Impacts of COVID‐19 and elective surgery cancellations on platelet supply and utilization in the Canadian Province of British Columbia

Abstract

Background and Objectives The coronavirus disease 2019 (COVID‐19) pandemic raised concerns about the vulnerability of platelet supply and the uncertain impact of the resumption of elective surgery on utilization. We report the impact of COVID‐19 on platelet supply and utilization across a large, integrated healthcare system in the Canadian province of British Columbia (BC). Materials and Methods Historical platelet use in BC by indication was compiled for fiscal year 2010/2011–2019/2020. Platelet collections, initial daily inventory and disposition data were assessed pre‐COVID‐19 (1 April 2018–15 March 2020) and for two COVID‐19 time periods in BC: a shutdown phase with elective surgeries halted (16 March–17 May, 2020) and a renewal phase when elective surgeries resumed (18 May–27 September 2020); comparisons were made provincially and for individual health authorities. Results Historically, elective surgeries accounted for 10% of platelets transfused in BC. Initial daily supplier inventory increased from baseline during both COVID‐19 periods (93/90 units vs. 75 units pre‐COVID‐19). During the shutdown phase, platelet utilization decreased 10.4% (41 units/week; p < 0.0001), and remained significantly decreased during the ensuing renewal period. Decreased platelet utilization was attributed to fewer transfusions during the shutdown phase followed by a decreased discard/expiry rate during the renewal phase compared to pre‐COVID‐19 (15.2% vs. 18.9% pre‐COVID‐19; p < 0.0001). Differences in COVID‐19 platelet utilization patterns were noted between health authorities. Conclusion Decreased platelet utilization was observed in BC compared to pre‐COVID‐19, likely due to a transient reduction in elective surgery as well as practice and policy changes triggered by pandemic concerns.

Control of airborne particles in surgical procedures during the Covid-19 pandemic: scoping review

“…Given this scenario and the need to protect health teams and patients, precautionary measures were required and have been constantly reassessed (5)(6)(7) . More specifically, in the operating room environment, elective surgeries were initially suspended until a more favorable epidemiological scenario was reached (6) .…”

Controle de partículas aéreas nos procedimentos cirúrgicos durante a pandemia da Covid-19: revisão de escopo

“…Diante desse cenário e da necessidade de proteger as equipes de saúde e pacientes, medidas de precauções foram necessárias e têm sido constantemente reavaliadas (5)(6)(7) . Mais especificamente, no ambiente de centro cirúrgico, cirurgias eletivas foram inicialmente suspensas até que se alcançasse um panorama epidemiológico mais favorável (6) .…”

“…Diante desse cenário e da necessidade de proteger as equipes de saúde e pacientes, medidas de precauções foram necessárias e têm sido constantemente reavaliadas (5)(6)(7) . Mais especificamente, no ambiente de centro cirúrgico, cirurgias eletivas foram inicialmente suspensas até que se alcançasse um panorama epidemiológico mais favorável (6) . Essas medidas foram necessárias devido ao alto risco de exposição que os procedimentos realizados no centro cirúrgico oferecem à equipe de saúde e aos pacientes em relação à infecção pelo SARS-CoV-2 (7) .…”

Controle de partículas aéreas nos procedimentos cirúrgicos durante a pandemia da covid-19: revisão de escopo

“…Nesse cenário, um dos critérios adotados visando proteger a equipe e os pacientes da exposição e contaminação pelo Sars-CoV-2 foi a suspensão das cirurgias eletivas (SHOPSOWITZ et al, 2021). Excetua-se a essa suspensão os casos de cirurgia oncológica, uma vez que a demora pode acarretar prejuízos ao resultado terapêutico (ALVES, 2020).…”

“…Além do uso do EPIs, as medidas de precaução têm sido reavaliadas com frequência (RAMÍREZ; THÉODORE; DANTÉS, , CARBONE et al, 2021. No que se refere ao centro cirúrgico, as cirurgias eletivas foram suspensas até que se vislumbrasse um quadro epidemiológico favorável (SHOPSOWITZ et al, 2021). Entre os procedimentos realizados no centro cirúrgico que oferecem alto potencial para produção de aerossóis, está a intubação e a extubação, ventilação manual das vias aéreas, utilização de eletrocautério e brocas de alta rotação (AAL IBRAHIM et al, 2021).…”