As coronavirus numbers 'spin out of control,' Holcomb cancels elective procedures

With more than a third of Indiana counties in the red zone for the highest level of coronavirus spread, Gov. Eric Holcomb on Wednesday ordered the state’s hospitals to suspend non-emergency procedures and placed hard limits on social gatherings.

“The state of Indiana is on fire,” Holcomb said at his weekly news conference detailing the coronavirus response, adding that the numbers had begun to “spin out of control.”

On Wednesday, Indiana reported 5,853 new cases of coronavirus and an additional 98 deaths, bringing the pandemic’s death toll to more than 6,200. Last Thursday, the state once more shattered its record for daily cases, reporting more than 8,450 new cases.

All of the state’s 92 counties now have more than 200 cases of coronavirus per 100,000 residents. The state’s seven-day rolling positivity rate exceeds 14%. Hospitals are seeing more than 400 new admissions a day for COVID-19. 

“It’s an exponential rise,” said Indiana State Health Commissioner Dr. Kris Box, talking about the case trajectory of recent weeks. "This clearly shows the surge is far from over."

Beginning this weekend, Holcomb said, local health departments will no longer be able to grant exceptions to the 50-person cap on social gatherings in orange counties and the 25-person cap in red counties. 

Because an increase in hospitalizations often comes on the heels of an increase in cases, Holcomb said he would suspend all elective surgeries from Dec. 16 to Jan. 3 so that hospitals could reassign staff and preserve beds for those in need.

“This is a directive I don’t take lightly,” Holcomb said. “I understand the impact this will have on our hospital network overall.”

Holcomb added that those who need care should not hesitate to seek it.

The state’s hospitals are already overcrowded, asking staff to work long, exhausting hours. In some cases they have turned away patients, directing them to other facilities. Currently more than 3,200 people are hospitalized with COVID-19, far more than the spring’s peak of just under 1,800.

In the spring, Holcomb took a similar step as part of a more comprehensive lockdown. Many rural hospitals, which waited for a surge that never came, felt a financial sting from having to cancel elective procedures, which can be more lucrative than other forms of care.

As the coronavirus cases have risen, Holcomb has said over and over that he wants to balance “lives and livelihoods.” He has been loathe to return Indiana to the early days of the pandemic when much of the state was shut down.

But with more cases expected to follow as a fallout from Thanksgiving gatherings and the winter holidays on the horizon, hospitals are bracing to see yet another spike of COVID-19 patients.

Delaying procedures can come at a cost for all, said Brian Tabor, president of the Indiana Hospital Association.

“We have learned the lesson from earlier this year that delaying essential care has consequences on the short- and long-term health of patients, and this, together with the record number of COVID-19 admissions, are the major reasons hospitals are so busy right now,” he said in an emailed statement. “It is literally a matter of life and death that all stakeholders do everything they can."

While the stakes may not be quite as high for patients who do not need urgent care, Holcomb's order to halt non-emergency procedures may come at an awkward time for both surgeons and patients alike.

Typically December is a busy time as people try to squeeze in costly elective procedures once they have met their insurance deductibles for the year.

Just hours before Holcomb made his announcement Wednesday, Vincent Walter, 54, Lafayette, was talking to his doctor about whether he might need surgery on an arm he injured in June. He's had several medical expenses apply toward his deductible this year, so he thought it would be more cost-effective to fix his arm this year, too. 

Then he heard about Holcomb's announcement.

"That puts a damper on that ... I didn't see that coming," Walter said. "Basically I would be back to page one .... The clock resets at midnight on Jan. 1st."

Contact IndyStar reporter Shari Rudavsky at shari.rudavsky@indystar.com. Follow her on Facebook and on Twitter: @srudavsky.