Impact of Lockdown on General Surgery Patients in Mankweng Hospital, Limpopo (original) (raw)
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South African Medical Journal
The President of SA declared a 3-week nationwide lockdown, starting on 27 March 2020, in an effort to reduce the transmission rate, a decision guided by the Ministerial Advisory Committee on COVID-19. [2] The lockdown was subsequently extended to 1 May 2020, after which phased easing of restrictions would occur at a rate directed by epidemiological trends and healthcare operational capacity. [3] At its highest alert level, the lockdown regulated personal movement by implementing a curfew and mandating the public to remain at home other than for the purposes of purchasing essential living supplies and seeking emergency or chronic medical attention. [4] Furthermore, transport regulations limited the operating hours and carrying capacity of public transport vehicles. [3] It is important to note the personal financial cost that would result from these measures, especially in the context of SA, where poverty is rife and the unemployment rate is 29%, making the population vulnerable to economic instability. [5] Additionally, the general public was inundated with news reports stressing the severity of COVID-19 and social media trends, instantiated by #StayAtHome, highlighting the importance of social distancing. Ultimately these measures resulted in people ensconcing themselves in their homes and specifically avoiding healthcare facilities, which are perceived as places of high transmission risk, notwithstanding the National Department of Health's efforts to reduce this danger. [6] Many people's finances have been depleted, raising the question of affordability of the already lockdown-limited public transport system. Our hypothesis is that these inadvertent outcomes prevent patients from accessing healthcare, either physically owing to inaccessible transport, or psychologically through the fear of COVID-19 prompting personal infection mitigation behaviours. Objectives Having speculatively considered reasons driving a possible decline in admission statistics, we endeavoured through this research to investigate the change in urgent and emergency admissions to the Department of Surgery at Klerksdorp-Tshepong Hospital Complex (KTHC) prior to and during the first stage of COVID-19 lockdown. Methods Setting KTHC is a tertiary hospital in the largest city of North West Province, SA, and provides partial level 3 services to the entire province. [7] So This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.
Pattern of surgical emergencies during COVID-19 lockdown in a tertiary care centre
International Surgery Journal
Background: COVID-19 is a novel pandemic affecting almost all countries of the world. The containment measures in form of lockdown taken to prevent its spread has impacted pattern and volume of surgical emergencies. As emergency admissions form a major bulk of total surgical admissions hence this study was planned to look for the impact of lockdown on the spectrum of surgical emergencies in a tertiary care hospital.Methods: A descriptive register based study was done by collecting data of surgical emergencies in three phases – pre lockdown, lockdown and lockdown with relaxations. Data regarding surgical admissions which includes trauma as well as non-trauma emergencies during various phases was collected and analysed.Results: Total number of surgical emergencies decreased by 55.6% during lockdown when compared with pre-lockdown phase. In lockdown phase with relaxations, total admissions increased by 35.2% over lockdown phase however they was overall decrease by 19.4% than pre-lockdo...
European Journal of Medical Research
Purpose The burden of the coronavirus disease of 2019 (COVID-19) pandemic on the healthcare sector has been overwhelming, leading to drastic changes in access to healthcare for the public. We aimed to establish the impact of implemented government partial and complete lockdown policies on the volume of surgical patient admissions at a tertiary referral center during the pandemic. Methods A database was retrospectively created from records of patients admitted to the surgical ward through the emergency department. Three 6-week periods were examined: The complete lockdown period (CLP), which included a ban on the use of cars with the exception of health service providers and essential sector workers; A pre-COVID period (PCP) 1 year earlier (no lockdown); and a partial lockdown period (PLP) that involved a comprehensive curfew and implementing social distancing regulations and wear of personal protective equipment (e.g., masks) in public places. Results The number of patients admitted ...
