Delivering Urgent Elective Surgery at a COVID Clean Facility During Phase 1 of the UK Lockdown and Developing a Contingency Plan for Potential Future Waves

Shafaque Shaikh; Lok Ka Cheung; Shanju Rai; Thenmalar Vadiveloo; David Lawrie; Abdul Qadir

doi:doi:10.11648/j.js.20221001.16

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Delivering Urgent Elective Surgery at a COVID Clean Facility During Phase 1 of the UK Lockdown and Developing a Contingency Plan for Potential Future Waves

Shafaque Shaikh, Lok Ka Cheung, Shanju Rai, Thenmalar Vadiveloo, David Lawrie, Abdul Qadir

Published in Journal of Surgery (Volume 10, Issue 1)

Received: 1 January 2022 Accepted: 25 January 2022 Published: 9 February 2022

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Abstract

Background: The COVID-19 pandemic has resulted in unprecedented disruption in the delivery of elective surgical care and fears of ongoing waves exist. Our organisation explored a model of care to enable safe delivery of urgent elective surgical care for the diagnosis of cancer across various specialties. This study presents the results of this model and the development of a contingency plan for a future wave of the COVID-19 pandemic. Methods: Early on during phase-1 of the UK lockdown, a clean facility fit for purpose for delivering elective surgical care was identified and measures implemented to ensure safety across the process. Results: A total of 499 patients were booked between 20/03/2020 to 18/06/2020 (Phase-1), 44 were cancelled because 7 developed symptoms of COVID-19 pre-operatively, household members of 2 patients became symptomatic, 4 failed to attend and 31 were unsuitable due to co-morbidities. There was no mortality at 7 or 30 days. Twenty two patients developed complications post-operatively, 4 required escalation of care, 5 required transfer to the parent site, 13 were readmitted and 4 required a re-operation. None of the patients developed COVID-19 in the post-operative period up to 30 days. Thirty-one patients developed symptoms suggestive of COVID-19 all of whom tested negative on a swab test. Overall, patient satisfaction was good. Conclusion: It was possible to safely deliver urgent elective surgical care at a COVID clean facility in our population. This strategy may facilitate the continued delivery of urgent elective surgical care during potential further waves of COVID-19 pandemic or similar future health crisis.

Published in	Journal of Surgery (Volume 10, Issue 1)
DOI	10.11648/j.js.20221001.16
Page(s)	27-33
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

