He didn’t have to wait too much longer: On May 6, he underwent a procedure to repair a hiatal hernia, a condition in which part of the stomach bulges through the diaphragm. He’s now recovering at his San Jose, California, home, with most of the symptoms a memory.

Soliman was one of the first patients to undergo surgery after Stanford Medicine restarted nonemergency procedures, including outpatient visits, screenings and diagnostic tests on May 4. Now, physicians and other providers at about 90% of Stanford Medicine’s 600-plus clinics are back to caring for patients.

Stanford Health Care — including Stanford Health Care – ValleyCare, the Stanford Medicine Outpatient Center, Stanford Cancer Center South Bay, Byers Eye Institute, and Stanford Health Care, Emeryville — had paused most procedures and in-person visits starting on March 13, in part to preserve resources for an anticipated surge of COVID-19 patients.

Clinicians at Stanford Medicine’s hospitals and outpatient centers continued to treat patients with emergencies such as heart attacks, strokes and trauma during the pause, and treated cancer patients and others who could not safely wait. For patients who didn’t need hands-on services, clinicians provided care via video and phone, and they continue to do so.

Instituting safety protocols

Stanford Medicine didn’t experience a COVID-19 patient surge, but it did institute new protocols as a result of the pandemic. Nearly all patients undergoing procedures are now tested for the coronavirus beforehand, excluding patients having minor outpatient procedures. More than 2,000 patients have been tested. In addition, anyone entering a Stanford Medicine facility must wear a mask; with few exceptions, visitors are not allowed; and health care workers must undergo daily checks for symptoms. 

Throughout the pandemic, Stanford Medicine has maintained an adequate supply of personal protective equipment, including N-95 masks and face shields for those caring for infected patients, said Sam Wald, MD, vice president and associate chief medical officer at Stanford Health Care. And as a further safety measure, it has tested about 95% of its health care workers. Less than 0.3% of them without COVID-19 symptoms have tested positive.

“This low incidence shows the level of safety at our hospitals,” Wald said. “Even though we have had COVID-positive patients in the hospital, we are not exposing our staff to infection.”

Stanford Medicine leaders are confident that their hospitals and clinics are safe for health care providers and patients, among whom there have been no recorded transmissions of the coronavirus. 

“Stanford Medicine is probably one of the safest places you can be,” said Mary Hawn, MD, professor and chair of surgery. “We are taking every precaution.”

Moving to a new normal

Amy Semple, RN, administrative director of operations, said that Stanford Health Care is performing procedures at close to its pre-COVID levels. During the week of May 11, clinicians performed 94% of the volume of procedures conducted during the same period in 2019. 

Semple said she expects the volume to completely return to pre-pandemic levels soon.

Hawn, who performed a procedure known as nissen fundoplication to repair Soliman’s hernia, said that Soliman was one of the first patients her office called to reschedule surgery. 

“He was incredibly patient, working with us through this process,” she said.

As he waited, Soliman spent time volunteering for his church, delivering food to people affected by the pandemic. When Hawn’s staff called to ask if he was ready, he didn’t hesitate. “I felt that they were taking care of things — in fact, going above and beyond,” he said, “so I felt comfortable.”

Soliman stayed one night at Stanford Hospital and left the next day. The surgery was a success, Hawn said. He was limited to a liquid diet for several weeks. Hawn expects him to be back to normal in a few months. 

Recently, as Soliman ran some spinach and kale through the blender for his dinner, he reflected on the years he toughed it out, before his surgery. The pain from the hernia radiated to his back, his shoulders and his sinuses, and medication didn’t help. 

“I’m much better now,” he said.