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. 2020 Aug:140:e360-e366.
doi: 10.1016/j.wneu.2020.05.124. Epub 2020 May 20.

Neurosurgery Services in Dr. Sardjito General Hospital, Yogyakarta, Indonesia, During the COVID-19 Pandemic: Experience from a Developing Country

Wiryawan Manusubroto  1 , Adiguno Suryo Wicaksono  2 , Daniel Agriva Tamba  1 , Paulus Sudiharto  1 , Handoyo Pramusinto  1 , Rachmat Andi Hartanto  1 , Endro Basuki  1
Affiliations

Neurosurgery Services in Dr. Sardjito General Hospital, Yogyakarta, Indonesia, During the COVID-19 Pandemic: Experience from a Developing Country

Wiryawan Manusubroto et al. World Neurosurg. 2020 Aug.

Abstract

Background: Most articles describing the effect of the coronavirus disease 2019 (COVID-19) pandemic on neurosurgical services have been from developed countries. We report our experience in carrying out neurosurgical services at Dr. Sardjito General Hospital, Yogyakarta, Indonesia, during the time of the pandemic.

Methods: To collect information on the effect of the pandemic in Indonesia and Yogyakarta, we gathered data from the Indonesian Ministry of Health's online database for the national data and local government records for the local data (including records of Dr. Sardjito General Hospital Division of Neurosurgery).

Results: Compared with other countries, Indonesia has not been severely hit by the impact of COVID-19. To increase our understanding of the natural history of the pandemic, we divided the period into 4 phases: phase 1 (when there were confirmed cases in Indonesia but no cases in Yogyakarta), phase 2 (when the first case in Yogyakarta was detected), phase 3 (when the cumulative cases surpass their peak), and phase 4 (when the pandemic ends). At the time of this writing, we were still in phase 2 and in this phase, we experienced a decrease in the number of emergency surgical procedures, from an average of 4 to 2.4 per week. Moreover, the number of elective operations dropped from an average of 12 to 9 per week.

Conclusions: A pandemic, such as COVID-19, reduces both inpatient and outpatient neurosurgical activities. A comprehensive plan can improve both utilization and safety of the neurosurgical staff.

Keywords: COVID-19; Low- and middle-income countries; Neurosurgery service; Pandemic.

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Figures

Figure 1
Figure 1
The confirmed cases in 34 provinces in Indonesia as of April 14, 2020. DKI Jakarta and Special Region of Yogyakarta are highlighted owing to their status as the capital city of Indonesia and the province in which our hospital is located, respectively.
Figure 2
Figure 2
Summary of our experiences during the outbreak, described in a four-phase model, in Dr. Sardjito General Hospital. Note that Phase 3 and 4 have not yet passed by our institution. Therefore, the purpose of stating those two phases is to explain our expectations.
Figure 3
Figure 3
The amount of elective (solid line) and emergency (dashed line) neurosurgery operations from February 2, 2020 to April 18, 2020 at Dr. Sardjito General Hospital. The data from February 2020 is presented to illustrate the average number of surgical procedures during typical period in Dr. Sardjito General Hospital. The black arrow indicates the time when the Indonesian first case of COVID-19 was announced (the beginning of Phase 1). Black arrowhead denotes the date when the first COVID-19 case in Yogyakarta was revealed (Phase 2).
Figure 4
Figure 4
The number of neurosurgical procedures in Dr. Sardjito General Hospital based on the operative categories during March 2020.
Figure 5
Figure 5
The amount of patient who came to Dr. Sardjito General Hospital neurosurgery outpatient clinic. The data from January 2020 is presented to illustrate the average number of outpatients during typical period in Dr. Sardjito General Hospital. The black arrow indicates the time when the Indonesian first case of COVID-19 was announced (the beginning of Phase 1). Black arrowhead denotes the date when the first COVID-19 case in Yogyakarta was revealed (Phase 2).
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References

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