Early look at the future of healthcare during the COVID-19 pandemic

Hilal, Mohammad Abu; Besselink, Marc G.; Lemmers, Daniel H.L.; Mb, Taylor; Triboldi, Alessandro

doi:10.1002/bjs.11666

Cited by 12 publications

(14 citation statements)

References 3 publications

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“…1,2 Critical care capacity was increased, staff and equipment were redeployed and, in some cases, new hospitals were built. [3][4][5] In England, the National Health Service (NHS) postponed all non-urgent surgery from 15 th April 2020 to support the response to the first wave of the pandemic, with repetition of these delays from December 2020 in response to the second wave. [6][7][8] This has had an enormous, but as yet uncharacterised, impact on the provision of surgery, resulting in the cancellation of a large portion of elective surgery and delayed urgent surgery for almost an entire year.…”

Section: Introductionmentioning

confidence: 99%

Surgical activity in England and Wales during the COVID-19 pandemic: a nationwide observational cohort study

Dobbs

Gibson

Fowler

et al. 2021

Preprint

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ObjectivesTo report the volume of surgical activity and the number of cancelled surgical procedures during the COVID-19 pandemic.Design and settingAnalysis of electronic health record data from the National Health Service (NHS) in England and Wales.MethodsWe used hospital episode statistics for all adult patients undergoing surgery between 1st January 2020 and 31st December 2020. We identified surgical procedures using a previously published list of procedure codes. Procedures were stratified by urgency of surgery as defined by NHS England. We calculated the deficit of surgical activity by comparing the expected number of procedures from the years 2016-2019 with the actual number of procedures in 2020. We estimated the cumulative number of cancelled procedures by 31st December 2021 according patterns of activity in 2020.ResultsThe total number of surgical procedures carried out in England and Wales in 2020 was 3,102,674 compared to the predicted number of 4,671,338. This represents a 33.6% reduction in the national volume of surgical activity. There were 763,730 emergency surgical procedures (13.4% reduction), compared to 2,338,944 elective surgical procedures (38.6% reduction). The cumulative number of cancelled or postponed procedures was 1,568,664. We estimate that this will increase to 2,358,420 by 31st December 2021.ConclusionsThe volume of surgical activity in England and Wales was reduced by 33.6% in 2020, resulting in over 1,568,664 cancelled operations. This deficit will continue to grow in 2021.Summary boxesWhat is already known on this topicThe COVID-19 pandemic necessitated a rapid change in the provision of care, including the suspension of a large proportion of surgical activitySurgical activity has yet to return to normal and has been further impacted by subsequent waves of the pandemicThis will lead to a large backlog of casesWhat this study adds3,102,674 surgical procedures were performed in England and Wales during 2020, a 33.6% reduction on the expected yearly surgical activityOver 1.5 million procedures were not performed, with this deficit likely to continue to grow to 2.3 million by the end of 2021This deficit is the equivalent of more than 6 months of pre-pandemic surgical activity, requiring a monumental financial and logistic challenge to manage

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Section: Introductionmentioning

confidence: 99%

Surgical activity in England and Wales during the COVID-19 pandemic: a nationwide observational cohort study

Dobbs

Gibson

Fowler

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…The outbreak of novel coronavirus SARS-CoV-2 and the disease COVID-19 were first reported in December 2019 in Wuhan, China 1 , and the WHO declared a global pandemic in March 2020. The healthcare response to the COVID-19 pandemic has required rapid changes to the provision of secondary healthcare services, including the creation of new hospitals 2 , 3 . Critical care capacity has increased substantially in high-income countries, requiring redeployment of staff and equipment from other departments 4 .…”

Section: Introductionmentioning

confidence: 99%

Resource requirements for reintroducing elective surgery during the COVID-19 pandemic: modelling study

