Ministry of Health and Family Welfare issued an advisory to Hospitals and Medical Institution on 22′ March 2020 to postpone non-essential elective surgeries.
According to a report published in British Journal of Surgery on 18th May 2020 number of elective surgeries cancelled in India have reached 585,000 with the rate of 48728 cancellations per week
What is Elective surgery Elective surgery is a medical surgery that is scheduled in advance because it does not involve emergency. In this type of procedure time of procedure can be determined by patient or doctor. Example of elective surgery are:
✓ Cosmetic surgery ✓ Treatment of initial stage cancer by surgery ✓ Removal of gallbladder by surgery
✓ . v Laparoscopic surgeries ✓ Endoscopic surgeries ✓ Hernia surgery ✓ Cataract surgery
Reason for postponement of elective surgeries
Aerosols generated during laparoscopy increases the risk of viral contamination while treating a Covid-19 patient.
Lack of Personal Protection Equipment (PPE) kit for all medical practitioners involved in elective surgeries.
Journal of Visceral Surgery
Mailable online 17 April 2020 In Press. Correceo Proof
Rolm Risks of viral contamination in healthcare professionals during laparoscopy in the Covid-19 pandemic
Effects of Delay in Elective Surgeries
Few elective surgery become emergency surgery with the time Blow to the revenue of healthcare sector Increasing pendency of cases
Few elective surgery become emergency surgery with the time
Unavailability of surgery at early stages of cancer may cause the disease to advance stage where it is not curable by surgery.
Sudden worsening of gallbladder surgery may require immediate removal of gallbladder
Excessive blockage of arteries may demand immediate endoscopic heart surgery.
Blow to the Revenue of Healthcare Sector
Large portion of revenue for hospitals come from elective surgery. It has been three months since hospitals have performed their last elective surgery.
Increasing Pendency of Cases
According to Indian Institute of Public Health , current pendency of elective surgeries require 2 months of work with 2o% extra workforce.
While number of cases will keep on increasing during this period.
How to Resume The Elective Surgeries
The American College of Surgeons has released io recommendations to guide healthcare providers when they resume elective surgery that has been put on hold during the Covid-ig pandemic. Know Your Community’s Coronavirus Statistics
The maximum incubation period for the Corona virus is estimated at two weeks.
There should be a decrease in local incidence of COVID-cases for at least two weeks before elective
surgery is resumed
Know Availability Of Covid-19 Testing And Craft Testing Policies
Monitor local Covid-ig testing availability and lab result times.
Craft testing policies for patients such as pre-operative testing of patients scheduled for surgery.
Craft testing policies for healthcare workers such as screening and testing guidance.
Prioritization Of Surgery
The prioritization process should be adjustable to local, regional, and national epidemiological trends and changes in COVID-ig care.
The prioritization process should also take a facility’s resources, priorities, and patient needs into account.
Ensure Safety And High Value In All Five Phases Of Surgical Care
Optimal care in the preoperative phase Optimal care in the immediate preoperative phase Optimal care in the intraoperative phase Optimal care in the postoperative phase Optimal care in the post discharge phase