Long Island hospitals resuming surgeries after delays from COVID-19 pandemic

When Sherry Kunjbehari of New Hyde Park was diagnosed with breast cancer in February, the plan was for her to have a double mastectomy and breast reconstruction in early April.

Then came the COVID-19 pandemic.

Kunjbehari ended up waiting a month before having surgery May 5 at Northwell Health's Syosset Hospital.

She was one of thousands of patients at Long Island hospitals who had their surgeries delayed as COVID-19 peaked and drained system resources. Nurses and other support staff usually dedicated to cancer, cardiac or other services were placed in emergency departments to help handle the influx of COVID-19 patients.

"I was afraid, because I wasn't sure if the cancer would spread," said Kunjbehari, 46. "I'm not an anxious person, but waiting definitely made me anxious."

In March, the state also halted elective surgeries. That order has yet to be lifted, which meant that while Kunjbehari was able to have her breasts — and thus her cancer — removed, she still had to wait for the reconstruction. So, a surgery many breast cancer patients have at once will turn into two for Kunjbehari.

"At least the cancer is out of me," she said.

Northwell, the largest health system and private employer in the state, began ramping up surgeries over the past week, as patients able to wait began having them. Northwell cleared Syosset Hospital of COVID-19 patients, moving them to nearby facilities, including the larger Long Island Jewish Medical Center in New Hyde Park and North Shore University Hospital in Manhasset. 

It has increased surgeries at other hospitals, too, as the number of COVID-19 patients has dropped, said Dr. Jose Prince, vice chairman of surgery at Northwell Health. 

He said the number of surgeries at the health system's hospitals fell from 1,000 per day to about 100 daily during the height of the pandemic. 

"We postponed 12,000 surgeries, but a patient can wait only so long, and as we've analyzed them, about 2,000 of the postponed surgeries are now more urgent and need to be done," Prince said. "Waiting has been incredibly stressful for patients and, quite frankly, for surgeons. But we had to keep patients safe, and statistics showed that people who contracted COVID and had surgery had significantly worse outcomes."

Prince said some surgery patients are still scared to come into hospitals.

"There is a lot of tension in both directions," he said. "Some are afraid to wait; others are afraid to come to the hospital."

At Mount Sinai South Nassau in Oceanside, surgeries went from an average of 40 daily before the COVID-19 outbreak to about three or four emergency procedures per day during the surge, said Dr. Rajiv Datta, chief of surgery at the hospital.

Datta said the hospital is up to performing 10 to 15 surgeries daily for patients whose conditions significantly worsened.

Some surgeries that were pushed back because they were considered elective have now become more urgent due to the delay, he said. For example, one patient waiting for spine surgery started feeling numbness, Datta said, adding that there was also an early stage colon cancer patient who started to bleed, so "we did that surgery."

 A South Nassau patient with an ulcer on his left toe also had to have surgery after he developed gangrene, in which body tissue dies because of either a lack of blood flow or an infection. 

"It's really sad to see all this," Datta said.

Patricia DeFreitas, 55, of Lindenhurst, had neck and spine surgery at Mount Sinai South Nassau on May 4, after her procedure was postponed in March. 

"My right arm was going numb from my fingers to my shoulders, and I was dropping things," DeFreitas said. "It was getting worse and worse, and then the left arm was starting to feel the same way, so they had to operate."

She said, "I was a little scared going to the hospital, but I was more scared that I was dropping things. It had to get done."

Catholic Health Services also has seen an increase in surgeries as more elective procedures become urgent, said Dr. Patrick O'Shaughnessy, executive vice president and chief clinical officer. He said some cancer, cardiovascular and cardiac patients couldn't wait.

O'Shaughnessy added that CHS plans to see a large increase in surgery volume at its six hospitals once the elective surgery ban is lifted.

"Our concern is with elective surgeries, which are defined as surgeries we can safely delay for three months," he said. "It's coming up on that time period soon, and we're hoping to be able to start elective surgeries by May 29. We're waiting to see if the state gives the go-ahead."

NYU Winthrop also has started to perform more surgeries, said Dr. Joseph Greco, chief of hospital operations at the Mineola hospital.

Before the pandemic, NYU Winthrop averaged about 100 surgeries per day. In April, that number was down nearly 90%.

Greco said the hospital is back up to about 40 operations daily, which is about 40% of its normal high. Greco said he doesn't expect any hospitals to get to pre-COVID-19 numbers soon.

"We are still conscious of social distancing," he said. "Arrival times are going to have to be very carefully coordinated. We aren't going to see waiting rooms full of people."

Stony Brook University Hospital is performing about 15% to 20% of normal pre-pandemic activity, said Dr. Todd Griffin, president of the medical staff at Stony Brook Medicine.

"During the height of the pandemic, we only performed urgent/emergency cases and our operating rooms ran at about 5 to 10 percent of our pre-pandemic capacity," Griffin said.