South African Medical Journal
Background. The global COVID-19 pandemic caused many countries to institute nationwide lockdowns to limit the spread of the disease. Objectives. To describe the effect of the national COVID-19 lockdown in South Africa (SA) on the workload and case mix of patients presenting to a district-level emergency centre. Methods. The electronic patient tracking and registration database at Mitchells Plain Hospital, a district-level hospital in Cape Town, was retrospectively analysed. The 5-week lockdown period (27 March-30 April 2020) was compared with a similar period immediately before the lockdown (21 February-26 March). A comparison was also made with corresponding time periods during 2018 and 2019. Patient demographics, characteristics, diagnoses and disposition, as well as process times, were compared. Results. A total of 26 164 emergency centre visits were analysed (8 297 in 2020, 9 726 in 2019, 8 141 in 2018). There was a reduction of 15% in overall emergency centre visits from 2019 to 2020 (non-trauma 14%, trauma 20%). A 35% decrease was seen between the 2020 lockdown period and the 5-week period before lockdown (non-trauma 33%, trauma 43%), and the reduced number of visits stayed similar throughout the lockdown period. The median age increased by 5 years during the 2020 lockdown period, along with an 8% decrease in patients aged <12 years. High-acuity patients increased by 6% and the emergency centre mortality rate increased by 1%. All process times were shorter during the lockdown period (time to triage-24%, time to consultation-56%, time to disposition decision-29%, time in the emergency centre-20%). Conclusions. The SA national COVID-19 lockdown resulted in a substantial decrease in the number of patients presenting to the emergency centre. It is yet to be seen how quickly emergency centre volumes will recover as lockdown measures are eased.
2021
Background: The COVID-19 pandemic caused a rise in healthcare demands and has necessitated a significant restructuring of hospital Emergency Departments.The present study aims to determine the pandemic lockdown's impact on the number of patients seeking assessment in the Surgical Emergency Department (SED) with General Surgery emergencies. Methods: Since the start of the Covid pandemic in Greece (1 March, 2020) and up to 15 December 2020, the charts of all patients arriving at the SED of the third surgical department of the “Attikon” University Hospital (a tertiary referral center for surgical and COVID-19 cases) were retrospectively reviewed and broken down in four periods reflecting two nationwide lockdown (period A; 1/3/2020 to 30/4/2020 and period D; 16/10/2020 to 15/12/2020) and two interim (period B; 1/5/2020 to 15/6/2020 and period C; 15/9/2020 to 30/10/2020) periods. Demographic and clinical data were compared to those obtained from the same time periods of the year 2019...
Emergency Surgery during Lockdown: Experience at a tertiary care hospital
2020
Introduction: COVID-19 has halted the economic and social progression of the human race. This pandemic has exposed the vulnerabilities of all walks of life. But, most of all, this crisis has jolted the health care systems around the globe. A decrease in emergency surgical interventions was observed at District headquarters Hospital, Rawalpindi. The purpose of this study was to evaluate the impact of a pandemic on acute surgical emergency presentation and referral to a tertiary care hospital. Material and Methods: It is a retrospective cohort study. We compared emergency surgical interventions requiring spinal or general anaesthesia followed by admission in a ward at DHQ hospital, Rawalpindi during a control period (15th March 2019–15th June 2019) and during the pandemic lockdown period (15th March 202015th June 2020). Results: A total of 228 cases were included in the study including both groups. About 73% (167 ) cases were performed in an emergency during Pre COVID-19 period i.e. f...
Open Access Macedonian Journal of Medical Sciences, 2021
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has severely affected the provision of health-care services in hospitals around the world, including bringing challenges to those who perform surgical procedures. Multidepartment data analysis will reflect the pandemic’s impact and challenges in managing surgical cases in various surgery departments. AIM: This study aims to assess the impact of COVID-19 lockdowns on surgical cases carried out in eight tertiary care center surgery departments. METHODS: Retrospective data from all patients in the eight surgery departments of Dr. Moewardi General Hospital, Surakarta, during the lockdown period due to COVID-19 were collected and compared to the period before the lockdown. Then, the data were analyzed regarding the effects of following the standard operating procedure for surgical services in the hospital during the lockdown period. RESULTS: All the surgery departments involved in the study showed a significant reduction in the...
