Surgery for non-Covid-19 patients during the pandemic

Abstract

Background In the early phase of the Covid-19 pandemic, mainly data related to the burden of care required by infected patients were reported. The aim of this study was to illustrate the timeline of actions taken and to measure and analyze their impact on surgical patients. Method This is a retrospective review of actions to limit Covid-19 spread and their impact on surgical activity in a Swiss tertiary referral center. Data on patient care, human resources and hospital logistics were collected. Impact on surgical activity was measured by comparing 6-week periods before and after the first measures were taken. Results After the first Swiss Covid-19 case appeared on February 25, progressively restrictive measures were taken over a period of 23 days. Covid-19 positive inpatients increased from 5 to 131, and ICU patients from 2 to 31, between days 10 and 30, respectively, without ever overloading resources. A 43% decrease of elective visceral surgical procedures was observed after Covid-19 (295 vs 165, p<0.01), while the urgent operations (all specialties) decreased by 39% (1476 vs 897, p<0.01). Fifty-two and 38 major oncological surgeries were performed, respectively, representing a 27% decrease (p = 0.316). Outpatient consultations dropped by 59%, from 728 to 296 (p<0.01). Conclusion While allowing for maximal care of Covid-19 patients during the pandemic, the shift of resources limited the access to elective surgical care, with less impact on cancer care.

Corona Collateral Damage Syndrome: Perception of the Damage

“… 5 A 50% reduction in number was seen in patients attending hospital for a cardiac ailment, whereas the cancer-related services were also down by 27%. 6 , 7 Effect of the pandemic has also been evident on patients with kidney diseases where almost 28.2% of patients missed one or more dialysis services while 4.13% did not turn up at all, further substantiating the CCDS. 5 …”

From the sidelines: The indirect repercussions of COVID‐19 on the delivery of hospital surgical services

“…9 As time has progressed, a growing number of publications have begun reporting on the indirect impact of COVID‐19 on emergency and elective surgery worldwide. Despite differences in settings, country, surgical procedure and time‐points analysed, the overall volume of emergency surgeries have decreased anywhere between 8% and 81%, 10 , 11 , 12 , 13 whereas elective surgery has decreased between 33% and 62%. 1 , 11 , 12 Although the road ahead still remains unclear, it is evident that contemporaneously demonstrating both the ongoing repercussions of the COVID‐19 pandemic and the organisational response on the delivery of hospital surgical services is important for contributing to the knowledge base and future decision making.…”

Managing Visitor and Patient Flow During the COVID-19 Pandemic: ExpectingU App

“…Family presence has been shown to be an important source of psychological stability for the patient, as well as a source of support for better recovery [3,6]. During the first wave of the pandemic all non-essential medical and surgical activity and all visits were postponed [1,4]; during the second wave, it was important to maintain a minimal activity and allow limited visitors to avoid worsening the condition of non-COVID patients.…”