Healthcare professionals around the globe all agree that “COVID-19 is here to stay”. The simple reality is that until testing can be expanded substantially, we all live in the shadow that this disease now casts and its impact also now shapes almost all of the decisions we make.
In the guidance for resuming elective surgeries provided by the American College of Surgeons, this “new” reality is front and center. The first category for the ACS’s set of principles to consider is “COVID Awareness”. Before anyone can begin to resume elective surgeries, the ACS recommends that there “should be a sustained reduction in the rate of new COVID-19 cases in the relevant geographic area for at least 14 days”. The challenge with this metric is the lack of testing available, which can prove that cases are diminishing. In the absence of comprehensive testing, how can healthcare providers know with confidence who is infected but asymptomatic? Being confident that the 14-day trend is accurate necessitates testing.
Furthermore, testing will also be a pivotal component of the process once elective surgeries begin to resume. As patients prepare for necessary elective procedures, facilities will need to screen them in advance of their surgery date. Patients who screen positive will need to be rescheduled. Patients will also need to be handled with protocols that minimize any potential exposure within the hospital, based on current infection treatment levels. Policies for staff will need to be clear and precise as part of this process. Beyond testing, hospitals will need to make certain that critical PPE supplies are available for both treating COVID patients as well as for the surgical staff. PPE can be hard to come by just to treat existing infection.
Unfortunately, facilities will also need to be proactive in preparing for a potential surge in infections, which could happen at a moment’s notice based on the volatility of this disease. Per the ACS guidance, “With near-future reversal of physical distancing, local incidence may increase, including among health care workers” and “there is a threat of subsequent waves of COVID-19 infection regardless of whether isolation/physical distancing mandates are reversed”.
COVID-19 has changed our world in immeasurable ways. We must now respond with changes of our own. We need to begin resuming elective surgeries in a manner commensurate with those changes. Testing tools and PPE are necessary at levels far in excess of what used to be acceptable. Changes to how we make sure patients and staff are ready for elective surgery is simply our “new normal”. There will be so many changes to come.
Together, we can lift each other up!
-Marcus Perez, vice-président exécutif