Banner-University Medical Centerย ย 

 Kelly Presnell, Arizona Daily Star 2018

Banner Health, the stateโ€™s largest hospital network, reported Tuesday that it is operating over capacity at several facilities and turning away surgeries that arenโ€™t medically necessary.

Dr. Marjorie Bessel, Bannerโ€™s chief medical officer, said she expects conditions to only get worse in the next month.

That will result in more instances of people with nonlife-threatening conditions having their surgeries delayed.

Moreover, โ€œif the forecasted trends continue, we will soon be unable to meet the health-care needs of Arizonansโ€ at Banner hospitals, Bessel said.

She said the hospital system is not yet using a โ€œtriageโ€ system to turn away patients whose illnesses or injuries are not considered severe enough, or where patientsโ€™ chances of survival are so low as to not merit care in an overcrowded situation.

Bannerโ€™s two hospitals in Tucson are Banner-University Medical Center, 1625 N. Campbell Ave., and Banner-University Medical Center South, 2800 E. Ajo Way.

For now, Bessel said, Banner does not anticipate a need in Arizona to have the National Guard called out to help set up medical facilities outside of hospitals, as has happened in some other states.

But it does not look good.

โ€œInpatient volumes are at their highest levels since the start of the pandemic, with several Banner hospitals operating above capacity,โ€™โ€™ Bessel said.

โ€œBannerโ€™s predictive modeling tools show no sign of letting up,โ€™โ€™ she continued. โ€œWe expect volumes will continue to increase throughout December and into the beginning of next year before peaking around the middle of January.โ€™โ€™

Those predictions do not account for the emergence of the omicron variant of COVID-19 that is now is present in Arizona, she cautioned.

Bessel said while omicron appears to be highly transmissible, there is still a lot to learn about how severe it is and whether those who contract it will need to be hospitalized or put into already overburdened intensive care units.

She repeatedly emphasized the importance of getting vaccinated and wearing masks to help deal with the problem, but declined to call on Gov. Doug Ducey to use his emergency powers to mandate either.

โ€œIโ€™m asking the community to assist us in preserving health-care capacity for all of you,โ€ she said. โ€œI believe that each one of us can make a personal decision to do our part.โ€

Her comments come as the state on Tuesday posted another 203 known deaths from COVID-19, bringing the total since the beginning of the pandemic to 23,243. There also were another 2,168 cases.

Itโ€™s not just a question of having beds, both in the intensive care units as well as for standard care, but a problem of not having enough staff to provide the necessary medical care, Bessel said.

โ€œWe are more stretched now than we have been since the start of the pandemic,โ€ she said. Many โ€œcore team membersโ€ decided to retire, seek another position within the hospitals that does not involve face-to-face health care or to get out of the profession entirely, she said.

Thatโ€™s due to โ€œprior surges and the enormous physical and mental impact the pandemic has had on them,โ€ Bessel said.

There is a significant difference, though, in what is causing the current overcrowding problem at hospitals.

In January, when more than 90% of intensive care beds were occupied, COVID-19 patients accounted for about two-thirds. Now, by contrast, those with COVID take up about 40% of all ICU beds.

But Bessel said the balance of patients is still a direct result of the pandemic.

โ€œWe know that individuals throughout the pandemic have, very unfortunately, because of the scenario that we have been experiencing, (been) delaying care,โ€ she said.

โ€œSome of them delayed preventative care,โ€ Bessel continued. โ€œSome of them are presenting after having symptoms over a protracted period of time and presenting late in the course of their disease or illness.โ€

The bottom line, she said, is that Banner has more patients now than since the beginning of the pandemic.

That leads to concerns about whether patients will be able to get into hospitals and also about how quickly they will be able to get care at Banner clinics.

Emergency rooms are crowded.

Bessel said patients whose injuries and illnesses are not life-threatening are instead being referred to primary care clinics. But that, in turn, means those clinics will be giving priority to established patients who are sick.

โ€œAs a result, patients may experience an increased wait for nonurgent primary care physician appointments that can safely be delayed, such as routine follow-ups, โ€˜well visitsโ€™ and new patient visits,โ€ she said.

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As to surgical care, Bessel said Banner hospitals and surgery centers are continuing to offer โ€œmedically necessaryโ€™โ€™ procedures, though each facility makes its own scheduling decisions day-by-day, depending on available staffing resources and capacity.

Medically necessary surgeries โ€œinclude things like mastectomies for breast cancer, gall bladder removal for stones, and hip replacement for those who are in pain,โ€ Bessel said.

One key to deciding whether to allow a surgery, she said, is whether significantly postponing it might result in it later becoming an emergency procedure.

โ€œEmergency surgeries often have a longer recovery and worse outcomes, which can then require hospitalization and ICU level of care,โ€ Bessel said.

One positive, she said, is that most scheduled surgeries do not require a stay in the already overcrowded intensive care units โ€œand many can be performed on an outpatient basis.โ€

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