How London maxillofacial units faced the demands of COVID lockdown and lessons learnt

ABSTRACT

Introduction In the UK between the 23rd of March 2020 and 10th of May 2020, the government enforced a lockdown. This, combined with COVID, caused OMFS hospitals across London to experience a change in staffing, resources and patient presentations. This study examines these changes, how patient care was adapted during this period and what can be learnt for the future. Method Data was collected from OMFS units attached to all 4 level 1 trauma centers in London. Prospective data was collected from 23rd of March 2020–10th of May 2020 (1st period). Retrospective data was collected from hospital coding records for 23rd of March - 10th of May 2019 (2nd period). Data was collected on all referrals to the OMFS team including diagnosis, patient demographics and treatment received. Results There was an 84% reduction in patients presenting with mandible fracture. 2 units with dental emergency services experienced no change in dental abscess presentations whilst the other 2 units saw a decrease of 70–75%. There was a trend towards reducing admission and general anaesthetic treatments. Most mandible fractures were treated in the outpatient setting with 1 unit discharging 100% of mandible fractures that presented to A&E. Only 13 of 72 paediatric lacerations were treated with general anaesthetic. Conclusion The COVID lockdown period, like war time, posed great challenges to healthcare provision. This paper presents the changes experienced and how patients were managed. Aiming to allow reflection and learning to guide changes in management to be adopted for the future.