Impact of COVID-19 pandemic on cataract surgical volume: A North Indian experience.

PURPOSE: To analyze the impact of the pandemic on trends in cataract surgical volume in 2020 in a high-volume tertiary care academic center in North India. METHODS: The monthly cataract surgical volume for a large, high-volume, tertiary care academic center in North India was obtained from January 2018 through December 2020. Based on historical trends, we used time-series forecasting, probability sensitivity analysis, and linear regression models to estimate what the expected monthly cataract volume should have been from March 2020 onward. RESULTS: In 2020, we expected to perform 7500 cases (assuming historical trends) but performed only 2500 cases (33% of the expected volume). The remaining 5000 cases (67% cases) constituted the "fixed" backlog. Assuming the ramp-up in cataract surgical volume starts in January 2021, results of the Monte Carlo simulation revealed that for our system, it would take on average 5 months (May 2021) under the optimistic scenario and 10 months (October 2021) under the ambivalent scenario to reach pre-pandemic expected surgical volume. There would be a collective backlog of 5500 cases under the optimistic scenario (8.8 months' worth of cases) and a collective backlog of 6900 cases under the ambivalent scenario (11 months' worth of cases). CONCLUSION: An intuitive approach and out-of-the-box solutions are required by the government and private institutes' collaborative efforts to help mitigate the disruptions caused by the pandemic and lessen the backlog without causing provider burnout.

SARS-CoV-2 Impact on Elective Orthopaedic Surgery: Implications for Post-Pandemic Recovery.

BACKGROUND: The aim of our study was to explore the impact of elective-surgery deferment on the United States health-care system and subsequent recovery after COVID-19 containment. Using an orthopaedic elective surgery model, we aimed to answer the following: (1) What is the expected recovery time until the health-care system is back to nearly full capacity for performing elective surgery? (2) What will be the expected backlog of elective surgery over time? (3) How should health care change to address the backlog? METHODS: A Monte Carlo stochastic simulation-based analysis was performed to forecast the post-pandemic volume of elective, inpatient total joint arthroplasty and spinal fusion surgical cases. The cumulative backlog was calculated and analyzed. We tested model assumptions with sensitivity analyses. RESULTS: Assuming that elective orthopaedic surgery resumes in June 2020, it will take 7, 12, and 16 months-in optimistic, ambivalent, and pessimistic scenarios, respectively-until the health-care system can perform 90% of the expected pre-pandemic forecasted volume of surgery. In the optimistic scenario, there will be a cumulative backlog of >1 million surgical cases at 2 years after the end of elective-surgery deferment. CONCLUSIONS: The deferment of elective surgical cases during the SARS-CoV-2 pandemic will have a lasting impact on the United States health-care system. As part of disaster mitigation, it is critical to start planning for recovery now.

COVID-19 and cataract surgery backlog in Medicare beneficiaries.

PURPOSE: To forecast the volume of cataract surgery in Medicare beneficiaries in the United States in 2020 and to estimate the surgical backlog that may be created due to COVID-19. SETTING: Medicare Beneficiaries, United States. DESIGN: Epidemiologic modeling. METHODS: Baseline trends in cataract surgery among Medicare beneficiaries were assessed by querying the Medicare Part B Provider Utilization National Summary data. It was assumed that once the surgical deferment is over, there will be a ramp-up period; this was modeled using a stochastic Monte Carlo simulation. Total surgical backlog 2 years postsuspension was estimated. Sensitivity analyses were used to test model assumptions. RESULTS: Assuming cataract surgeries were to resume in May 2020, it would take 4 months under an optimistic scenario to revert to 90% of the expected pre-COVID forecasted volume. At 2-year postsuspension, the resulting backlog would be between 1.1 and 1.6 million cases. Sensitivity analyses revealed that a substantial surgical backlog would remain despite potentially lower surgical demand in the future. CONCLUSIONS: Suspension of elective cataract surgical care during the COVID-19 surge might have a lasting impact on ophthalmology and will likely result in a cataract surgical patient backlog. These data may aid physicians, payers, and policymakers in planning for postpandemic recovery.