Plastic Surgery amidst the Pandemic: The New York University Experience at the Epicenter of the COVID-19 Crisis.

SUMMARY: The coronavirus disease of 2019 pandemic became a global threat in a matter of weeks, with its future implications yet to be defined. New York City was swiftly declared the epicenter of the pandemic in the United States as case numbers grew exponentially in a matter of days, quickly threatening to overwhelm the capacity of the health care system. This burgeoning crisis led practitioners across specialties to adapt and mobilize rapidly. Plastic surgeons and trainees within the New York University Langone Health system faced uncertainty in terms of future practice, in addition to immediate and long-term effects on undergraduate and graduate medical education. The administration remained vigilant and adaptive, enacting departmental policies prioritizing safety and productivity, with early deployment of faculty for clinical support at the front lines. The authors anticipate that this pandemic will have far-reaching effects on the future of plastic surgery education, trends in the pursuit of elective surgical procedures, and considerable consequences for certain research endeavors. Undoubtedly, there will be substantial impact on the physical and mental well-being of health care practitioners across specialties. Coordinated efforts and clear lines of communication between the Department of Plastic Surgery and its faculty and trainees allowed a concerted effort toward the immediate challenge of tempering the spread of coronavirus disease of 2019 and preserving structure and throughput for education and research. Adaptation and creativity have ultimately allowed for early rebooting of in-person clinical and surgical practice. The authors present their coordinated efforts and lessons gleaned from their experience to inform their community's preparedness as this formidable challenge evolves.

The Readability of Outpatient Plastic Surgery Clinic Letters: Are We Adhering to Plain English Writing Standards?

The readability of letters sent to patients plays a pivotal role in facilitating joint decision making and positive health outcomes. Guidance suggests that all correspondence should be directed to patients. Covid-19 led to an increase in direct-to-patient communication. This study aims to determine the quantity and quality of plastic surgery clinic letters sent to patients before and during the Covid-19 pandemic. A total of 127 pre-Covid clinic letters from November to December 2019 and 103 peri-Covid clinic letters from April to May 2020 were identified and assessed for readability. Text was analyzed using a standardized set of commonly used readability formulae, including SMOG, Flesch Reading Ease, and the Coleman-Liao Index. A total of 100 pre-Covid and 58 peri-Covid letters were suitable for inclusion. Median results for formulae that output a U.S. grade score ranged between 9 and 12.9 for letters written prior to Covid-19 and 9 and 13.2 for those written during Covid-19. Eight percent of letters were sent to patients pre-Covid, increasing to 28% during the pandemic. Letters sent to patients had a median grade score of between 8 and 12 prior to Covid-19 and 8 and 10.6 during Covid-19. Letters sent to clinicians ranged between 9 and 13 and 9 and 13.3, respectively. Outpatient plastic surgery letters are written at a readability level too high to facilitate understanding among the general population. The increase in direct-to-patient contact during the Covid-19 outbreak has not led to a significant improvement in the readability of clinic letters. The authors suggest an increase in letter standardization and raising awareness of readability when writing clinic letters.

Surviving the COVID-19 Pandemic: Surge Capacity Planning for Nonemergent Surgery.

The coronavirus disease 2019 (COVID-19) pandemic has confronted the U.S. health care system with unprecedented challenges amidst a tenuous economic environment. As inpatient hospitals across the country prepare for an overwhelming influx of highly contagious COVID-19 cases, many nonemergent procedures have been cancelled or indefinitely postponed without guidance regarding eventual safe accommodation of these procedures in the future. Given the potentially prolonged impact of the COVID-19 pandemic on health care use, it is imperative for plastic surgeons to collaborate with other medical and surgical specialties to develop surge capacity protocols that allow continuation of safe, high-quality, nonemergent procedures. The purpose of this article is to provide necessary and timely public health information relevant to plastic surgery and also share a conceptual framework to guide surge capacity protocols for nonemergent surgery.

Availability of COVID-19 Information from National and International Aesthetic Surgery Society Websites.

BACKGROUND: National and international aesthetic surgery society websites are an important source of information for patients and aesthetic surgeons. The current COVID-19 pandemic represents an unprecedented global health crisis. The aim of this study was to assess the information available on national and international aesthetic surgery society websites on the current pandemic of COVID-19. METHODS: National and international aesthetic surgery society websites were assessed with regard to COVID-19 information. RESULTS: Thirty-one per cent of nations had aesthetic surgery society websites. Twenty-two per cent of national society websites had a specific COVID-19 section. Seventeen per cent of these websites had COVID-19-specific guidelines available; of these websites with guidelines, 77% had a specific COVID-19 section advising to provide only urgent or emergent care and 46% provided their sovereign state's directives to provide only urgent or emergent care. Two international aesthetic surgery society websites had COVID-19-specific guidelines, and one of the two had significant educational resources. CONCLUSION: The availability of COVID-19 clinical guidelines and patient information sheets on national plastic surgery society websites is sparse. In contrast, one international society website carefully analysed national and international recommendations and guidelines and made general recommendations for its members with regularly updated resources. This study suggests that improvement and increase in COVID-19 information provided by many national aesthetic surgery society websites may be improved by links to the ISAPS website. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.