IMPACTS ON THE TREATMENTOF CLEFT LIP AND PALATE DURING THE COVID 19 PANDEMIC IN BRAZIL

ABSTRACT

Background/Purpose: During the COVID 19 pandemic in Brazil, for a period of six months to a year and by determination of the National Supplementary Health Agency (ANS), elective health procedures were suspended in public and private hospitals, including cleft lip and palate treatment. The measure took into account the high occupancy rates of Intensive Care Unit (ICU) beds in the country and the prevention of contamination. For a condition such as cleft lip and palate, can be harmful to the patient. To report the impacts on cleft lip and palate treatment during the COVID 19 pandemic in Brazil. Methods/Description Exploratory and descriptive research with 55 accredited cleft lip and palate treatment centers and partners of an international philanthropic institution. Results: Among the of 55 partners centers (100%), 11% provided essentially multidisciplinary outpatient care and 89% provided surgical procedures besides the outpatient care. In the latter, 100% of the surgeries were postponed but, with the support of the International Philanthropic Institution, the 55 centers continued to provide integral care, including nutrition, speech therapy, social service, dentistry and psychological support to the patients through telemedicine. This online working method has saved lives, such as breastfeeding and proper nutritional counseling for mothers of babies born with the malformation. Doctors from these partner centers have treated thousands of patients remotely, providing vital guidance to families, following up with new patients who were waiting for their surgeries. They also received personal protective equipment (PPE) and essential equipment, such as pulse oximeters and non-contact infrared thermometers, so they could continue to care for patients with clefts, protecting against COVID-19. As government restrictions begin to ease around the world, there is a cautious resumption of free cleft lip and palate surgeries and life-saving outpatient follow-ups. Partner centers are developing safe surgery guidelines in accordance with regulations and recommendations from local and global Medical Advisory Boards allowing for continuity of care and a full and productive life for patients. Conclusions: The COVID-19 pandemic postponed the treatment of many children with cleft lip and palate in Brazil, but gave the partner centers the possibility to study in depth the problems relevant to clinical practice. It was in this context that the International Philanthropic Institution promoted online training with the teams, covering the integral care of the cleft patient, from the first consultation to the surgical treatment and multidisciplinary continuity.