COVID-19 and Orthopaedics: Recovery After the Pandemic Surge

Abstract

The novel Coronavirus (COVID-19) pandemic has placed an immense strain on health care systems and orthopedic surgeons across the world. To limit the spread, federal and state governments mandated the cancellation of all nonurgent surgical cases to address surging hospital admissions and manage workforce and resource reallocation. During the pandemic surge, thousands of surgical cancellations have been required. We outline our experience through the onset and advance of the surge, detail our incident response and discuss the transition toward recovery. Level of Evidence: Level V

The orthopaedic experience of COVID-19: A literature review

“…The backlog of elective cases will eventually need to be faced ( Petrone et al 2020 ), but reduced resources in some countries may compromise this ( Jain & Vaishya 2020 ).…”

Ethical standards for distribution of Covid-19 relief aid

“…There are several myths about the origin, nature, mode of transmission, and the ravaging effects of covid-19 more than our mortal minds can comprehend. The pandemic's devastating dynamism has paved for several opinions circulating about its nature, which are often found not consistent with scientific findings (Petrone et al, 2020). This section of the work dwells mainly on the nature of coronavirus (COVID-19), intending to understand its effects on human beings' social lives rather than consider the molecular mechanisms of viral replication and pathogenesis since the concern here is not principally metascience.…”

COVID-19: Moral and Ethical Implications for Orthopaedic Spine Surgeons

“…New York State's largest healthcare provider, Northwell Health, uses similar guidelines. At Northwell, surgeons identified their cases from levels 0-4, with level 4 representing emergent surgeries and level 3 representing urgent surgeries, both of which were prioritized for surgery, whereas levels 2 and lower were postponed [10]. Level 0 indicates an elective surgery, where the timing of surgical intervention would not impact a patient's outcome.…”

“…These classifications for prioritizing surgery are determined based on how harmful a time-based delay in surgical intervention would be for the patient. Cases that are deemed a level 4 priority indicate that the patient would be at an immediate risk for permanent disability or severe harm without surgery and indicate a need for immediate surgical intervention [10]. An accepted treatment protocol in the United States for spinal cord injury, which would render a case emergent, follows a suggested 8-24hour surgical intervention time window for the best recovery results [5].…”

“…Cases deemed urgent do not currently have a clear exact recommended timing of surgical intervention in the United States, although these cases are considered in need of prompt intervention, more so than levels 0-2 but not as immediate as level 1 cases [5]. Finally, level 2 surgeries are considered semiurgent, where a delay past three months would put the patient at a risk of harm, and a case considered level 1 indicates that a delay past six months would not put a patient at risk of harm [10]. The pause of elective surgeries in New York lasted from March 32rd, 2020, to June 28 th , 2020 [11].…”