Above illustrates how ridiculous Abbots order is. Hospitals and drs are better equipped to make these decisions on their own.
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AggieMPH2005
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12:39p, 6/25/20
Soup almost all service lines are loss leaders for hospitals these days except for ortho and vascular ( cardiology) which are elective procedure based almost exclusively.

Also hospital reimbursement has been admission based not patient day based for a long time and we get penalized financially if someone is in a bed longer than the actuaries at Medicare have decided is acceptable. So there is a big difference.
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Player To Be Named Later
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12:40p, 6/25/20
AG
Not to worry... bars and buffets are open. Hospitals will still have a good supply of patients in Texas
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Knucklesammich
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In reply to docaggie • 12:46p, 6/25/20
docaggie said:
Patients get arranged into tiers.
Tier 3 - needs surgery within 72 hours.
Tier 2 - needs surgery within 2-4 weeks
Tier 1 - no timetable for when surgery needs to occur.

During the last shutdown, we started off with Tier 3 surgeries only, plus surgery for cancer.
As things opened up a bit, we moved to Tier 2. Then on May 1st, to Tier 1 patients.
Learn something every day thanks for the detail.
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HotardAg07
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1:44p, 6/25/20
AG
100% of "base capacity" is in use in Houston per the Texas Medical Center.


Obviously, we have a lot more "surge" capacity:

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cav14
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5:29a, 6/26/20
Luckily this is a recommendation, not a mandate. You're not going to get arrested or fined if you don't stay at home. It's no different than the "mandatory" evacuations that are given out every time a Hurricane comes barreling down towards the Texas coast.
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