COVID-19, Surgical Care, Elective, Clean Facility, Contingency Planning

References

[1]	COVIDSurg Collaborative. Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans. BR J Surg. 2020 Oct; 107: 1440-1449.
[2]	Sullivan R, Alatise OI, Anderson BO, et al: Global cancer surgery: Delivering safe, affordable, and timely cancer surgery. Lancet Oncol 16: 1193-1224, 2015.
[3]	Woo YL, Kyrgiou M, Bryant A, et al: Centralisation of services for gynaecological cancers - a Cochrane systematic review. Gynecol Oncol 126: 286-290, 2012.
[4]	Faluyi OO, Connor JL, Chatterjee M, et al: Advanced pancreatic adenocarcinoma outcomes with transition from devolved to centralised care in a regional cancer centre. Br J Cancer 116: 424-431, 2017.
[5]	El-Boghdadly K, Cook TM, Goodacre T, et al. SARS-CoV-2 infection, COVID-19 and timing of elective surgery: A multidisciplinary consensus statement on behalf of the Association of Anaesthetists, the Centre for Peri-operative Care, the Federation of Surgical Specialty Associations, the Royal College of Anaesthetists and the Royal College of Surgeons of England. Anaesthesia. 2021 Jul; 76 (7): 940-946. doi: 10.1111/anae.15464. Epub 2021 Mar 18.
[6]	Assadian O, Golling M, Krüger CM, Leaper D, Mutters NT, Roth B, Kramer A. Surgical site infections: guidance for elective surgery during the SARS-CoV-2 pandemic - international recommendations and clinical experience. J Hosp Infect. 2021 May; 111: 189-199.
[7]	Dai M, Liu D, Liu M, et al: Patients with cancer appear more vulnerable to SARS-COV-2: A multi-center study during the COVID-19 outbreak. Cancer Discov 10: 783-791, 2020.
[8]	Liang W, Guan W, Chen R, et al: Cancer patients in SARS-CoV-2 infection: A nationwide analysis in China. Lancet Oncol 21: 335-337, 2020.
[9]	Mehta V, Goel S, Kabarriti R, et al: Case fatality rate of cancer patients with COVID-19 in a New York hospital system. Cancer Discov 10: 935-941, 2020.
[10]	Jonker PKC, van der Plas WY, Steinkamp PJ, Poelstra R, Emous M, van der Meij W, Thunnissen F, Bierman WFW, Struys MMRF, de Reuver PR, de Vries JPM, Kruijff S; Dutch Surgical COVID-19 Research Collaborative. Perioperative SARS-CoV-2 infections increase mortality, pulmonary complications, and thromboembolic events: A Dutch, multicenter, matched-cohort clinical study. Surgery. 2021 Feb; 169 (2): 264-274.
[11]	COVIDSurg Collaborative. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. Lancet. 2020 Jul; 396: 27-38.
[12]	Schurz H, Salie M, Tromp G et al. The x chromosome and sex-specific effects in infectious disease susceptibility. Hum Genomics 2019 Jan 8; 13 (1): 2.
[13]	Jordan RE, Adab P and Cheng KK. COVID-19: risk factors for severe diseases and death. BMJ 2020 Mar 26; 368.
[14]	NHS Reset For the Future of Health And Care. Getting the NHS back on track planning for the next phase of COVID-19. NHS Confederation 2020 June.
[15]	Alderson D and Henderson K. Helping the NHS recover from COVID-19 A joint memorandum from the Royal College of Emergency Medicine (RCEM) 2020 https://www.rcem.ac.uk/docs/Policy/200615_Joint_Memorandum_Commons_HSC_Committee.pdf Assessed on 21 June 2020.
[16]	Health and Social Care Committee. Delivering Core NHS and Care Services during the Pandemic and Beyond. UK Parliament 2020 June https://www.parliamentlive.tv/Event/Index/9dcb0e56-5ae5-4566-a1f8-9c7cb5a33c45 (Assessed on 16 June 2020).

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APA Style

Shafaque Shaikh, Lok Ka Cheung, Shanju Rai, Thenmalar Vadiveloo, David Lawrie, et al. (2022). Delivering Urgent Elective Surgery at a COVID Clean Facility During Phase 1 of the UK Lockdown and Developing a Contingency Plan for Potential Future Waves. Journal of Surgery, 10(1), 27-33. https://doi.org/10.11648/j.js.20221001.16

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ACS Style

Shafaque Shaikh; Lok Ka Cheung; Shanju Rai; Thenmalar Vadiveloo; David Lawrie, et al. Delivering Urgent Elective Surgery at a COVID Clean Facility During Phase 1 of the UK Lockdown and Developing a Contingency Plan for Potential Future Waves. J. Surg. 2022, 10(1), 27-33. doi: 10.11648/j.js.20221001.16

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AMA Style

Shafaque Shaikh, Lok Ka Cheung, Shanju Rai, Thenmalar Vadiveloo, David Lawrie, et al. Delivering Urgent Elective Surgery at a COVID Clean Facility During Phase 1 of the UK Lockdown and Developing a Contingency Plan for Potential Future Waves. J Surg. 2022;10(1):27-33. doi: 10.11648/j.js.20221001.16

