Changing practices of delivering orthopedic and coronavirus disease 2019 care: Outcome of a pan-India survey

ABSTRACT

Purpose: Coronavirus disease 2019 (COVID-19) pandemic has caused severe disruption of services for other health-related ailments. This study was done to assess change in practices of orthopedic surgeons, availability of proper training and personal protective equipment (PPEs), and changes in hospital setup/preparedness for the management of COVID-19 patients. Materials and Methods: A pan-India online survey was done among practicing orthopedic surgeons. Orthopedicians not practicing in India, trainees, and those who had left their practice before the pandemic were excluded from the study. Survey MonkeyR questionnaire and Google FormsR were sent to 10,055 orthopedicians, during the 7th week of nationwide lockdown in the month of May, 2020. Complete responses were received from 407 participants who were included in the final analysis. Results: Only a quarter (n = 100/407, 24.6%) of the doctors were visiting hospitals at a frequency similar to that before the pandemic. Onus of orthopedic care among COVID-19 suspected/diagnosed cases and routine COVID-19 patients were mainly borne by the government sector. Only 38.8% (n = 158/407) doctors felt that they received adequate training while 64.9% (n = 264/407) of the doctors had adequate supply of PPE kits. “Designation of specific areas of their hospitals exclusively for COVID-19 patients” was opined by 43.7% (n = 178/407), urgent diagnostic facilities by 52.8% (n = 215/407), and exclusive operation theaters by only 28.3% (n = 115/407) of the respondents. Conclusion: This study has shown a drastic fall in the frequency of hospital visits by orthopedic surgeons, predominant involvement of government sector orthopedicians, inadequate training of doctors and inadequate availability of PPE kits, lack of proper designated areas, operation theaters, and urgent diagnostic facilities for the management of COVID-19 patients.