COVID-19: new challenges, risks, and the future provision of care in spinal services

Minhas, Zulfiqar; Ganau, Mario; Thakar, Chrishan; Reynolds, Jeremy; Rothenfluh, Dominique A.; Bojanić, Stana; Grannum, S; Chaudhary, Bedansh Roy; Pyrovolou, N.; Sikander, Murtuza; Bowden, Gavin; Patel, Umang; Nnadi, Colin

doi:10.1302/0301-620x.102b6.bjj-2020-0686

Cited by 14 publications

(11 citation statements)

References 18 publications

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“…COVID-19 is expected to evolve into multiple waves, and forecasts on bed availability might mean the difference between being offered surgical or conservative treatment for individual neurosurgical patients. Neurosurgery is under a higher economic burden than many other medical branches in terms of both the cost of patient treatment and the training of residents and medical students interested in neurosurgery 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 The fair and effective use of resources has become even more important during the pandemic, which seems to be lasting longer than initially thought. Therefore, it is imperative that neurosurgery clinics and neurosurgical societies organize longer-term work patterns and training programs, including professional congresses.…”

Section: Discussionmentioning

confidence: 99%

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A simple mathematical tool to forecast COVID-19 cumulative case numbers

Balak¹,

İnan²,

Ganau³

et al. 2021

Clinical Epidemiology and Global Health

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Objective Mathematical models are known to help determine potential intervention strategies by providing an approximate idea of the transmission dynamics of infectious diseases. To develop proper responses, not only are more accurate disease spread models needed, but also those that are easy to use. Materials and methods As of July 1, 2020, we selected the 20 countries with the highest numbers of COVID-19 cases in the world. Using the Verhulst–Pearl logistic function formula, we calculated estimates for the total number of cases for each country. We compared these estimates to the actual figures given by the WHO on the same dates. Finally, the formula was tested for longer-term reliability at t = 18 and t = 40 weeks. Results The Verhulst–Pearl logistic function formula estimated the actual numbers precisely, with only a 0.5% discrepancy on average for the first month. For all countries in the study and the world at large, the estimates for the 40th week were usually overestimated, although the estimates for some countries were still relatively close to the actual numbers in the forecasting long term. The estimated number for the world in general was about 8 times that actually observed for the long term. Conclusions The Verhulst–Pearl equation has the advantage of being very straightforward and applicable in clinical use for predicting the demand on hospitals in the short term of 4–6 weeks, which is usually enough time to reschedule elective procedures and free beds for new waves of the pandemic patients.

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Section: Discussionmentioning

confidence: 99%

“…As well as the direct effects of the epidemic, attempts to control it have profound economic consequences. 55 , 70 , 71 This continuing situation, the length of which is unknown, has caused many government to make economic decisions. Economic decisions have a tremendous influence on the character of life in a society.…”

Section: Discussionmentioning

confidence: 99%

A simple mathematical tool to forecast COVID-19 cumulative case numbers

Balak¹,

İnan²,

Ganau³

et al. 2021

Clinical Epidemiology and Global Health

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“…The pandemic could increase the risk for the cultural clash (between specialties) due to the differences in perceived priorities among neurosurgeons and other specialists. The clash between specialties might well justify an increase in the Modified Maslach Burnout inventory score [ 19 ]. In our hospital, every surgical specialty had individualized operating theatre and inpatient ward, so the competition between specialties rarely happened.…”

Section: Discussionmentioning

confidence: 99%

New adaptation of neurosurgical practice and residency programs during the Covid-19 pandemic and their effects on neurosurgery resident satisfaction and welfare at the National General Hospital, Jakarta, Indonesia