Fowler

Dobbs

Wan

et al. 2020

British Journal of Surgery

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Background The COVID-19 response required the cancellation of all but the most urgent surgical procedures. The number of cancelled surgical procedures owing to Covid-19, and the reintroduction of surgical acivirt, was modelled. Methods This was a modelling study using Hospital Episode Statistics data (2014–2019). Surgical procedures were grouped into four urgency classes. Expected numbers of surgical procedures performed between 1 March 2020 and 28 February 2021 were modelled. Procedure deficit was estimated using conservative assumptions and the gradual reintroduction of elective surgery from the 1 June 2020. Costs were calculated using NHS reference costs and are reported as millions or billions of euros. Estimates are reported with 95 per cent confidence intervals. Results A total of 4 547 534 (95 per cent c.i. 3 318 195 to 6 250 771) patients with a pooled mean age of 53.5 years were expected to undergo surgery between 1 March 2020 and 28 February 2021. By 31 May 2020, 749 247 (513 564 to 1 077 448) surgical procedures had been cancelled. Assuming that elective surgery is reintroduced gradually, 2 328 193 (1 483 834 – 3 450 043) patients will be awaiting surgery by 28 February 2021. The cost of delayed procedures is €5.3 (3.1 to 8.0) billion. Safe delivery of surgery during the pandemic will require substantial extra resources costing €526.8 (449.3 to 633.9) million. Conclusion As a consequence of the Covid-19 pandemic, provision of elective surgery will be delayed and associated with increased healthcare costs.

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“…1,2 National restrictions varied from total lockdown to targeted quarantine and social distancing. 3-5 Despite drastic efforts, the World Health Organization (WHO) declared the COVID-19 outbreak officially a pandemic on March 11, 2020. 6…”

Section: Introductionmentioning

confidence: 99%

The impact of the COVID-19 pandemic on quality of life, physical and psychosocial wellbeing in breast cancer patients and survivors – a prospective, multicenter cohort study

Batenburg

Stam

et al. 2020

Preprint

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Purpose: The COVID-19 pandemic and the resulting social distancing and lockdown measures are having a substantial impact on daily life and medical management of people with breast cancer. We evaluated to what extent these changes have affected quality of life and physical, and psychosocial wellbeing of people (being) treated for breast cancer. Methods: This study was conducted within the prospective Utrecht cohort for Multiple BREast cancer intervention studies and Long-term evaluation (UMBRELLA). Shortly after the implementation of COVID-19 measures, extra questionnaires were sent to 1595 cohort participants, including standard UMBRELLA quality of life (EORTC) questionnaires. Patient-reported outcomes (PROs) were compared to the most recent PROs collected within UMBRELLA before COVID-19. The impact of COVID-19 on PROs was evaluated using mixed models analysis. Results: In total, 1051 patients (66%) completed the questionnaires. One third (n = 327, 31%) reported a higher threshold to contact their general practitioner due to COVID-19. A significant deterioration in emotional functioning was observed (82.6 to 77.9, p < 0.001) and 505 (48%, 95% CI 45-51) patients reported moderate to severe loneliness. Small significant improvements were observed in QoL, physical-, social- and role functioning scores. In the subgroup of 51 patients under active treatment, there was a strong deterioration in social functioning (69.8 to 5.0, p = 0.03). Conclusion: Due to COVID-19, patients (being) treated for breast cancer are less likely to contact physicians, and experience a deterioration in emotional functioning. Patients undergoing active treatment report a strong drop in social functioning. One in two patients reports (severe) loneliness. Online applications facilitating peer contact and e-mental health interventions could support mental health and social interaction times of total lockdown or social distancing.

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Early look at the future of healthcare during the COVID-19 pandemic

Cited by 12 publications

References 3 publications

Surgical activity in England and Wales during the COVID-19 pandemic: a nationwide observational cohort study

Surgical activity in England and Wales during the COVID-19 pandemic: a nationwide observational cohort study

Resource requirements for reintroducing elective surgery during the COVID-19 pandemic: modelling study

The impact of the COVID-19 pandemic on quality of life, physical and psychosocial wellbeing in breast cancer patients and survivors – a prospective, multicenter cohort study

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