UPDATE (12:11 p.m. PT) – Gov. Kate Brown announced Thursday she plans to lift restrictions on hospitals, allowing them to reopen for non-essential surgical procedures starting next month as long as they reserve enough hospital beds and protective gear — gowns, masks, gloves — for a surge in coronavirus cases.

“As anyone waiting for an elective surgery knows, ‘non-urgent’ does not mean ‘minor,’” Brown said in a statement. “This is incredibly important medical care that we would not have told providers to delay if the threat of COVID-19 had not made it necessary.

Across the nation, governors put a stop to the procedures to free up hospital beds for a spike in coronavirus cases and preserve protective gear for health care workers.

Last week, Brown signaled easing restrictions on hospitals and allowing nonessential hospital procedures to resume would be one of her first moves toward reopening the state’s economy. 

On Thursday, Brown likened her latest order to testing the ice on the frozen lakes she grew up near in Minnesota. 

You take a “small step, put your weight on it and pause,” the governor said, warning there is always a chance she would need to reverse course. 

“We are only stepping onto the ice carefully and cautiously.  One step at a time,” she said.

Canceling elective and non-urgent procedures thrust hospitals into a difficult position: They were told to prepare for the COVID-19 pandemic, while at the same time seeing a dramatic drop in revenue waiting for the spike in patients.

Oregon Health and Science University announced it was cutting salaries on Thursday, in anticipation of a loss of more than $1 billion in the next two years, due to coronavirus.

Members of the Oregon Association of Hospitals and Health Systems wrote the governor a letter in early April warning of the hospitals’ finances’ dramatic dip and voiced concerns about how hospitals were being forced to lay off health care workers — people they would rely on in the midst of a pandemic.

“I would like to thank Oregonians for the sacrifices they have made during this crisis to ensure that our health care workers have the personal protective equipment they need to treat COVID-19 patients,” Brown said in a statement. “Lifting this order will allow our health care system to get up and running again, with appropriate safeguards in place, so that Oregonians can get health care treatment without delay.”

Bruce Goldberg, a doctor who sits on the governor’s medical advisory board, said the state will continue to monitor hospital admissions, hospital bed capacity and the number of cases and testing of COVID-19. 

“There will be an ability in terms of those metrics (to determine) whether some of the steps that have been taken have any adverse effect on what’s going on in our community,” Goldberg said. “I think there is going to be an ability to monitor this.” 

The state still needs to ramp up testing and its ability to contact trace infections. The state’s health authority is recommending hiring a force of 600 people to help trace down the contacts of anyone who tests positive.

Here’s a look at the framework Brown unveiled on Thursday that hospitals must follow if they wish to reopen starting on May 1:

  • Hospitals must be able to accommodate an increase in both COVID-19 hospitalizations along with other post-surgery hospitalizations.
  • Larger facilities must keep a 30-day supply of protective gear available and smaller ones must have a two-week supply on hand with a clear way to obtain more.
  • Hospitals need to continue to report their daily protective gear supply to the Oregon Health Authority-Facilities; they need to have access to COVID-19 testing and assurances they are able to quickly obtain results.
  • Facilities must also continue to limit the volume of elective procedures, and be prepared to halt procedures should a surge of COVID-19 cases happen.
  • Finally, facilities should continue to weigh the risks with accepting patients in higher-risk categories, such as those over 60, those with compromised immune, lung or heart functions and should try to continue to postpone elective procedures that would require blood transfusion or a transfer to a skilled nursing facility, where there are many vulnerable people living in communal settings.

The governor issued similar guidelines for reopening dental offices.