INDIANAPOLIS — Gov. Eric Holcomb announced that health care systems could phase in elective medical procedures within the week if personal protective equipment (PPE) numbers remain steady.
"After working with the Indiana Hospital Association and our 10 different health districts around the state of Indiana in regards to our supply inventory of PPE ... we will be opening up elective procedures in a staged way," Holcomb said Monday.
Holcomb stressed that reopening elective surgeries, just like reopening the state economy, would be deliberately eased in to reduce the spread of the coronavirus. Starting Tuesday, healthcare providers could diagnose, screen and treat medical conditions for possible surgeries starting April 27.
"You are practicing, in large part, good physical distancing," Holcomb said to Hoosiers. "That has made a significant difference."
Joseph Heerens, the governor's general counsel, said that the order included details for dental offices, ambulatory surgical centers and plastic surgeons who may reopen following the easing of guidance on PPE conservation.
"The idea behind the suspension of elective surgeries and invasive procedures for certain categories ... was to preserve that PPE for the surge that we were anticipating," Heerens said. "Between now and Sunday there will be an evaluation, based on the circumstances, to allow those ... to resume."
Every seven days the state would reevaluate, Heerens said, whether further easing of protective measures would be possible.
But State Health Commissioner Dr. Kristina Box remained unconvinced that Indiana had overcome the predicted surge, last projected for late April in Marion County and early May for the rest of the state. She said that even as more sectors open some high-risk Hoosiers might need to continue staying or working from home.
"Last week, we saw some flattening in several areas like we have potentially reached a plateau," Box said. "I'm not 100% that we've reached that peak. I think I'll be interested to see what our modeling shows (later) this week."
Box said the modeling did show that Indiana's case numbers were running lower than originally projected.
But the number of reported deaths will increase in the upcoming week as the department adds presumptive positive cases, or cases where the patient didn't have a positive test for COVID-19.
"It's important to me, to the state and to the nation that we do capture people who lost their lives from this disease," Box said. "But that test may come back negative because we do have false negatives ... it's making sure we're realistically capturing every individual."
Box also said the department would issue new guidance on end-of-life measures for patients, saying decisions should be made on a case-by-case basis to give families this "last gift" and allow goodbyes.
Box said the decision to reopen to elective procedures would be a hospital-by-hospital decision, as health care systems evaluated their COVID-19 cases and their PPE supplies.
"The ability to know as a hospital system that you are well-stocked with all of these things and that you safely can allow these other procedures to start happening is really, really critical," Box said. "As we go forward, if we start to see a surge (a hospital system may) ... say we need to lock this down for a little bit and reopen as needed."