March 27, 2020: Posted by Saqib Noor
The world has been turned upside down by an unprecedented pandemic. Whilst the major outbreaks of the corona virus have largely affected China, Europe, and the USA, the rest of the world now holds it’s breath at the potential devastation that is yet to come.
Healthcare workers are stretched on the front line in the hardest hit nations and all their resources have been diverted to treating and containing the spread of covid-19. Although this contagious condition does not result in a surgically treatable disease, the impact that the pandemic is having on surgical services are extensive. Non-urgent surgeries, including cancer surgery, are now being postponed all over the world as the risks of covid-19 transmission is too high, both to the surgical patients and the operating room staff that treat them. Furthermore, all surgical personnel, as well as theatre space and equipment usually reserved for surgery, is now being streamlined to caring for the sickest patients of the corona outbreak.
The consequences of this loss of surgical services to those patients needing surgery are yet to be determined, but there can be no doubt there will be surgical morbidity and even surgically preventable mortality as a result of this pandemic.
Reading through the recent British Orthopaedic Association (BOA) recommendations in treating orthopaedic cases during this difficult times remind me a great deal of managing patients routinely in a low-resource environment. The guidelines from the BOA in this current crisis are almost standard operating practices in many parts of the world. The BOA guidelines are advocating to curtail all non-essential investigations including x-rays, recommending conservative management for many fracture patterns, reducing all orthopaedic surgical treatment except in the most severest of injuries or infections and minimising out-patient follow up. Suddenly, orthopaedic treatment in the UK has overnight become akin to the daily practice of an orthopaedic service in a resource poor nation.
The impact of covid-19 in the global surgery sphere are also extensive. Current statements from leading organisations in the field such as Operation Hernia, Smile Train, Watsi, Lifebox and Mercy Ships have shown their surgical work being understandably reduced or indeed diverted away from surgical practice to other healthcare priorities.
Undoubtedly, covid-19 therefore will have a huge short term and probable long term impact on the global surgery movement. Whilst we all pool together in our efforts to overcome this global pandemic, either on the frontline or with our combined efforts to flatten the curve, now is the time that the global surgery community needs to come even closer together. We must use this opportunity to communicate and collaborate more effectively and efficiently, learn from the advances we are making in technology and treatment pathways, because when the world comes out of this crisis, there will be an enormous amount of surgical need that we will need to prioritise once more.
1.Suspension of all operation hernia missions due to the coronavirus outbreak.
2.Mercy Ships – COVID-19 UPDATE
3.How Smile Train is navigating the coronavirus pandemic.
4.Watsi – A brighter, healthier world is ahead.
5.Lifebox and Covid-19
6.British Orthopaedic Association – Management of patients with urgent orthopaedic conditions and trauma during the coronavirus pandemic
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