Impact of Covid-19 on General Surgical Practice in India

Nasta, Amrit Manik; Goel, Ramen; Manickavasagam, Kanagavel; Sundaram, Easwaramoorthy

doi:10.21203/rs.3.rs-31151/v1

Cited by 6 publications

(11 citation statements)

References 6 publications

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“…A survey conducted in India during the nationwide lockdown by Manik Nasta et al . reported a higher rate of deferring elective surgery by general surgeons (77%)[ 16 ] in comparison to this study. This hints towards the rising trend of the resumption of elective surgical care post lockdown.…”

Section: Discussioncontrasting

confidence: 60%

“…There have been reports of widespread shortage and re-use of PPE to circumvent the shortage. [ 21 ] This study shows that approximately 66%–86% of surgeons are using the recommended PPE as compared to that of the previous studies conducted during the lockdown,[ 16 ] which reported 34%–56.9% usage of PPE. Around 95% of the surgeons are using respirators, such as N95 or respirators, that offer a higher level of protection.…”

Section: Discussionmentioning

confidence: 64%

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Minimally invasive surgery in India during the COVID-19 pandemic

Balakrishna

Singh

Kumar

et al. 2022

Journal of Minimal Access Surgery

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Background: The coronavirus disease 2019 (COVID-19) pandemic has posed an unprecedented challenge to the healthcare systems worldwide. This uncharted territory has changed the practices in modern healthcare delivery; this is particularly true in the case of minimally invasive surgery (MIS) where various changes are being adopted. This survey was conducted to determine the impact of the pandemic and the changes being adopted in the field of MIS, from a resource-limited developing country, India. Materials and Methods: The survey was carried out from 27 July to 22 August 2020, amongst MIS surgeons in India using an online questionnaire generated on Google Forms . Results: The survey was completed by 251 MIS surgeons nationwide. There was a proportional reduction of overall elective surgeries and MIS. Approximately 30% of the surgeons continued to use MIS, as during the pre-pandemic era. Pre-operative tests for COVID-19 (96.1%) and personal protective equipment (PPE, 66%–86%), including respirators (95.2%), are used uniformly across the nation. Almost half (43.1%) of the MIS surgeons are using ≥6 recommended intraoperative modifications in MIS to mitigate the COVID-19 transmission. Conclusion: MIS surgeons in India have adapted within a short time to the challenge of the pandemic by embracing pre-operative testing, PPE and new techniques/technologies to continue patient care. Innovations and low-cost indigenous customisations are the need of the hour for a developing country like India. Further studies are required to establish the true risk of viral transmission involved in MIS and the efficacies of the techniques/devices to reduce the spread of the virus.

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Section: Discussioncontrasting

confidence: 60%

Section: Discussionmentioning

confidence: 64%

Minimally invasive surgery in India during the COVID-19 pandemic

Balakrishna

Singh

Kumar

et al. 2022

Journal of Minimal Access Surgery

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“…Lockdown measures in India have also been associated with decreased access to health care and exacerbation of common non-communicable or chronic conditions 28 including cancer, 29 diabetes, 30 tuberculosis, 31 and others. 32 , 33 Longer-term studies remain important to determine the effect of these changes on mortality.…”

Section: Discussionmentioning

confidence: 99%

All-cause mortality during the COVID-19 pandemic in Chennai, India: an observational study

Lewnard

Mahmud

Narayan

et al. 2022

The Lancet Infectious Diseases

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Background India has been severely affected by the ongoing COVID-19 pandemic. However, due to shortcomings in disease surveillance, the burden of mortality associated with COVID-19 remains poorly understood. We aimed to assess changes in mortality during the pandemic in Chennai, Tamil Nadu, using data on all-cause mortality within the district. Methods For this observational study, we analysed comprehensive death registrations in Chennai, from Jan 1, 2016, to June 30, 2021. We estimated expected mortality without the effects of the COVID-19 pandemic by fitting models to observed mortality time series during the pre-pandemic period, with stratification by age and sex. Additionally, we considered three periods of interest: the first 4 weeks of India's first lockdown (March 24 to April 20, 2020), the 4-month period including the first wave of the pandemic in Chennai (May 1 to Aug 31, 2020), and the 4-month period including the second wave of the pandemic in Chennai (March 1 to June 30, 2021). We computed the difference between observed and expected mortality from March 1, 2020, to June 30, 2021, and compared pandemic-associated mortality across socioeconomically distinct communities (measured with use of 2011 census of India data) with regression analyses. Findings Between March 1, 2020, and June 30, 2021, 87 870 deaths were registered in areas of Chennai district represented by the 2011 census, exceeding expected deaths by 25 990 (95% uncertainty interval 25 640–26 360) or 5·18 (5·11–5·25) excess deaths per 1000 people. Stratified by age, excess deaths numbered 21·02 (20·54–21·49) excess deaths per 1000 people for individuals aged 60–69 years, 39·74 (38·73–40·69) for those aged 70–79 years, and 96·90 (93·35–100·16) for those aged 80 years or older. Neighbourhoods with lower socioeconomic status had 0·7% to 2·8% increases in pandemic-associated mortality per 1 SD increase in each measure of community disadvantage, due largely to a disproportionate increase in mortality within these neighbourhoods during the second wave. Conversely, differences in excess mortality across communities were not clearly associated with socioeconomic status measures during the first wave. For each increase by 1 SD in measures of community disadvantage, neighbourhoods had 3·6% to 8·6% lower pandemic-associated mortality during the first 4 weeks of India's country-wide lockdown, before widespread SARS-CoV-2 circulation was underway in Chennai. The greatest reductions in mortality during this early lockdown period were observed among men aged 20–29 years, with 58% (54–62) fewer deaths than expected from pre-pandemic trends. Interpretation Mortality in Chennai increased substantially but heterogeneously during the COVID-19 pandemic, with the greatest burden concentrated in disadvantaged communities. Reported COVID-19 deaths greatly underestimated pandemic-associated mortality. Funding National Institute of Gener...

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“…2 The pandemic has affected the hospital functioning and patient care. [1][2][3][4] Doctors and health care workers are the frontline workers in the battle against ongoing pandemic. We conducted this survey to study the impact of COVID-19 pandemic on doctors' clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Impact of COVID-19 pandemic on doctors’ clinical practice

et al. 2022

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Background: The pandemic of COVID-19 has affected doctors, nurses, patients, and people working in hospitals. Aims and Objectives: This study aims to study the trends in doctors’ clinical practice during COVID-19 pandemic. Materials and Methods: The study conducted at SDMCMS&H, Dharwad, includes questionnaire on the impact of COVID-19 pandemic on doctors’clinical practice. The experience of doctors between May 2020 and June 2021 working in SDM University is considered in this study. Results: The number of non-COVID patients in OPD and IPD has reduced. The time spent in clinical examination is reduced, reliability on investigations has increased. The use of telemedicine is increasing. Conclusion: The impact of COVID-19 on clinical practice and doctors is multifactorial.The doctors and other health care workers can modify the COVID-19 impact on clinical practice by continuing to deliver the services as during pre-pandemic.

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Impact of Covid-19 on General Surgical Practice in India

Cited by 6 publications

References 6 publications

Minimally invasive surgery in India during the COVID-19 pandemic

Minimally invasive surgery in India during the COVID-19 pandemic

All-cause mortality during the COVID-19 pandemic in Chennai, India: an observational study

Impact of COVID-19 pandemic on doctors’ clinical practice

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