Elective Surgery During The Pandemic

When the pandemic started, elective surgeries were postponed. And a majority of orthopedic procedures, including spine surgery, are considered elective. Then, in May, when these surgeries could resume, patients were slow to trust the safety of the hospital environment again. But, little by little, the numbers of elective surgeries have increased and were almost back to pre-Covid levels in terms of treating patients.

The new safety protocols include screening for Covid-19 symptoms and mandatory testing within 4 days of surgery. Even with these new protocols in place, the number of surgeries has been able to continue to rise. However, with the recent significant increases in Covid cases, and the subsequent shutdowns in so many states, elective surgeries are once again being cancelled and/or postponed in hospitals.

Surgery centers though, may still be open to certain elective procedures. A decision whether a procedure or surgery is elective, and whether or not it should be postponed or canceled under any state directive to do so, is a clinical determination that each provider and facility must determine. This is based on the risks and benefits of each case as well as the surgical environment.

Naturally, in determining whether to proceed with an operation, providers must heed any executive orders from their respective states, local governments, or other directives from agencies such as a Department of Health. CDC and CMS guidelines should also be considered.

During elective surgery, the safety and security of the patient is our first priority. We must ensure patients who are already in the hospital, and caregivers, are not negatively impacted during elective procedures. Therefore, urgent and emergent cases are prioritized first. In March, elective surgeries were postponed to allow the maximization of social distancing efforts.

With the current rate of Covid spread, your surgeon’s office, hospital and/or surgical center are working together to prioritize all patient scheduling. When your procedure is available for scheduling or rescheduling, the surgeon’s office should contact you directly, and get you on the schedule.

Some things you should expect as you move forward to surgery:

Patients will be phone screened before their appointment, followed by a hospital or surgical center screening upon arrival. In some cases, patients will be asked to self-isolate for 10-14 days prior to a procedure and they will be tested for Covid-19, prior to the date of their operation.

Patients should wear barrier masks from home upon arrival to the facility. A mask must be worn at all times while in the facility. Teams are making accommodations to maximize social distancing in waiting rooms and shared areas. In most cases, patients will be escorted from registration and delivered to the pre-op procedure room directly after arrival. However, when waiting is required, rigorous cleaning protocols and increased space between seats, to keep everyone at a safe distance, is being applied.

However, starting November 18, 2020, for most facilities, no visitors are allowed for inpatient or outpatient surgery or at most hospitals and/or surgical centers. The patient's caregiver and/or ride will need to drop off and pick up but, in most cases, may not enter a surgical facility. Currently, in the case of a minor patient only, a parent/guardian may accompany the minor inside and wait during the procedure.

Each facility continues to follow guidelines provided by their state, Centers for Disease Control and Prevention (CDC) and the US Surgeon General. With the safety of patients and caregivers as the highest priority, precautions continue to be taken, and accessed, to prevent the spread of COVID-19. Personal protective equipment (PPE), staffing and the COVID-19 surge potential is constantly being monitored.