Impact of lockdown on emergency general surgery during first 2020 COVID-19 outbreak
European Journal of Trauma and Emergency Surgery, 2021
Purpose To evaluate and analyze the impact of lockdown strategy due to coronavirus disease 2019 (COVID-19) on emergency general surgery (EGS) in the Milan area at the beginning of pandemic outbreak. Methods A survey was distributed to 14 different hospitals of the Milan area to analyze the variation of EGS procedures. Each hospital reported the number of EGS procedures in the same time frame comparing 2019 and 2020. The survey revealed that the number of patients during the COVID-19 pandemic outbreak in 2020 was reduced by 19% when compared with 2019. The decrease was statistically significant only for abdominal wall surgery. Interestingly, in 2020, there was an increase of three procedures: surgical intervention for acute mesenteric ischemia (p = 0.002), drainage of perianal abscesses (p = 0.000285), and cholecystostomy for acute cholecystitis (p = 0.08). Conclusions During the first COVID-19 pandemic wave in the metropolitan area of Milan, the number of patients operated for emergency diseases decreased by around 19%. We believe that this decrease is related either to the fear of the population to ask for emergency department (ED) consultation and to a shift towards a more non-operative management in the surgeons 'decision making' process. The increase of acute mesenteric ischaemia and perianal abscess might be related to the modification of dietary habits and reduction of physical activity related to the lockdown.
2021
BACKGROUND: The aim of this retrospective comparative study was to assess the impact of the COVID-19 related disease on emergency surgery, comparing clinical main outcomes in the period March –May 2019 (Group 1) with the same period in Covid-19 Italian lockdown (March-May 2020, Group 2).METHODS: A comparison (Group 1 versus 2) was performed between the demographic, anamnestic, surgical, clinical and management features.RESULTS: 246 patients were included, 137 in Group 1 and 109 in Group 2 (p=0.03). No significant differences in peri-operative characteristics were registered. A declared delay in access to hospital and SARS-CoV-2 preoperatively infection rates were 15.5% and 5.8% respectively in Group 2. The overall morbidity (OR=2.22, 95%CI=1.08-4.55, p=0.03) and 30-day mortality (OR=1.34, 95%CI=0.33-5.50, =0.68) increased significantly in Group 2. Delayed access cohort demonstrated a close correlation with increased morbidity (OR=3.19, 95%CI=0.89-11.44, p=0.07), blood transfusion (O...
The Effect of the COVID 19 Pandemic on Elective Surgical Services in Jos, North Central, Nigeria
Journal of Biosciences and Medicines
Background. The COVID 19 pandemic affected healthcare delivery systems worldwide. There was a redistribution of health care resources in order to deal with the effects of the pandemic, with a corresponding consequence on other clinical services rendered. The extent of this effect on other non COVID 19 related services has been reported in other centres worldwide. In our own setting, health care resources are limited with suboptimal access even in normal situations. Objective. We sought to evaluate the effects of the COVID 19 pandemic on elective surgical services in our hospital. Methods. This was a cross sectional comparative study carried out at the Jos University Teaching hospital, (North central, Nigeria) of the elective surgical services rendered during the first wave of the COVID 19 pandemic lockdown covering the period April to June 2020 with a corresponding period of the preceding year 2019. Data was obtained from the hospital records department, theatres and service areas for clinic attendance, elective surgeries and ward occupancy. The paired sample t-test was used to compare the assessed variables across the three months of both years with a level of significance of P < 0.05. Results. There was mean clinic attendance of 2859.33 ± 223.36 covering the three months in 2019 as against a mean attendance of 648.67 ± 578.24 covering a similar period in 2020, P = 0.037. The elective surgical procedures carried out across the surgical specialties over the period in 2019 gave a mean of 352.33 ± 44.60 as opposed to 64.001 ± 7.32 over the corresponding period in 2020, P = 0.018. Ward occupancy over April to June 2019 was a mean 297.33 ± 18.58 across the various surgical wards and 158.33 ± 25.70 in the same period in 2020, P = 0.007. Conclusion. There was a significant reduction in the elective surgical services rendered in the hospital during the first wave of the COVID 19