Polis orders halt to cosmetic procedures to preserve hospital beds

Gov. Jared Polis on Sunday ordered a one-month halt to cosmetic surgeries in Colorado to try to preserve hospital capacity, but it’s not clear how many beds that might free up.

A separate order, also released Sunday, gave the state more power to direct hospital transfers by forbidding hospitals to refuse to accept a patient they have the capacity to treat, or to refuse to send the patient to a different facility. Polis had said last week that hospitals were trying to keep patients within their own system, but didn’t specify how often that had happened.

The order on cosmetic procedures took effect Monday and expires Dec. 1. It applies to hospitals and to outpatient surgery centers, but only covers a fraction of all elective procedures. Any surgery that can be scheduled — ranging from knee replacements to removing tumors — is considered elective. Polis had floated the possibility of delaying all non-emergency procedures at a news conference last week.

There is an exception for cosmetic surgeries that have to happen in the next six months to prevent a person from dying or losing significant physical functioning. That would seem to leave the door open for certain reconstructive surgeries, which may have a cosmetic component, but also are intended to repair an injury.

The state didn’t release an estimate of how many beds might be freed up by halting cosmetic procedures. Some hospitals have been triaging surgeries for weeks, delaying those where the patient is less likely to suffer permanent harm.

Last week, Polis laid out five possible options for dealing with the shortage of hospital beds: expanding access to a treatment to reduce the odds of hospitalization; taking control of the transfer process, to use all available beds; calling on the Federal Emergency Management Agency for staffing help; stopping all elective procedures; and implementing crisis standards of care, which could involve care rationing or less-than-ideal staffing patterns in hospitals.

On Thursday, the state announced that it would expand treatment starting this week. The weekend’s executive orders take control of the transfer process, and partially limit elective surgeries. So far, the state hasn’t activated any crisis standards of care in this wave, though an order on Sunday amending the governor’s disaster declaration would pave the way for it to do so.

Another order required counties to consult with the Colorado Department of Public Health and Environment about additional restrictions if at least 85% of their hospital beds are full in the next month, but didn’t specify what those restrictions might be, or if the state would have any legal ability to enforce them.

It also required almost everyone 12 and older to wear masks in long-term care homes, medical facilities and correctional buildings. Previously, only unvaccinated people were required to mask up in those settings.

A third executive order issued Sunday required vaccine providers to give second shots to anyone who is eligible, even if they didn’t give the first shot, and to give boosters to anyone who says they qualify. That order didn’t have a sunset date.

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