Responsible Return to Essential and Non-Essential Surgery During the COVID-19 Pandemic

Abstract

Non-essential surgery had largely been suspended during the COVID-19 Pandemic. Enormous amounts of resources were utilized to shift surgical practices to a "disaster footing" with most elective surgeons assuming new roles to offset the anticipated burden from surgical and medical personnel delivering acute care. As the number of COVID-19-infected patients began to plateau in the state of Ohio, a four-phase "Responsible Return to Surgery" approach was adopted in concert with the Ohio Department of Health and the Ohio Hospital Association. This approach was adopted understanding that a simple return to the status quo prior to the COVID-19 pandemic might be harmful to patients, providers, and staff. The discrete phases undertaken at our quaternary care institution for a responsible return to non-essential surgery are outlined with the goal of ensuring timely care, minimizing community transmission, and preserving personal protective equipment. Operationalizing these phases relied upon the widespread use of telehealth, systematic COVID-19 testing, and real-time monitoring of hospital and personal protective equipment resources.

Keywords: COVID-19; Elective surgery.

Fig. 1

Phased approach for a Responsible Return to Essential and Non-Essential Surgery: Each subsequent phase is inclusive of operations performed in the previous phase. Essential surgery is defined as any surgical procedure that, if postponed, would result in at least a threat to the patient’s life if surgery or procedure is not performed, a threat of permanent dysfunction of an extremity or organ system, a risk of metastasis or progression of staging, or a risk of rapidly worsening to severe symptoms