Impact of COVID-19 Pandemic Forced Lockdown on Non-COVID Super-specialty Surgical Case Management in India

JOURNAL TITLE: Indian Journal of Endocrine Surgery and Research

Author
1. Ankur Bhatnagar
2. R Rahul
3. Pawan Verma
4. Asish Singh
5. Mandakini Pradhan
6. Rajan Saxena
7. Vijai D Upadhyaya
8. Priyank Yadav
9. Shantanu Pande
ISSN
DOI
10.5005/jp-journals-10088-11174
Volume
16
Issue
2
Publishing Year
2021
Pages
7
Author Affiliations
    1. Department of Surgical Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
    1. Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
    2. Indraprastha Apollo Hospital, New Delhi; Sanjay Gandhi Postgraduate Institute, Lucknow, Uttar Pradesh, India
    1. Department of Surgical Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
    1. Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
    1. Department of Pediatric Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
    1. Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
    1. Department of Cardiovascular Thoracic Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow Uttar Pradesh, India
    1. Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
    2. Lucknow, Uttar Pradesh, India
    3. SGPGIMS, Lucknow, UP, India
    4. Sanjay Gandhi Postgraduate, Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
    5. Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
    1. Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, Uttar Pradesh, India
  • Article keywords
    Lockdown, Non-COVID care, Pandemic, Surgical case management

    Abstract

    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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