Impact of COVID-19 Related Lockdown on the Frequency of Acute and Oncological Surgeries—Lessons Learned From an Austrian University Hospital

Abstract

Innsbruck Medical University Hospital, Austria, provides the highest level of care for a region of approximately 1.8 million people. During the early COVID-19 outbreak in spring 2020 surgical activity was drastically reduced with the prime goal of preserving hospital capacities, especially intensive care beds. We conducted a retrospective analysis of surgical activities performed at Innsbruck Medical University Hospital during the lockdown period from March 15 to April 14, 2020 and compared these activities to the same period during the previous 5 years. Total surgical activity was reduced by 65.4% compared to the same period during the previous 5 years (p < 0.001); elective surgeries were reduced by 88.7%, acute surgeries by 35.3% and oncological surgeries by 47.8% compared to the previous 5 years (all p < 0.001). This dramatic decrease in acute and oncological surgeries can most likely be ascribed to the fact that many patients avoided health care facilities because of the strict stay-at-home policy and/or the fear of contracting SARS-CoV-2 in the hospital. In view of future waves, the population should be encouraged to seek medical help for acute symptoms and to attend cancer screening programs.

Impact of COVID-19 on elective, emergency and oncological surgery during the first and the second wave in a tertiary university hospital

“…Ethics approval (EK Nr: 1124/2020, dated 2020_05_17, and EK Nr: 1099/2020, dated 2020-04-28) for this retrospective assessment was obtained from the local ethics committee ( Ethikkommission der Medizinischen Universität Innsbruck —Austria). The methods and the study design were assumed from our previous study [ 2 ].…”

“…The results describing the amount and type of reduction of surgical activities in the first lockdown period have already been published [ 2 ]. To evaluate the management of the various phases and the dynamics of the pandemic, we describe these previous data again and compare the changes in the two waves in a second step.…”

“…One side effect of the so-called first wave of the pandemic was that frequencies of elective and oncologic surgeries were severely influenced, as during this period a drastic reduction in elective surgery was advised [ 2 ]. Anesthesiology and critical care departments often share medical personnel; in order to provide sufficient resources, staff members from the operating theaters were shifted to intensive care units [ 3 , 4 ].…”

“…Anesthesiology and critical care departments often share medical personnel; in order to provide sufficient resources, staff members from the operating theaters were shifted to intensive care units [ 3 , 4 ]. Even if efforts were undertaken to prevent insufficient supply for other patients needing medical treatment, countless studies have described a massive reduction in emergency and cancer surgery [ 2 , 5 , 6 ]. To date, the impact of the pandemic on public health is not completely clear but many authors agree that due to interventions such as the suspension of cancer screening programs and the prioritization only for urgent symptomatic cases, as was the practice in some countries in spring 2020, a substantial increase in potentially avoidable damage and also cancer deaths have to be expected [ 7 , 8 ].…”

“…Including surrounding areas, it provides the highest level of care for approximately 1.8 million people and is also centrally involved in the regional COVID-19 network to cover ICU demand during the pandemic [ 9 ]. During the first lockdown in spring 2020 a drastic reduction in elective and oncological surgical activities was observed as compared to the same period during the previous 5 years [ 2 ]. As some characteristics of the two first waves of the COVID-19 pandemic strongly differed, such as different measures of social restriction, general knowledge on the nature of the disease, availability of disposables and medical supply, a difference in the overall amount of surgical activity should be expected.…”