A memo from the North Texas Mass Critical Guidelines Task Force was sent to members about a plan should the region run out of intensive care beds, according to the Dallas Morning News.
If this occurs, physicians can take into account whether or not a person has been vaccinated when deciding how to triage beds.
Dr Mark Casanova, director of clinical ethics for Baylor University Medical Center and a spokesperson of the group, initially told NBC Dallas-Fort Worth on Thursday that it was meant to be a guide for doctors in rare situations.
However, in a separate interview, he backpedaled and said the memo was a ‘homework assignment’ that members can think about and make suggestions for.
A memo on patient care was written by members of the North Texas Mass Critical Guidelines Task Force that says that if the region run out of ICU beds, physicians can take into account whether or not a person has been vaccinated. Pictured: Dr Michael Nguyen tends to a patient in a hallway at the Houston Methodist The Woodlands Hospital in Houston, August 18
‘Seriously, we need help. We need help to help you. We’re not exaggerating things,’ Casanova told NBC DFW.
‘We have limited capabilities at this time. Limited bandwidth, limited staff, and the numbers are likely to outpace our capabilities.’
The memo was written by Dr Robert Fine, co-chair of the task force, and a copy was leaked to the Morning News.
The guidelines in the memo are not enforceable but are generally followed by the members, who work at dozens of hospitals in North Texas.
In Texas, COVID-19 cases have risen dramatically over the last four weeks from an average of 9,238 per day to 19,899 per day, according to data from Johns Hopkins University.
This is not a 115 percent jump but nearing the seven-day average record for 23,195 cases per day set on January 12.
Data from the Department of Health and Human Services (HHS) show than 91.8 percent of all ICU beds are occupied with COVID-19 patients accounting for half.
North Texas has been hit especially hard, asking for thousands of staff to be deployed to the area.
According to the Dallas-Fort Worth Hospital Council, there are also no pediatric beds left in trauma service area E, made up of 19 counties in North Texas.
The Morning News said the memo. which summarized decisions made by the task force during a meeting on Monday, has three main points:
- Vaccination status can be ‘considered when making triage decisions’ estimating a patient’s likelihood of survival
- Factors ‘beyond the patient’s control’ have to be considered if he or she is unvaccinated such as a caretaker refusing to have a dependent vaccinated
- Healthcare professionals have to continue to be show ‘care and compassion’ even if angry that a patient is unvaccinated
According to the memo, these rules will only go into effect if North Texas hospitals declare a Level 3, or crisis, alert, reported the Morning News.
The group says vaccination status is not he only factor, meaning a vaccinated patient will not automatically be chosen over a non-vaccinated person for a bed.
Doctors will have to considered other factors when triaging care including pre-existing conditions and the chances the person will recover and be discharged.
Dr Harald Schmidt, a professor of medical ethics and health policy at the University of Pennsylvania, told the Morning News the memo does not take into account patients that are at a socioeconomic disadvantage such as poor people and minorities.
He explained there are several reasons these groups have lower vaccination rates than rich and white Americans including lack of transportation to appointments and distrust of healthcare.
‘This policy pretends that it is just focusing on objective medical knowledge, but it ignores societal injustices,’ Schmidt told the newspaper.
‘In such cruel clarity, COVID-19 has exposed the consequences of the structural inequities that we’ve had so long. That’s why it’s critical that we don’t add to that, and in this case, we risk that.’