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Hospitals, docs pitch roadmap to keep essential surgeries going even with coronavirus surges.

Four national healthcare associations proposed a roadmap Thursday to facilitate continuation of essential surgery at a time when COVID-19 cases are filling up hospitals in some regions.

The American College of Surgeons, American Hospital Association and two other groups are calling for healthcare providers to cooperate to address capacity needs and source the personal protective equipment they need to safely perform procedures.

The goal is to ensure procedures continue but the roadmap contains provisions for rationing care. AHA and its collaborators want facilities to prioritize medically necessary, time-sensitive cases and identify essential medical device representatives per procedure.

As COVID-19 began spreading across the U.S. in March, groups including the Centers for Disease Control and Prevention recommended the deferral of elective procedures to increase the chance of hospitals having the capacity to safely cope with an anticipated surge in coronavirus cases. Hospitals followed the advice, causing steep declines in medical device sales in April.

In recent weeks, second quarter results released by medtech companies have shown that elective procedures resumed faster than anticipated, supported by roadmaps for reopening, with some reporting that sales were close to pre-pandemic levels by June. The statement published by ACS, AHA,the American Society of Anesthesiologists and the Association of periOperative Registered Nurses suggests those gains could be reversed.

“The recent resurgence of the virus in many regions has many states near or at bed and ICU capacity, and healthcare facilities’ ability to meet the needs of patients presenting for essential surgery may be stressed by new influxes of COVID-19 patients,” the organizations wrote.

In response to the pressures on some hospitals, the healthcare organizations published a nine-point roadmap for maintaining essential surgery during the pandemic. The roadmap features provisions that, if enacted by providers, may affect sales of medtech products, such as a recommendation that hospitals focus on outpatient cases and partner with ambulatory surgery centers to increase capacity. 

Medtech companies are alert to the ASC opportunity. Smith & Nephew, for example, identified ASCs as a growth area and saw a “significant increase” in their use for joint replacements over the first half of the year. Even so, such sites still only account for around 10% of Smith & Nephew’s knee sales.  

The fact that AHA and its collaborators see a potential need for hospitals to source additional surgery capacity reveals concerns about the ability of healthcare systems to cope with COVID-19 on top of their other work. Those concerns were largely absent from the comments medtech executives made when talking about their prospects for the rest of 2020.

While some companies referred to limited deferrals in response to the uptick in COVID-19 cases in parts of the country after the close of the second quarter, many more downplayed the risk of a shutdown on the scale of that seen in April and factored that view into their forecasts for the year.

Johnson & Johnson CFO Joseph Wolk characterized the mood when he told investors a second wave “should not have the same level of global impact that's been experienced in the last four months.”  

Author: Nick Paul Taylor


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