Significant evidence base demonstrates an increased risk of perioperative mortality in COVID positive surgical patients
Based on previous knowledge of preoperative pulmonary infections, as well as early clinical data, most professional associations recommend a deferral of at least 7 weeks from symptom onset or positive test to elective surgery
New evidence in light of the existing surgical backlogs indicates that those with asymptomatic or mild infections can proceed to minor, low-risk elective surgeries 4 weeks after symptom onset or positive test
Guidelines and frameworks indicate that timelines are only recommendations and individuals need to be assessed objectively for preoperative fitness, that the risks and benefits of both surgery and delay be discussed, and that shared decision making used between multidisciplinary care teams and patients
Badea, A; Groot, G; Reeder, B; Fox, L; Young, C. What is the evidence on timing and outcomes of elective surgery after a COVID infection? 2022 May 27, Document no.: EOC220504 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2022. 11 p. (CEST rapid review report).
Consequences of delayed surgeries have potential patient-level and system-level consequences
Modelling indicates that even complete resumption of services requires additional resources to clear the backlogs caused by service disruptions
Retrospective data analysis indicates that minor delays for most cancer surgeries does not negatively impact patients, however the length of time to safely delay is largely dependent on condition and urgency
Badea, A; Groot, G; Young, C; Mueller, M. What have been the consequences of delayed surgeries due to the COVID-19 pandemic? 2021 Oct 18. Document no.: EOC210903 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2021. 14 p. (CEST rapid review report).
Physician and nursing staff members can be redeployed from various clinical areas, but in particular non-acute or elective practice areas such as ambulatory settings and surgical practices.
Providing patient-care in new clinical areas can be restructured into a task-based format that utilizes the skills already possessed by redeployed clinicians and staff.
Medical students, residents, internationally trained medical graduates and other health professionals such as respiratory therapists and pharmacists should also be considered for redeployment to high-need areas.
Scope of practice limitations, practice permit approvals and licensing may pose as potential barriers to being able to optimize our healthcare workforce in a surge.
Efficient but effective training should be provided to all staff that have volunteered for redeployment, in preparation of the next surge.
The safety of all health professionals should be ensured throughout the redeployment process.
Radu, L; Badea, A; Groot, G; Fox, L; Howell-Spooner, B; Young, C. What are the existing policies for the re-deployment or deployment of healthcare workers whose regular work has been disrupted by COVID-19 in high-resource clinical settings? 2020 Jul 29; Document no.: EOC072701 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 16 p. (CEST rapid review report)