A month after a sharp increase in COVID-19 cases in the Appalachian Highlands prompted Ballad Health to postpone all elective and non-emergent surgeries, the health system is now preparing to resume some procedures.

Eric Deaton, Ballad Health’s chief operating officer and incident commander of its Corporate Emergency Operations Center, announced the change at a press conference Wednesday morning.

Beginning Wednesday, Ballad hospitals once again began providing some elective surgeries that do not require overnight stays. Patients are currently being contacted by their providers’ offices to schedule procedures, and capacity at each facility is determined by individual hospitals’ staffing and space availability.

Any facilities that did not resume some elective procedures Wednesday will resume those procedures on Monday.

“This summer, we had to prepare for a high volume of COVID-19 patients and plan for a worst-case scenario, which unfortunately required us to curtail some services. Given the limitations on available staffing, it was necessary to take these steps to ensure the safest possible environment for our patients and team members,” Deaton said. “We are grateful for everyone’s ongoing cooperation and input – from the medical staffs who provided their guidance, expertise and support, to the team members who continue to rise to the challenge and meet the needs of our patients, wherever they may be.”

Ballad Health did not furlough any team members during the deferral period, but many affected team members were asked to provide support in various areas throughout the facilities in which they work. This change enabled Ballad Health to prioritize the most critical and highest-acuity patients and address the worst COVID-19 surge it had seen to date, with a record high of 413 COVID-19 inpatients on Sept. 7, and an all-time high number of 112 COVID-19 patients in its intensive care units on Sept. 13.

The steps Ballad Health took to limit non-emergent elective surgical procedures helped mitigate the impact on Ballad Health’s capacity as volumes shifted from surgical to COVID-19 and other urgent medical admissions. Deaton and other Ballad Health leaders, however, caution that the system is still seeing high numbers of COVID-19 patients, who require additional support for frontline team members.

As of Wednesday, Ballad was caring for 324 COVID-19 patients in its facilities, down from 371 a week prior. Ninety-seven of those patients hospitalized Wednesday were in intensive care, and 73 were on ventilators.

“We have to face the new reality of the pandemic, in which we have to care for hundreds of COVID-19 inpatients while also providing the health care services our community needs and deserves,” Deaton said. “We’re going to do everything possible to support our team members in those areas with the assistance they need, and we’re going to continue advocating for our communities to get vaccinated, wear masks and follow prevention measures to bring these cases to a heel.”

Of the 324 COVID-19 patients currently hospitalized in Ballad facilities, 94% are unvaccinated. Ninety-eight percent of COVID-19 patients in ICUs are unvaccinated, and 99% of COVID-19 patients on ventilators are unvaccinated.

Currently, the only elective or non-emergent surgeries being scheduled at Ballad Health hospitals are those that do not require an overnight stay, and the capacity at each facility is determined by the hospital’s staffing and space. Ballad Health leaders, though, are hopeful the service can be extended in the coming weeks.

To determine which procedures are classified as non-emergent, Ballad Health will continue to follow the Elective Surgery Acuity Scale, which was developed by St. Louis University and is recommended by the American College of Surgeons as hospitals and health systems respond to challenges posed by COVID-19.

As examples, postponed procedures have included low-acuity surgeries for healthy and unhealthy patients, such as hernia repair, cholecystectomy, cardiac and interventional radiology procedures, aesthetic and plastic surgeries, podiatric procedures, vasectomies, bariatrics, joint replacements, screening endoscopies and non-essential spine surgery.

In coordination with the respective chairs of the medical staff, and surgery and anesthesiology leaders, Ballad Health will continuously evaluate its capabilities to return to full services, taking into account the spread of the COVID-19 virus and projected volumes, patient demand for urgent and emergent services requiring medical or surgical admission and available staffing.

“We will continue to monitor our COVID-19 patient numbers. If we continue to see a decrease in hospitalizations we will bring back more and more elective surgeries moving forward,” Deaton said.

Heather Smith, a woman whose father, Leeroy Garland, passed away from COVID-19 a few weeks ago, spoke at Ballad’s press conference Wednesday.

Smith said her father was unvaccinated after buying into misinformation about COVID-19, particularly the false equivalence between the flu and flu vaccine, and COVID-19 and the COVID-19 vaccine. Her father, who once had a severe reaction to a flu vaccine decades ago when in the Army, never thought to have a conversation with his doctor about the differences between the flu vaccine and COVID-19 vaccine.

“I feel very strongly that had my dad been vaccinated, he would still be with us today. It’s a horrible, horrible death, to watch someone you love die from COVID-19,” Smith said. “My dad, on his literal death bed, reached up and grabbed my brother by the collar and said, ‘get the shot.’”

Smith said her 61-year-old father was healthy. He was not overweight and had no co-morbidities.

Deaton continued to urge those in the area to get vaccinated to help prevent further deaths.

“All this can be prevented. We know that,” Deaton said. “Please do the right thing and get the vaccine as soon as possible.”