All Maryland health care facilities, including hospitals, will no longer be allowed to perform elective or non-urgent medical procedures while the state grapples with the public health emergency caused by COVID-19.
The directive from Maryland Secretary of Health Robert Neall also includes information on use of personal protective equipment, testing and use of hospital-owned buildings for additional beds.
Procedures often involve the use of personal protective equipment, said Dr. Barbara Brookmyer, Frederick County health officer.
“Reducing the number of medical procedures to those that are critically necessary will help to conserve [personal protective equipment] for the care of persons who are ill from COVID-19,” Brookmyer said in an email.
Licensed health professionals can decide what is elective based on medical judgment and considering the patient and their circumstances, Brookmyer said.
Frederick Health Hospital has already stopped elective procedures, Dr. Manny Casiano, chief medical officer, previously told The News-Post. But Frederick Health is looking at buildings it owns to offer more space for beds, he said in an email.
The health care system is preparing its business center to increase capacity of medical and surgical beds by 30 percent, Casiano said. The system also made changes to increase intensive care unit bed capacity by 100 percent.
“We have contingency plans ready to use those Business Center beds if/when the hospital capacity makes that necessary,” Casiano said.
Dr. Julio Menocal, who runs a medical practice that sees many patients in the Hispanic and Maryland Medical Assistance community, will continue to see patients, he said.
Using Centers for Disease Control and Prevention guidelines, Menocal’s office is screening patients so that no one in the waiting room is feverish. Patients who do have a fever are taken around back to an examination room, Menocal said.
The office can test patients, he said, and has supplies for about 50 tests with more on the way. So far the office has tested 38 patients for COVID-19, and all of the tests have come back negative, Menocal said.
He is following CDC guidelines for those who should be tested.
The directive from the Maryland Department of Health has set prioritization for testing, starting with people who are hospitalized. Symptomatic law enforcement, health care workers and emergency management personnel are next.
Following those are people in nursing homes or long-term care centers. After that are people who are at high risk and whose care would be affected by a diagnosis, according to the directive.
Frederick Health has been testing people since Wednesday. Almost 500 tests have been done with 75 others conducted at the hospital, Casiano said in an email. The health care system is using the prioritization guidelines set by the state health department and CDC.
Positive tests are reported to the Frederick County Health Department so they can do contact tracing.
“Unfortunately, test results are currently taking upwards of 5 days to get back from the commercial and State lab,” Casiano said in his email.
The health secretary’s directive also allowed masks to be reused, following the CDC’s Contingency and Crisis Capacity Strategies. Masks are allowed to be used past their shelf life and can be reused, provided that appropriate precautions are taken.
When reusing masks, health care providers need to make sure they do not touch the mask during care, Brookmyer said in the email.
Frederick Health staff are reusing N95 masks, Casiano said.
“We are doing this from an abundance of caution, since we cannot be sure of future deliveries and availability,” he said in the email.
Supplies are tight at Menocal’s office, he said. People in the community have donated masks and homemade ones, he said.
Frederick Health donated toilet paper to his office, Tyler Hegamyer and McClintock Distilling donated 5 gallons of hand sanitizer, Menocal said in an email. Dr. Rafael Acosta, a dentist, donated 50 masks, and Luke Markey and ShieldCo Art Inc. donated 10 N95 masks and are making 20 cloth masks. They are also making face shields.
Kenny Bromfield and the Red Horse Steak House donated 100 level 2 masks, as well as offered discounted meals for Menocal’s office.
Cloth and homemade masks should be used only as a last resort, Brookmyer said in her email. Whether these masks protect health care providers is unknown, and they should be used in combination with a face shield that covers the entire face and sides of the face.
Menocal said he offered his staff the ability to go home and use vacation and sick time, but they all decided to continue working.
“They are my true heroes,” Menocal said.