Hospitals battling with elective surgery backlogs due to Covid-19
There is growing concern about the collateral damage that could happen if the public and private health systems fail to pull together and deal with surgery backlogs being caused by Covid-19.
Six senior surgeons attached to universities and hospitals have cautioned that hospitals have reduced and cancelled surgical services as they prioritised medical resources to the novel virus.
KM Chu, M Smith, E Steyn, P Goldberg, H Bougard and I Buccimazza conducted their study via a survey that was answered by 130 surgeons from 85 public and private hospitals.
Their study, published by the SA Medical Journal, explored the drastic surgeon-related decisions hospitals took as they prioritised attending to Covid-19 cases.
All but one of the respondents to the survey said their hospitals cancelled or reduced non-cancer elective operations.
Of the 85 hospitals, 45.9% continued the same access to surgery patients, 51.8% reduced access and 2.3% stopped all emergency operations.
The report said non-emergency operations and clinic visits were drastically reduced or cancelled.
In a country where surgical care treated a significant proportion of the burden of disease, the de-escalation did not augur well for patients.
“The short and long-term effects of the disruption to surgical services will be detrimental to the health of South Africans,” the study said.
“Some participants noted that even though access to emergency surgical care was still available at their hospitals, fewer patients with emergency conditions were presenting than expected.
“In some hospitals, access to timely operative care for cancer operations has been reduced, which could lead to an excess in deaths.”
A large backlog of surgical conditions needing care should be expected once the virus peaked, the six surgeons said.
The public and private health systems needed to work together to handle the surgery backlog and save lives, they said.
Public hospitals’ timely return to surgeries will be hindered by Covid-19.
The “hospitalised Covid-19 burden has been higher in public hospitals than in private facilities, reducing staff and bed availability for surgical care”.
In contrast, some private facilities returned to elective surgery in the past two months. “The Covid-19 pandemic emphasises the need for both sectors to work together as one co-ordinated health system,” said the study.
“A single surgical backlog list of the most medically time sensitive surgical conditions, shared between the public and private sectors, could be one solution to mitigate excess morbidity and mortality from cancelled operations.”