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@article{10.11648/j.js.20221001.16,
  author = {Shafaque Shaikh and Lok Ka Cheung and Shanju Rai and Thenmalar Vadiveloo and David Lawrie and Abdul Qadir},
  title = {Delivering Urgent Elective Surgery at a COVID Clean Facility During Phase 1 of the UK Lockdown and Developing a Contingency Plan for Potential Future Waves},
  journal = {Journal of Surgery},
  volume = {10},
  number = {1},
  pages = {27-33},
  doi = {10.11648/j.js.20221001.16},
  url = {https://doi.org/10.11648/j.js.20221001.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20221001.16},
  abstract = {Background: The COVID-19 pandemic has resulted in unprecedented disruption in the delivery of elective surgical care and fears of ongoing waves exist. Our organisation explored a model of care to enable safe delivery of urgent elective surgical care for the diagnosis of cancer across various specialties. This study presents the results of this model and the development of a contingency plan for a future wave of the COVID-19 pandemic. Methods: Early on during phase-1 of the UK lockdown, a clean facility fit for purpose for delivering elective surgical care was identified and measures implemented to ensure safety across the process. Results: A total of 499 patients were booked between 20/03/2020 to 18/06/2020 (Phase-1), 44 were cancelled because 7 developed symptoms of COVID-19 pre-operatively, household members of 2 patients became symptomatic, 4 failed to attend and 31 were unsuitable due to co-morbidities. There was no mortality at 7 or 30 days. Twenty two patients developed complications post-operatively, 4 required escalation of care, 5 required transfer to the parent site, 13 were readmitted and 4 required a re-operation. None of the patients developed COVID-19 in the post-operative period up to 30 days. Thirty-one patients developed symptoms suggestive of COVID-19 all of whom tested negative on a swab test. Overall, patient satisfaction was good. Conclusion: It was possible to safely deliver urgent elective surgical care at a COVID clean facility in our population. This strategy may facilitate the continued delivery of urgent elective surgical care during potential further waves of COVID-19 pandemic or similar future health crisis.},
 year = {2022}
}

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TY - JOUR
T1 - Delivering Urgent Elective Surgery at a COVID Clean Facility During Phase 1 of the UK Lockdown and Developing a Contingency Plan for Potential Future Waves
AU - Shafaque Shaikh
AU - Lok Ka Cheung
AU - Shanju Rai
AU - Thenmalar Vadiveloo
AU - David Lawrie
AU - Abdul Qadir
Y1 - 2022/02/09
PY - 2022
N1 - https://doi.org/10.11648/j.js.20221001.16
DO - 10.11648/j.js.20221001.16
T2 - Journal of Surgery
JF - Journal of Surgery
JO - Journal of Surgery
SP - 27
EP - 33
PB - Science Publishing Group
SN - 2330-0930
UR - https://doi.org/10.11648/j.js.20221001.16
AB - Background: The COVID-19 pandemic has resulted in unprecedented disruption in the delivery of elective surgical care and fears of ongoing waves exist. Our organisation explored a model of care to enable safe delivery of urgent elective surgical care for the diagnosis of cancer across various specialties. This study presents the results of this model and the development of a contingency plan for a future wave of the COVID-19 pandemic. Methods: Early on during phase-1 of the UK lockdown, a clean facility fit for purpose for delivering elective surgical care was identified and measures implemented to ensure safety across the process. Results: A total of 499 patients were booked between 20/03/2020 to 18/06/2020 (Phase-1), 44 were cancelled because 7 developed symptoms of COVID-19 pre-operatively, household members of 2 patients became symptomatic, 4 failed to attend and 31 were unsuitable due to co-morbidities. There was no mortality at 7 or 30 days. Twenty two patients developed complications post-operatively, 4 required escalation of care, 5 required transfer to the parent site, 13 were readmitted and 4 required a re-operation. None of the patients developed COVID-19 in the post-operative period up to 30 days. Thirty-one patients developed symptoms suggestive of COVID-19 all of whom tested negative on a swab test. Overall, patient satisfaction was good. Conclusion: It was possible to safely deliver urgent elective surgical care at a COVID clean facility in our population. This strategy may facilitate the continued delivery of urgent elective surgical care during potential further waves of COVID-19 pandemic or similar future health crisis.
VL - 10
IS - 1
ER -

