Surgical Cancellations (in light of the Coronovirus (COVID-19))

[Artina Dawkins]

Dear ARCOS Community –

There is a possibility that we may limit or postpone surgeries in light of precautions taken to prevent the spread of the Coronovirus (COVID-19). The first surgical cases to be impacted may be elective cases. If your institutions are making or have made similar decisions, how are you implementing this plan?

Thank you,
Artina

[Jennifer Duane]

Hi Artina and Community,

In my program, most if not all elective surgeries are being cancelled. In terms of resident staffing, we are telling residents to stay home and do their best to stay healthy when they are not in surgery. These residents are “on reserve” so they can replace residents who become ill. We are a 4-hospital program so the ortho team at each hospital is creating its own staffing plan. I know that at least one of our teams is planning to rotate residents on/off trauma on a 2-week schedule to give the trauma residents a break and avoid long-term COVID-19 exposure.

Our hospital policies state that anyone with fever, sore throat, cough, or nasal congestion should stay/go home and report symptoms to Occ Health for further guidance regarding return to work. We are taking this very seriously which means residents who have just 1 of these symptoms need to stay/go home and follow occ health’s directions based on symptom review. So it is extra important to have a back-up system.

Right now, our focus is on contingency planning and adapting to the constantly evolving situation. These are definitely intense times, especially in healthcare.

I hope that is helpful! Take care everyone

[Laurel Lewis]

It seems that every time Jen posts something in Boston, it happens the next day in Pennsylvania! We have the option to work from home so I will probably start tomorrow. Also, starting tomorrow in PA, all “non-essential stores” including restaurants and bars are to close for 2 weeks, at least. Grocery, medical, and trash collection will continue. You can get take out at a place that serves food, tho. All med students have been sent home, all meetings and education has been canceled for 2 weeks all over the system. All elective surgeries have been canceled. I have attached information regarding our surgery scheduling in this situation.

Residents have not been told that they are “on reserve” but we have canceled all their education and surgeries so they will be “home schooling” with OrthoBullets and research projects which have not been canceled hahaha.
I am scheduling our Hand Fellowship Interviews via Microsoft Teams video conferencing in April. That should be interesting – at least I will be learning a new skill. 🙂
Blessings to all! I’m not very good a “Home Working” so keep in touch!
~Laurel

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[Artina Dawkins]

Thank you, Laurel and Jen, for your thorough responses.

Since my initial post, our institution has implemented the following tiered plan. We’re currently at Level 1:

Level 1: (our current level) Contact patients prior to visits to clinic and/or OR to delay surgery if elective and have fever and recent onset cough.
Level 2: Delay non time sensitive elective cases (requires departmental plan).
Level 3: All elective surgery deferred.
Level 4: All non-emergent cases cancelled. Urgent cases transfer to outlying facilities.

Additionally, elective cases were cancelled yesterday for the next 60 days at the VA where our residents rotate. Thankfully, this only impacted two residents – their schedules are being adjusted accordingly.

Thank you,
Artina

[Artina Dawkins]

For those of you who don’t access the CORD discussion board, following is a response that was posted regarding my question about surgery cancellations:

Subject: followup ABOS and ACGME
By Terrance D. Peabody, MD, FAOA on March 16, 2020

I got this from Peter Murray and David Martin

from the Board perspective
https://www.abms.org/news-events/abms-statement-to-dios-regarding-coronavirus-disease-2019-covid-19/

from ACGME

https://www.acgme.org/Newsroom/Newsroom-Details/ArticleID/10085/ACGME-Resident-Fellow-Education-and-Training-Considerations-related-to-Coronavirus-COVID-19

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