Effect of the COVID‐19 pandemic first wave and public policy on elective and emergency surgery provision in Southern Queensland

Abstract

Background Several public health initiatives in Australia were implemented in March 2020 to contain the spread of COVID‐19. The effect of these initiatives on surgical provision is unknown. The primary objective was to determine the effect of public health policies and surgical society guidelines implemented during the pandemic on elective and emergency caseload of surgical specialities operating within South East Queensland. Methods This observational study utilized non re‐identifiable electronic data to quantify the caseload of surgical specialities across five secondary and tertiary referral hospitals in South East Queensland prior to and during the implementation of such initiatives. All patients undergoing a surgical procedure between 1 March and 24 April 2019 and the same period in 2020 were included. Participants' demographic and clinical information, such as age, the American Society of Anesthesiologists score, surgical date and location, surgical subspecialty and procedure name, was included. Results During the 2020 time period, there were 2991 elective cases compared to 4422 surgeries occurring in the same period in 2019 (32.4% reduction). Meanwhile, 2082 emergency surgeries were performed in the 2020 period compared to 2362 in 2019 (12.0% decrease). Ophthalmology and dental/ear, nose and throat/maxillofacial surgery experienced the largest reduction in elective surgeries, whereas emergency caseload increased for vascular and cardiothoracic services, and only slightly decreased for plastics and urology. Conclusion The public health initiatives and guidance implemented during the COVID‐19 pandemic reduced surgical specialties' elective caseload. However, emergency caseload was not affected to the same extent. This insight helps to guide resource allocation in future waves of the pandemic.

The impact of acute surgical unit rostering on National Emergency Access Targets during the COVID‐19 pandemic: a single hospital experience

“…Emergency surgical workload during this time did not change, and our numbers in the pre‐COVID and COVID groups were similar (252 and 271 patients respectively). This is consistent with data from a recently published Queensland study 4 …”

“…In the height of the COVID‐19 pandemic, Cairns Hospital introduced an acute surgical unit (ASU) in accordance with general surgeons Australia (GSA) 12‐point plan for emergency general surgery 2 . Additionally, a dedicated surgical rapid assessment unit (RAU) was created to improve emergency flow and redirect patients away from an overburdened emergency department 4 . The goal was to reduce overlap and redundancy in rostering, increase the availability of senior surgical staff and reduce emergency department workload and possible COVID‐19 exposure for surgical patients and staff.…”

Emergency surgery admissions and the COVID-19 pandemic: did the first wave really change our practice? Results of an ACOI/WSES international retrospective cohort audit on 6263 patients

“…Our audit demonstrated an overall reduction in surgical emergency admission of about 36%, while average age and gender distribution did not change significantly. Few Italian Authors have reported a much more significant reduction on the basis of their own local experience [6][7][8], while a study from Australia reported a minimal reduction in overall emergency cases of only 12%, and a subgroup analysis of the general surgery emergencies shows a variation of − 14% [9]. These disparities can be due to the different national guidelines, but the variations between the pre-Covid era and the first months of the Covid outbreak always present with a minus sign.…”

Emergency Surgery Admissions and The COVID-19 Pandemic: Did The First Wave Really Change Our Practice? Results of An ACOI/WSES International Audit On 6263 Patients.

“…Our audit demonstrated an overall reduction in surgical emergency admission of about 36%, while average age and gender distribution did not change signi cantly. Few Italian Authors have reported a much more signi cant reduction on the basis of their own local experience [4][5][6], while a study from Australia reported a minimal reduction in overall emergency cases of only 12%, and a subgroup analysis of the general surgery emergencies shows a variation of -14% [7]. These disparities can be due to the different national guidelines, but the variations between the pre-Covid era and the rst months of the Covid outbreak always present with a minus sign.…”