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Author Information

Shafaque Shaikh

Department of Surgery, Aberdeen Royal Infirmary, Aberdeen, UK
Lok Ka Cheung

Department of Surgery, Aberdeen Royal Infirmary, Aberdeen, UK
Shanju Rai

Department of Surgery, Aberdeen Royal Infirmary, Aberdeen, UK
Thenmalar Vadiveloo

Department of Surgery, Aberdeen Royal Infirmary, Aberdeen, UK
David Lawrie

Department of Surgery, Aberdeen Royal Infirmary, Aberdeen, UK
Abdul Qadir

Department of Surgery, Aberdeen Royal Infirmary, Aberdeen, UK

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APA Style

Shafaque Shaikh, Lok Ka Cheung, Shanju Rai, Thenmalar Vadiveloo, David Lawrie, et al. (2022). Delivering Urgent Elective Surgery at a COVID Clean Facility During Phase 1 of the UK Lockdown and Developing a Contingency Plan for Potential Future Waves. Journal of Surgery, 10(1), 27-33. https://doi.org/10.11648/j.js.20221001.16

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ACS Style

Shafaque Shaikh; Lok Ka Cheung; Shanju Rai; Thenmalar Vadiveloo; David Lawrie, et al. Delivering Urgent Elective Surgery at a COVID Clean Facility During Phase 1 of the UK Lockdown and Developing a Contingency Plan for Potential Future Waves. J. Surg. 2022, 10(1), 27-33. doi: 10.11648/j.js.20221001.16

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AMA Style

Shafaque Shaikh, Lok Ka Cheung, Shanju Rai, Thenmalar Vadiveloo, David Lawrie, et al. Delivering Urgent Elective Surgery at a COVID Clean Facility During Phase 1 of the UK Lockdown and Developing a Contingency Plan for Potential Future Waves. J Surg. 2022;10(1):27-33. doi: 10.11648/j.js.20221001.16

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@article{10.11648/j.js.20221001.16,
  author = {Shafaque Shaikh and Lok Ka Cheung and Shanju Rai and Thenmalar Vadiveloo and David Lawrie and Abdul Qadir},
  title = {Delivering Urgent Elective Surgery at a COVID Clean Facility During Phase 1 of the UK Lockdown and Developing a Contingency Plan for Potential Future Waves},
  journal = {Journal of Surgery},
  volume = {10},
  number = {1},
  pages = {27-33},
  doi = {10.11648/j.js.20221001.16},
  url = {https://doi.org/10.11648/j.js.20221001.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20221001.16},
  abstract = {Background: The COVID-19 pandemic has resulted in unprecedented disruption in the delivery of elective surgical care and fears of ongoing waves exist. Our organisation explored a model of care to enable safe delivery of urgent elective surgical care for the diagnosis of cancer across various specialties. This study presents the results of this model and the development of a contingency plan for a future wave of the COVID-19 pandemic. Methods: Early on during phase-1 of the UK lockdown, a clean facility fit for purpose for delivering elective surgical care was identified and measures implemented to ensure safety across the process. Results: A total of 499 patients were booked between 20/03/2020 to 18/06/2020 (Phase-1), 44 were cancelled because 7 developed symptoms of COVID-19 pre-operatively, household members of 2 patients became symptomatic, 4 failed to attend and 31 were unsuitable due to co-morbidities. There was no mortality at 7 or 30 days. Twenty two patients developed complications post-operatively, 4 required escalation of care, 5 required transfer to the parent site, 13 were readmitted and 4 required a re-operation. None of the patients developed COVID-19 in the post-operative period up to 30 days. Thirty-one patients developed symptoms suggestive of COVID-19 all of whom tested negative on a swab test. Overall, patient satisfaction was good. Conclusion: It was possible to safely deliver urgent elective surgical care at a COVID clean facility in our population. This strategy may facilitate the continued delivery of urgent elective surgical care during potential further waves of COVID-19 pandemic or similar future health crisis.},
 year = {2022}
}

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