By Tim Mastro

Several Delaware hospitals entered Crisis Standard of Care protocols on Monday to address the “unprecedented demand for hospital and health care services.”

ChristianaCare was the first health system to make the announcement and issued a joint statement with Bayhealth, TidalHealth Nanticoke and Trinity Health Mid-Atlantic-Saint Francis.

Crisis Standards of Care are used in times of emergency to guide decision-making when the demand for care surpasses the available resources, and contingency strategies designed to maintain conventional processes of care have been exhausted, according to a press release by ChristianaCare.

They provide a framework in which health care providers can modify processes or change the way resources are allocated in order to care for patients with the highest need in conditions when it is no longer possible to deliver care according to normal standards.

The new rules will allow hospitals to change admission or discharge criteria, adjust how supplies are allocated, change how treatment resources are distributed, modify surgical and other procedural and diagnostic schedules, limit availability of non-urgent services, change workflows and redeploy clinical and non-clinical staff. It will also simplify documentation requirements, adapt documentation, reporting and approach to regulatory requirements as well as adjust staffing standards including, among other things, staffing ratios, return to work, annual educational requirements or credentialing requirements.

“The health care system is under unprecedented strain,” said Dr. Janice Nevin, ChristianaCare president and CEO, in a statement. “Never have there been this many people in our community who need hospitalization, emergency care and other health care services. We have taken this step to implement Crisis Standards of Care so that our caregivers have the flexibility and decision-making tools they need in order to deliver care to patients with the highest need at this time when the demand exceeds all available resources.”

ChristianaCare has been operating at more than 100% of capacity in its hospitals, emergency departments, urgent care centers and practices, according to its statement. Approximately 40% of all patients at Christiana Hospital, Wilmington Hospital and Union Hospital in Elkton, Maryland are COVID-positive. The health system said the vast majority of these COVID-19 patients are symptomatic and were admitted because of COVID-19 or require a higher level of care because of the impact of COVID-19 on their health.

Delaware posted a record of 714 COVID-19 hospitalizations, according to the Division of Public Health’s most recent statistics, which reflect data as of Sunday at 6 p.m. The agency updated data for Saturday, which previously reported 784 hospitalizations which DPH has now adjusted to 688 after receiving updated information for one of the state’s hospital systems.

According to national data from the Centers for Disease Control and Prevention, an unvaccinated American is 14 times more likely to die from COVID-related complications than a fully vaccinated person. This goes up to 20 times more likely when compared with someone who has received a booster vaccination. ChristianaCare said this data aligns with what caregivers are seeing on the front lines, as families continue to lose loved ones and health care workers struggle to save lives under crisis conditions.

“This is not sustainable,” said Dr. Ken L. Silverstein, ChristianaCare chief physician executive.. “We urgently need the community to help us. We need everyone to get vaccinated, get their booster dose when eligible, and continue to practice the safety steps that we know are effective in reducing the spread of COVID — masking, social distancing and hand-washing — even in places where guidelines aren’t posted or masking isn’t required.”