A surgeon’s role in fighting a medical pandemic: Experiences from the unit at the epicentre of COVID-19 in Singapore – A cohort perspective

Abstract

Although Singapore was one of the first countries outside of China to be affected by COVID-19, for the first 2.5 months since its first reported case on January 23, 2020, it remained one of the few nations with successful containment of spread of the pandemic with little mortality and zero intra-hospital transmissions, without instituting a major lockdown of the country. In times of an infectious epidemic where medical subspecialties lead the frontline, a surgeon's role becomes rather vague. However, the only obstacle that stands in between the surgeon and fighting in the frontline of an infectious disease outbreak, is the traditional perception of what a surgeon can do. By presenting the strategies employed by our institution and its surgical unit, which remains the epicenter of the COVID-19 fight in Singapore, together with our medical counterparts, we hope to be able to improve our practices to respond and prevent the pandemic from escalating further as a collective community of surgeons across the globe. Observations: Contingencies should be in place for prioritization of existing patients, triaging and treatment of suspected patients, infection control, manpower management and novel strategies for inter-disciplinary communications and education in a hospital's surgical unit during a pandemic. Working in a high risk environment with manpower and resource limitations for prolonged periods of time has effect on morale and affects surgeon burn-out. Transparent communication, avenues to address psychological needs of surgeons and leadership by example are key strategies in ensuring a sustainable fight against the pandemic. Conclusions and Relevance: With the varies strategies implemented, every surgical discipline and every surgeon should be unified and place their desire to operate aside. There should not be any differentiation between surgeon and physician, but instead, everyone has to work together as one united health care front battling the common enemy -COVID-19.

Redeployment of Surgical Trainees to Intensive Care During the COVID-19 Pandemic: Evaluation of the Impact on Training and Wellbeing

“…Support' of the wellbeing of trainees is of crucial importance and cannot be overstated. 14 , 15 There is significant variation in the delivery of wellbeing support throughout the National Health Service, even between departments within the same hospital. Studies have suggested the introduction of a definition of wellbeing, with tangible outcome measures, may be useful in enabling staff to make better use of the wellbeing resources available to them.…”

“…Surgeons need to be more transparent about their psychological needs, and senior leaders should be encouraging and supportive of this. 14 Structured leadership programmes should be incorporated into surgical training curricula, 23 rather than courses that trainees are expected to attend of their own accord. Shared responsibility to support colleagues and encourage them not to continue working in the face of personal risk as self-less acts is essential.…”

Safety and Effectiveness of Orthopaedic Medical Staff in Providing Support in Combating the COVID‐19 Pandemic: A Retrospective Investigation from Wuhan, China

“…Given the high infection rate among healthcare workers, the safety of healthcare workers from specialties other than respiratory and infectious diseases has become a widespread concern. Although surgeons have shared their opinions and experiences in the work to combat the COVID‐19 pandemic 6–8 , based on the outcome of a search in PubMed, up to now no published data is able to provide evidence to illuminate whether or not it is safe for medical staff from other specialties to provide support in the work against the COVID‐19 pandemic. In addition, the effectiveness of this kind of support is not yet documented.…”

Public Preferences for Government Response Policies on Outbreak Control

“…The survey was administered to an adult sample of Singapore’s general population during the initial stages of the COVID-19 pandemic. This provided the unique opportunity to capture public opinion during a period of potential physical, psychological, and financial turmoil of an outbreak-turned-pandemic [ 10 – 13 ].…”