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Archive COVID-19 2021

Surgery During the Surge

Outpatient facilities remain ready to care for patients, even with COVID-19 infection rates on the rise.

Daniel Cook

Daniel Cook, Editor-in-Chief

BIO

TEAM EFFORT
Hospital of the University of Pennsylvania
TEAM EFFORT Surgical professionals are confident in their abilities to continue performing procedures during the pandemic.

Surgical facilities across the country are ramping case volumes back up to pre-pandemic levels even as the coronavirus rages through communities still recovering from the initial wave. The United States has hit 16 million COVID-19 cases and more than 300,000 Americans have died. Hospital ICUs are reaching full capacity and a difficult winter awaits. Still, despite the grim outlook, many surgical professionals say elective procedures should continue in outpatient facilities, where skilled providers spent the better part of last year implementing revamped protocols that allow for safe patient care.

Elective isn't always optional

Hospital-based elective cases are on pause in upstate New York because of COVID-19 hospitalization rates, according to Dave Uba, MBA, CEO of Buffalo Surgery Center in Amherst, N.Y. "At this time, surgery centers are not subject to the cessation of elective surgeries," he says. "Some cases can be performed in hospitals if patients are in intractable pain and a delay in surgery has the potential to result in future morbidity and mortality. That being said, the majority of elective hospital-based procedures are being rescheduled."

Procedures that improve the health of patients need to continue.
— Greg Deconciliis, PA-C, CACS

Before the resurgence of the virus in October and November, case volumes at Buffalo Surgery Center had returned to normal levels. Mr. Uba says cases are still significantly backlogged since the nationwide shutdown of elective procedures in April and May, and concedes his surgeons will likely never catch up. "But what we learned during the shutdown is that patients truly did suffer without having access to care," he says. "'Elective surgery' isn't a good description of life-changing procedures that can alleviate or eliminate pain and improve quality of life."

William Berry, MD, MPH, MPA, FACS, loosely defines elective surgery as procedures that can be delayed for six months without causing permanent harm. Knee replacements can be put off — although one could argue debilitating joint pain is reason enough to undergo surgery — but biopsies and treatments of malignancies should go on as planned. "There's evidence that a two-week delay can make a difference in the prognosis of breast cancer patients," points out Dr. Berry, associate director at Ariadne Labs, a joint center for health systems innovation at Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health in Boston.

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