Nugroho

Pradhana

Gunawan

2021

Heliyon

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Introduction Many institutions in numerous countries have made changes in their health care services during the COVID-19 pandemic. One change has been to reduce elective neurosurgery cases, which has impacted neurosurgery education. Published literature is lacking about the healthcare services, education, and residents’ well-being during adaptation to the pandemic, especially in national referral hospitals in developing countries. Methods We conducted a cross-sectional study on current neurosurgical services during 2020. We evaluated 34 neurosurgery residents in Cipto Mangunkusumo National General Hospital using a self-made questionnaire to determine the effects of the COVID-19 pandemic on their surroundings, education process, and satisfaction with the currently adapted education program. We used the modified Maslach Burnout Inventory to assess burnout in the residents before and during the pandemic. Results Neurosurgical residents spent more time studying neurosurgical theory (Mode 1–1.5h/day, p < 0.05) but spent less time learning neurosurgical skills (Mode 30 min–1 h/day, p < 0.05) compared to before the pandemic. The resident satisfaction mean score (scale 0–10) was 7.58 for live surgery and 8.53 for the microsurgical skills lab training program. On a scale of 1–10, the residents’ stress level increased after the pandemic but the change was not statistically significant (6.61 ± 1.87, p > 0.05). The Modified Maslach Burnout inventory score was 3.02 ± 3.74 during the pandemic, and increased from before the pandemic (2.41 ± 3.18), but the difference was not statistically significant. Conclusion The COVID-19 pandemics have reduced the working hours and the clinical exposure of neurosurgical residents. Fortunately, this pandemic has led to a new opportunity to find many suitable learning methods which may decrease the risk of burnout. The psychological burden of residents is still worrisome, and planned management is necessary to sustain resident performance.

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“…For some neurosurgeons, clinical practice changed substantially when they were redeployed to intensive care units (ICU) to assist critically ill patients requiring mechanical ventilation. Neurosurgeons who got involved into this drastic hospital reorganization ended up fulfilling duties for which most of them had not been formally trained in their career, a situation never seen before during peacetime periods (19).…”

Section: Introductionmentioning

confidence: 99%

Unequal Impact of COVID-19 on Private and Academic Neurosurgical Workforce: Results of an International Survey

et al. 2021

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Background: Since the COVID-19 outbreak several manuscripts regarding neurosurgical practice during this pandemic have been published. Qualitative studies on how the pandemic affected neurosurgeons, with additional focus on their practice, are still scarce. This study's objective was to investigate the impact of COVID-19 on various aspects of the professional and private life of a homogeneous group of international neurosurgeons affiliated to the European Association of Neurosurgical Societies (EANS).Methods: Neurosurgeons from Europe and abroad were invited to participate in an online survey endorsed by the Individual Membership Committee of the EANS. The survey captured a subjective snapshot of the impact of the first wave of the COVID-19 pandemic on EANS members and was advertised through its Institutional website. In addition to departmental data, personal feeling of safety, financial security, local precautions, number of surgeries performed, changes in daily routine, and other practice-related information were inquired. Differences among practice types were closely reviewed.Results: The survey was distributed between April and May 2020: 204 neurosurgeons participated. Participants were typically active EANS members (73%), consultants (57.9%), from university hospitals (64.5%). Elective surgical practice was still ongoing only for 15% of responders, whereas 18.7% of them had already transitioned to COVID-19 and emergency medical services. While 65.7% of participants thought their institutions were adequately prepared, lack of testing for SARS-CoV-2, and scarcity of personal protective equipment were still a matter of concern for most of them. Overall surgical activity dropped by 68% (cranial by 54%, spine by 71%), and even emergencies decreased by 35%. COVID-19 prompted changes in communication in 74% of departments, 44% increased telemedicine by >50%. While most neurosurgeons had concerns about personal and families' health, financial outlook appeared to be gloomy only for private practitioners.Conclusion: The lockdown imposed in many countries by the COVID-19 outbreak called for immediate modification of working routine and resulted in a dramatic decrease of elective surgical procedures. Neurosurgeons share common concerns but were not equally exposed to the personal health and financial dangers of the ongoing pandemic.

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COVID-19: new challenges, risks, and the future provision of care in spinal services

Cited by 14 publications

References 18 publications

A simple mathematical tool to forecast COVID-19 cumulative case numbers

A simple mathematical tool to forecast COVID-19 cumulative case numbers

New adaptation of neurosurgical practice and residency programs during the Covid-19 pandemic and their effects on neurosurgery resident satisfaction and welfare at the National General Hospital, Jakarta, Indonesia

Unequal Impact of COVID-19 on Private and Academic Neurosurgical Workforce: Results of an International Survey

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