Recommendations to Optimize the Safety of Elective Surgical Care While Limiting the Spread of COVID-19: Primum Non Nocere

Abstract

has drastically altered our lives in an unprecedented manner, shuttering industries and leaving most of the country in isolation as we adapt to the evolving crisis. Orthopedic surgery has not been spared from these effects, with the postponement of elective procedures in an attempt to mitigate disease transmission and preserve hospital resources as the pandemic continues to expand. During these turbulent times, it is crucial to understand that although patients' and care-providers' safety is paramount, canceling or postponing essential surgical care is not without consequences and may be irreversibly detrimental to patients' health and quality of life in some cases. The optimal solution to how to balance effectively the resumption of standard surgical care while doing everything possible to limit the spread of COVID-19 is undetermined and could include such strategies as social distancing, screening forms and tests, including temperature screening, segregation of inpatient and outpatient teams, proper use of protective gear, and the use of ambulatory surgery centers (ASCs) to provide elective, yet ultimately essential, surgical care while conserving resources and protecting the health of patients and health care providers. Of importance, these recommendations do not and should not supersede evolving United States Centers for Disease Control and Prevention and relevant federal, state and local public health guidelines. Level of Evidence: Level V.T he first confirmed case of COVID-19 in the United States was reported in northern Washington on January 20 of this year. Since then, the 2019 Novel Coronavirus (COVID-19) has upended our society and placed an unprecedented strain on health care systems across the country. 1 Orthopedic surgery has not been

Are Hospitals Safe? A Prospective Study on SARS-CoV-2 Prevalence and Outcome on Surgical Fracture Patients: A Closer Look at Hip Fracture Patients

“… 17 With respect to follow-up of surgical orthopaedic patients and with regard to outpatient clinics, attendance to health care centers should be reduced to avoid overcrowding. For that purpose, the use of telemedicine and telerehabilitation 18 , 19 should be considered while SARS-CoV-2 is still around.…”

Elective Orthopaedic Surgery During COVID-19

“…To or knowledge, there have been no results regarding management protocols for resuming orthopaedic elective surgical procedures during the COVID-19 pandemic in the literature. Several studies have proposed guidelines and protocols for a safe start, but none has offered scientific data 2 , 3 .…”

“…Today, globalization and ease of movement have laid the foundations for the current novel coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 2 . Despite the technological and scientific advances in this century, the severity and spread of coronavirus have greatly changed our home and work lives.…”

COVID-19 pandemic and lacrimal practice: Multipronged resumption strategies and getting back on our feet

“…There are growing voices across many surgical specialties on safe and effective resumption of elective procedures after the COVID-19 calms down and the author joins them with a proposal for lacrimal procedures. [ 25 26 27 28 ] Once the pandemic declines, institutional and individual practices would come under enormous pressure to scale up their elective procedures to cater to the needs of many waiting patients as well as for meeting the financial needs. Hence, the resumption of lacrimal practice needs planning which would include chalking out expected patient demand so that the systems can plan better utilization of staff and resources.…”