Elective Surgeries, Single-Use Devices, and COVID-19
COVID-19 has caused severe disruptions in the healthcare sector, leading to the cancellation of more than 28 million elective surgeries across the world during the first 12 weeks of the peak. Studies done by CovidSurg Collaborative Researchers reveal that each extra week of disruption resulted in 2.4 million more cancellations. The numbers worsen with extended lockdowns.
What Are the Consequences of Cancellation of Elective Surgeries?
Canceling elective surgery at such a massive scale has had devastating impacts on the patients and their families’ health. It also leads to substantial consequences to the health care systems across the world. The following are some of the direct consequences of canceled surgeries:
When time-sensitive elective operations are delayed, it will worsen health in patients with preexisting conditions like cancer. The delay will also worsen the quality of their life and may lead to unnecessary deaths. CovidSurg collaborative researchers confirmed that most of the cancellations are operations of benign diseases that need transplant surgeries. The researchers further revealed that globally, 25.4% of elective cesarean sections, 37.7% of cancer surgery, and 81.7 % of benign surgery were either canceled or postponed to a later date.
Cancellation and postponement of the surgeries have led to an unprecedented backlog of cases. Once the elective surgeries resume, it will take up to 45 weeks to clear that backlog only if the countries increase their daily surgical volume by 20%.
The disadvantaged and marginalized persons will experience poor health services as hospitals move to prioritize response to the COVID-19 pandemic. The emergency departments that would otherwise have come to aid the marginalized groups are experiencing a steep decline in the number of healthcare staff and patients. The disadvantaged groups also don’t have resources and technical know-how to use online or remote consultations with their doctors.
Was the Cancellation Necessary?
With the steep surge in the spread of the COVID-19 pandemic in the USA, the American College of Surgeons and CMS called for a nationwide cancellation or postponement of elective operations. Health care systems across the world followed suit and canceled the surgeries for the following reasons:
- Conserve supplies – Having enough supplies for anticipated high COVID-19 patients is a top priority for most hospitals. Surgical procedures were canceled to conserve critical supplies such as PPEs, ventilators, and respiratory masks.
- Protect against the transmission – Hospitals prioritized the reduction of people visiting their facilities to maintain patients’ and staff’s social distance. The essential team was only retained to help fight the pandemic. Cancellation of the surgeries also helped minimize the risk of the disease being brought to the hospitals by the patients, which kept the staff safe and decreased the chances of the patient contracting the virus from the hospital.
- Reduce staff workload – Hospitals are also making an effort to alleviate their staff’s workload even as they anticipate a sudden spike in COVID-19 patients. The hospitals are prioritizing more acute caseloads as staff shortages are becoming a serious matter of concern. Health care management prioritizes the need for frontline staff to stay healthy and not overworked.
- Creation of more capacity – Many hospitals are currently facing capacity challenges. The hospitals cannot safely isolate COVID-19 patients from the rest of the patients and staff. Therefore, hospital populations need to reduce drastically.
When Will Elective Surgeries Resume?
There is no ideal time for the surgeries to resume. The decision to resume the operations will likely depend on the flattening of the curve and reduction of COVID-19 cases in specific countries. As the pandemic begins to loosen its grip globally, many countries and health care systems are contemplating resuming to normalcy. An expert panel has issued several recommendations to guide healthcare practitioners on the safe resumption of elective surgery.
What Measures Are the Hospitals Putting in Place to Ensure the Safety of Staff and Patients Once Surgeries Resume?
The health care panel of experts has proposed a strategy that allows for the safe performance of elective surgery that reduces COVID-19 transmission risk. These strategies include:
Isolation of COVID-19 Treatment Facilities
Some nations and states with a lower number of cases resorted to in-hospital isolation of infected patients. However, this strategy presented a lot of challenges once the number of infected patients grew to exceed the hospitals’ capacity. The infection risk increases. For safe resumption of routine health care services, including elective surgeries, there is a need to isolate specific facilities to treat pandemic patients.
This strategy will keep the other health facilities untainted, thus reducing the risk of transmission. Besides, health care providers and staff should be isolated too.
Prioritization of Surgical Cases
Not all surgical procedures are time-critical. Therefore, surgeries should be classified according to their degree of urgency and indication and priority given to more urgent cases. However, it is essential to note that some elective surgical procedures could become urgent over time. Elective surgeries should be classified into essential and discretionary. The essential procedures maintain an increased risk of adverse outcomes. The discretionary cases are those that come with lower risks of adverse outcomes if delayed.
Screening Surgical Patients for COVID-19
Hospitals should put in place sound protocols to screen patients that require urgent elective procedures. These protocols will guarantee the safety of health care providers and patients. The symptomatic patients should have their surgeries postponed indefinitely, while the asymptomatic patients should postpone their operations until they become noninfectious. The other negative patients undergo surgeries once cleared.
Maintaining a Safe and Clean Hospital Environment
Hospitals assume that everyone within the hospital’s precincts is infected and therefore put in place various safety precautions that prevent the risk of viral transmission. The doctors and nurses should wear PPEs at all times. The operating room staff must wear face masks and eye coverings, and the cleaning and disinfection protocols scaled up and intensified across the health care facility. Visitors should also be reduced, and patients undergoing surgical procedures be provided with safe alternative communication platforms to pass messages to their loved ones. Screen visitors, if allowed, and made to wear gloves, masks, or gowns.
Use of Single-Use of Devices for Surgery
There is also an urgent need for hospitals to switch to single-use medical devices in the face of the pandemic. Disposable or single-use devices are those intended for use on only one patient during only one procedure. Single-use devices help protect patients from the risk of getting COVID-19 viral infections from cross-contamination during surgical procedures and treatments. The use of single-use devices for surgery will also help save time and relieve staff of the responsibility of cleaning, disinfecting ad sterilizing the devices, which often takes a lot of time.
As hospitals contemplate resuming elective surgical procedures, sound practices and protocols minimize the risk of the virus transferred to patients and hospital staff. Each hospital and staff should analyze their unique situation to help them implement the recommendations we have discussed. However, a critical recommendation that hospitals in various countries should urgently implement is using single-use medical devices to help minimize the risk of COVID-19 spread.
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