Resuming elective operations after COVID-19 pandemic.

Editor

With the current unprecedented times, we read with interest “Global guidance for surgical care during the COVID-19 pandemic”. Millions of elective surgeries across the globe have been cancelled leading to lengthy waiting times and a backlog of unresolved health issues. These cancellations allowed a release of ICU beds, operating theatres and general wards for the treatment of COVID-19 patients. Moreover, the cancellations are assumed to reduce the spread of infection from the hospital staff to elective patients.

As lockdown measures ease and confirmed positive cases decline, considerations need to be made about resuming elective surgery. One of the biggest issues the NHS will face is the influx of new cases alongside postponed elective operations. In South Korea, elective surgeries continue by screening patients beforehand to minimise cross infection risk. Hence, a 14-day quarantine alongside a COVID-19 screen prior to elective surgery may need to be implemented. Furthermore, surgeries at ONE SITE ONLY, away from COVID-19 patients, would reduce infection risk and will allow effective use of resources. In addition, elective surgeries will need to be spaced out to reduce the number of patients in close proximity to each other.

The three-phase strategy outlined by Radha, S et al. should be explored. These introduce elective surgeries in three phases depending on the urgency of the surgery. Careful planning utilising this strategy alongside local coordination of timing, testing and PPE are crucial in order to resume elective surgeries. Furthermore, surgeons working in the NHS will need to adapt to the backlog of elective surgeries alongside the drastic changes that will have to be implemented due to COVID-19. These changes could undeniably affect their mental health, hence preparations to introduce psychological first aid (PFA) should be made in advance.