Shaping a resilient future in response to COVID-19

Science today defines resilience as the capacity to live and develop with change and uncertainty, which is well beyond just the ability to ‘bounce back' to the status quo. It involves the capacity to absorb shocks, avoid tipping points, navigate surprise and keep options alive, and the ability to innovate and transform in the face of crises and traps. Five attributes underlie this capacity: diversity, redundancy, connectivity, inclusivity and equity, and adaptive learning. There is a mismatch between the talk of resilience recovery after COVID-19 and the latest science, which calls for major efforts to align resilience thinking with sustainable development action. © 2023, Springer Nature Limited.

Strategies for recovery of a surgical service in the COVID-19 era.

The COVID-19 pandemic has resulted in a massive backlog of elective cases. Delays in the provision of "elective" surgical care have dire consequences for the patient: progression of disease and comorbidities, higher complication rates, and lower overall survival. Delays in elective surgery also have significant consequences for the health system: added emotional strain on healthcare workers, a reduction in training opportunities, increased costs, and increased inequality in health-service provision. As the virus is likely to become endemic, the recovery of surgical services from the initial shock of the first three waves needs to be carefully planned, in order to mitigate the further loss of elective surgical services. This article presents a narrative review of the latest international guidelines and recommendations pertaining to surgical recovery strategies in the COVID-19 pandemic. To begin with, any recovery plan should be led by a local governance committee, who need to design and implement a number of strategies across the three phases of recovery. The preparation phase includes deciding on a system of case prioritisation, assessing and organising resources, and planning innovative ways to reorganise the service itself. The perioperative phase involves putting measures in place to reduce the risk of COVID-19 transmission. The post discharge phase includes the implementation of telemedicine for follow-up, as well as methods of service audit to enable continuous adjustment and improvement. Surgical service recovery presents many challenges; however, these also present a unique opportunity to reassess and improve the efficiency of surgical care delivery.

Strategies for recovery of a surgical service in the COVID-19 era

The COVID-19 pandemic has resulted in a massive backlog of elective cases. Delays in the provision of “elective” surgical care have dire consequences for the patient: progression of disease and comorbidities, higher complication rates, and lower overall survival. Delays in elective surgery also have significant consequences for the health system: added emotional strain on healthcare workers, a reduction in training opportunities, increased costs, and increased inequality in health-service provision. As the virus is likely to become endemic, the recovery of surgical services from the initial shock of the first three waves needs to be carefully planned, in order to mitigate the further loss of elective surgical services. This article presents a narrative review of the latest international guidelines and recommendations pertaining to surgical recovery strategies in the COVID-19 pandemic. To begin with, any recovery plan should be led by a local governance committee, who need to design and implement a number of strategies across the three phases of recovery. The preparation phase includes deciding on a system of case prioritisation, assessing and organising resources, and planning innovative ways to reorganise the service itself. The perioperative phase involves putting measures in place to reduce the risk of COVID-19 transmission. The post discharge phase includes the implementation of telemedicine for follow-up, as well as methods of service audit to enable continuous adjustment and improvement. Surgical service recovery presents many challenges;however, these also present a unique opportunity to reassess and improve the efficiency of surgical care delivery.

Anaesthetists’ knowledge of airborne infections

Background: Anaesthetists need to be knowledgeable regarding the control of airborne infection to ensure safe practice. The aim of this study was to determine anaesthetists’ knowledge regarding airborne infections in the perioperative period in the Department of Anaesthesiology at the University of the Witwatersrand. Methods: A cross-sectional research design was followed using an anonymous self-administered questionnaire. Data were collected at academic departmental meetings by convenience sampling. Returning the questionnaire implied consent. A score of 65% was considered adequate knowledge. Results: Of the 150 questionnaires distributed, 137 (91.3%) questionnaires were returned. An overall mean (standard deviation [s.d.]) score of 58.8% (4.252) was achieved, and only 11 (8.1%) of anaesthetists had adequate knowledge. There was no statistically significant association between seniority and passing or failing (p = 0.327). The highest mean (s.d.) score, 67.4% (6.979), was reported in the section pertaining to patients, followed by the section regarding operating theatre staff at 58.1% (11.899) and the lowest mark, 53.5% (5.553), for the environment section. Anaesthetists scored significantly better in the knowledge regarding patients’ section than in other sections (p < 0.0005). Conclusion: Knowledge of airborne infections in this study was poor, with only 8.1% achieving a pass, and no difference in knowledge between junior and senior anaesthetists was observed. Considering the ongoing coronavirus disease 2019 (COVID-19) pandemic at the time of the study, this was a surprising finding. Urgent action needs to be taken to ensure the safety of anaesthetists, other operating theatre staff and patients.

Anaesthetic considerations in the pregnant patient with COVID-19 disease

The world is currently in the middle of a pandemic as a result of the SARS-CoV-2 virus also known as the COVID-19 virus. To date, it had affected an estimated total of 24 million people in the world. An estimated 800 000 people have already died from the disease. The course of the disease varies from asymptomatic infection up to severe disease with acute respiratory distress syndrome (ARDS) and multi-organ failure. In addition, it is highly infectious and as such special precautions are needed to limit the exposure of health care workers, other patients and members of the community. Despite physiological changes in cell-mediated immunity that theoretically should predispose pregnant women to infection and more severe disease, there is no definitive evidence that pregnant patients are at higher risk of contracting COVID-19 or that they are more prone to severe disease.