Impact of COVID-19 Pandemic Forced Lockdown on Non-COVID Super-specialty Surgical Case Management in India
R Rahul, Priyank Yadav, Asish Singh, Pawan Verma, Sabaretnam Mayilvaganan, Vijai D Upadhyaya, Ankur Bhatnagar, Shantanu Pande, Mandakini Pradhan, Rajan Saxena
Citation Information :
Rahul R, Yadav P, Singh A, Verma P, Mayilvaganan S, Upadhyaya VD, Bhatnagar A, Pande S, Pradhan M, Saxena R. Impact of COVID-19 Pandemic Forced Lockdown on Non-COVID Super-specialty Surgical Case Management in India. 2021; 16 (2):70-76.
Introduction: The nationwide lockdown in India and diversion of healthcare resources toward COVID care have hampered the non-COVID care. In this study, we assessed the effect of the first 6 weeks of lockdown on non-COVID super-specialty surgical case management at a tertiary care center. Materials and methods: This was an observational study involving eight surgical specialties (cardiothoracic and vascular surgery (CVS), Endocrine Surgery, maternal and reproductive health [MRH], Neurosurgery, Pediatric Surgery, Plastic Surgery, Surgical Gastroenterology, and Urology). Information was gathered using two forms: (a) Patient-wise form for surgical procedure (preoperative preparation, anesthesia, and surgical details) (b) Department-wise summary of procedures for comparison with the last year's records. Results: During the study period, 112 cases were performed compared to 1,062 performed last year during the same time frame. CVS department experienced the greatest decline (98%) in cases. Except for COVID testing, no difference in practice was documented (preoperative investigation and anesthesia preference). However, majority of the procedures were performed by an open technique. The use of personal protective equipment (PPE) by anesthetists and surgeons was not widespread and uniform across various specialties; the level of comfort was low suggested by low acceptance. Duration of surgery as well as hospital stay did not increase due to the COVID pandemic. Conclusion: The nationwide lockdown resulted in a marked reduction in the number of non-COVID surgeries, much more than the diversion of the workforce toward COVID facilities. The number of procedures decreased to <20% than in the previous year. The use of PPE was not consistent during procedures on COVID-negative patients.
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