ABSTRACT
On March 1, 2020, New York State confirmed its first case of COVID-19. This state has had the largest initial mortality in the United States with more than 479,000 confirmed cases and over 25,000 deaths as of October 10, 2020. All elective surgeries in New York State were suspended on March 23, 2020, due to the national state of emergency. Syosset Hospital is a 75-bed community hospital dedicated primarily to elective surgery. During the COVID-19 surge, the hospital was converted to provide needed beds for the treatment of COVID-19 illness. In anticipation of the resumption of urgent elective procedures, this hospital became one of the two designated sites within the Northwell Health system to be "non-COVID." Once the hospital was emptied of all inpatients, a complete and thorough cleaning and disinfection was performed on the entire building. All equipment was thoroughly decontaminated following Centers for Disease Control and Prevention (CDC) guidelines. In anticipation of the resumption of elective surgery, each surgeon evaluated their cancelled case list to determine patient priority, based on a scale of 1 (elective, non-urgent), 2 (semi-urgent), 3 (urgent), to 4 (highly urgent). Site-specific disaster credentialing was expedited so that emergent surgeries could be performed by surgeons located at other Northwell sites. To ensure a structured and informative onboarding process, each visiting surgeon received a "welcome" email which requested pertinent information to facilitate the surgical process. Presurgical, surgical, and postoperative protocols were revised based on federal and local guidance and regulations. Resumption of elective surgery post COVID-19 placed the hospital into uncharted territory.
ABSTRACT
AIM: To assess the impact of the COVID-19 pandemic-related lockdown on lacrimal surgery among oculoplastic surgeons in the Asia-Pacific region. METHODS: An institutional board review approved anonymous electronic survey was sent out via email to oculoplastic surgeons across the Asia-Pacific region. All responses were tabulated and analysed. RESULTS: A total of 259 valid responses were received. Nearly 87% of the surgeons agreed that lacrimal procedures were associated with a high risk of COVID-19 transmission. In all, at the time of taking the survey, 151/259 (58.3%) of the surgeons were not performing any lacrimal surgeries in view of the COVID-19 pandemic and 71/259 (27.4%) of the respondents were only performing emergency lacrimal surgeries. External dacryocystorhinostomy was the most commonly performed lacrimal procedure across the region and lacrimal procedures contributed to at least 25% of the income for nearly a third of the respondents. Majority of the respondents were female (52.9%), but a significantly higher proportion of male oculoplastic surgeons were still performing lacrimal surgeries during the lockdown. Over 75% of respondents indicated that resuming lacrimal procedures is important to their practice. CONCLUSION: The survey showed that there was a general agreement among the surveyed oculoplastic surgeons in the Asia-Pacific region that lacrimal procedures were associated with a high risk of COVID-19 transmission and over 85% of them of had either stopped performing elective lacrimal surgeries altogether or were providing only emergent care. It is likely that not performing elective lacrimal procedures, COVID-19 has financially impacted a high percentage of the surveyed oculoplastic surgeons.