In a move to conserve hospital capacity and critical resources, and to reduce health care workers’ and patients’ exposure to the coronavirus, Gov. Greg Abbott on Sunday issued an executive order directing the postponement until late April of all surgeries and procedures “that are not immediately necessary.”
The governor said the patient’s physician will determine the necessity of the procedure.
“Patient care capacity is essential during this time,” he said at a news conference that was televised statewide.
The governor’s order comes on the heels of related guidance that the Texas Medical Board (TMB) issued Saturday.
“The cornerstone is to determine if these types of procedures are delayed or canceled, will a patient’s condition get rapidly worse,” the guidance said.
The TMB guidance referenced guidelines recently issued by the Centers for Disease Control and Prevention (CDC) and the tiered framework proposed by the Centers for Medicare & Medicaid Services (CMS). When determining whether to perform a procedure, that framework suggests considering factors such as the local prevalence of COVID-19 cases; the availability of personal protective equipment, staffing, and hospital beds; the patient’s health and age; and the urgency of the procedure.
Here is the text of Governor Abbott’s executive order:
“Continuing until 11:59 p.m. on April 21, 2020, all licensed health care professionals and all licensed health care facilities shall postpone all surgeries and procedures that are not immediately medically necessary to correct a serious medical condition of, or to preserve the life of, a patient who without immediate 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 procedure that, if performed in accordance with the commonly accepted standard of clinical practice, would not deplete the hospital capacity or the personal protective equipment needed to cope with the COVID-19 disaster.”
No Statewide Shelter in Place Order
Also during his news conference Sunday, the governor said he is not ready to issue a statewide order for Texans to shelter in place because of the coronavirus pandemic. Governor Abbott said he first wants to determine how the social distancing orders he issued last week are affecting the spread of the virus.
“Local officials have the authority to implement more strict standards than I as governor have implemented in the state of Texas,” he said. “If they choose to do so I would applaud them for doing so, but at this time it is not the appropriate approach to mandate that same strict standard across every area of the state, especially at a time when we are yet to see the results coming out of my most recent executive order.”
Several hours later, Dallas County Judge Clay Jenkins issued a shelter-in-place order through April 3 for the state’s second most-populous county. According to the Department of State Health Services’ most recent report, Dallas had more confirmed COVID-19 cases (33) than any other county in Texas.
“Because of the risk of the rapid spread of the virus, and the need to protect the most vulnerable members of the community, this order requires all individuals anywhere in Dallas County to shelter in place – that is, stay at home – except for certain essential activities and work to provide essential business and government services or perform essential public infrastructure construction, including housing,” Judge Jenkins’ order read.
“Essential businesses” under the Dallas County order include hospitals, clinics, dentists, pharmacies, other health care facilities, blood banks, and labs, among others.
For the latest news and information on the coronavirus pandemic in Texas, including links to official CDC, DSHS, and TMB documents, be sure to visit the TMA COVID-19 Resource Center regularly.