In a recent conversation, HealthTrust CMO, John Young, M.D., spoke with Duke Health Infectious Diseases Specialist, Shaefer Spires, M.D., about returning to elective surgeries, and the risks associated with delayed treatment

Balancing Risks of Elective Surgeries

Young: It’s this constant balancing: the risks of reopening versus the risks of some of these patients holding off on necessary treatments. For now, they’re presenting with some chronic conditions that they otherwise wouldn’t have had.

Spires: That’s a great point; there are things that you really cannot stay away from in health care or it’s going to get worse. For instance, just this week on the consult service I had a gentleman who had fevers and chills for over a week and avoided going to the ER and couldn’t get in to see his primary care doctor because he supposedly had to have a negative COVID test. He finally declined enough to where an ambulance brings him to the hospital, and it turns out he’s got a MRSA bacteremia. Things like wounds get worse if they’re not being addressed and there’s other syndromes like stroke and coordination drills and these guys need to be seen.

Safety of Hospitals and ERs

Spires: John, tell me if you disagree but I don’t think our ERs are necessarily an unsafe place to be. I mean, if there’s any place to be that is safe for patients it’s at the hospital. What we are

specifically thinking about is isolating and protecting healthcare workers and patients from the spread of this and we know from the little data we have here in the U.S., there’s actually been very little health care worker transmission and very little intra-hospital transmission of COVID even in the huge surge hospitals.

Young: I would agree. We’ve told everybody across the country to shelter in place and then you see on the news the pictures from the hospitals that can certainly be alarming and now what we’re faced with, to your point, is people not seeking care when they should and having chronic illnesses become worse. As a former interventional cardiologist, it’s interesting to me the 30 to 40 percent drop in acute MIs and strokes and the typical emergencies that you would see hitting our ERs that just aren’t showing up.


To hear the rest of the conversation, please visit our podcast: The Safest Place to Be


S. Shaefer Spires, M.D.
S. Shaefer Spires, M.D.
Infectious Disease

Dr. Spires graduated from the University of Georgia in 2003 and Mercer University School of Medicine in 2009. He completed residency training in Internal Medicine and fellowship training in Infectious Diseases at Vanderbilt University. He joined the faculty at Vanderbilt in 2014. He currently serves as the Hospital Epidemiologist at Williamson Medical Center and at the Tennessee Valley VA Healthcare System. He is physician chair for both the Infection Prevention Programs and the Antimicrobial Stewardship Programs at both institutions. His primary research interests are focused on the prevention of outpatient central line-associated bloodstream infections, antimicrobial stewardship, and infection prevention in the acute inpatient setting as well as in the long-term care setting.



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