Healthcare

Utah hospitals discussing plan to ration ICU care with governor as coronavirus cases surge in the state

Hospitals in Utah could soon be forced to begin prioritizing younger COVID-19 patients over older ones in some cases amid a surging rate of hospitalizations from the virus in the state, according to a plan presented to Utah's governor on Thursday.

Hospital administrators in the state told Gov. Gary Herbert (R) that they could ask him to approve a plan in the coming weeks that would take drastic steps to reduce intensive care unit (ICU) admissions in the event of hospital ICUs being overwhelmed, which they said was a serious possibility in the days ahead.

A state official told The Hill that the specifics of the plan were not presented to Herbert, but that he was advised that hospitals would likely have to enact a plan to deal with at-capacity ICUs in the coming weeks.

If ICUs are nearing capacity, patients who are not seen to be improving even with intensive care will be asked to consider moving to a regular hospital bed. Doctors will also be asked to clearly communicate with patients about do-not-resuscitate orders.

"These discussions on goals of care need to occur independently from triage decisions," read the guidelines, according to the Salt Lake Tribune. "Providers must be careful not to coerce patients or their families."

Once ICUs reach capacity, hospitals will take matters into their own hands to determine ICU priority, according to the Tribune. Lower priority will be given to patients who are older if two patients are otherwise equally eligible for an ICU bed, while those who are pregnant receive higher priority.

A spokesperson for Herbert's office and other state officials confirmed to the Tribune and other news outlets that ICUs in the state are nearing capacity, but did not say whether Herbert would approve the plan proposed by hospital administrators.

"Right now, it feels very close to being under the crisis standards of care. The [hospital administrators] were very clear about the level of stress that they're under," said Joe Dougherty, an official with Utah's Division of Emergency Management. "We can have a public health order ... but even with that in place, we still need people to choose to limit their gatherings."

"We are not there yet, but we are too close, uncomfortably close," added a spokesman for the governor.

Utah's daily rate of new coronavirus cases is now double what it was at the peak of the first wave of cases earlier this year, with state officials reporting 1,543 new cases on Saturday, according to The New York Times. Across the state, 319 patients are currently hospitalized with the virus, while 572 deaths have been reported in the state since the pandemic began.

Updated at 9:50 p.m.

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