Impact of COVID-19 Pandemic on Neurosurgical Practice in India: A Survey on Personal Protective Equipment Usage, Testing, and Perceptions on Disease Transmission.

ABSTRACT

BACKGROUND: There is a significant knowledge gap and anxiety among health care workers (HCWs) including neurosurgeons regarding in-hospital disease transmission and use of personal protective equipment (PPE) during the ensuing COVID-19 pandemic. OBJECTIVE: To assess present practice and perceptions among Indian neurosurgeons with respect to type of surgeries performed, PPE usage and SARS-CoV-2 testing. MATERIALS AND METHODS: A 12-item questionnaire on surgeries performed in the 6 weeks prior to the survey date, PPE usage, and preoperative SARS-CoV-2 testing was circulated electronically to Indian neurosurgeons from May 12, 2020 to May 31, 2020 and their responses analyzed. RESULTS: Two hundred forty-four neurosurgeons (237 males) participated in the survey; of whom, 230 had performed surgeries during the pandemic period. In total, 84.3% of respondents were performing semiemergency or emergency procedures only. N95 masks were utilized by only 83% of the respondents (n = 230) while performing surgical procedures. Only 40.9% of the respondents were satisfied regarding adequacy of available PPE. Preoperative SARS-CoV2 testing as well as testing of all asymptomatic patients prior to admission into ward/intensive care unit was perceived to be beneficial in reducing transmission risk by more than 85% respondents. More than 90% respondents felt that HCWs including neurosurgeons were at risk of acquiring infection through an outpatient consultation from an asymptomatic individual. CONCLUSIONS: Access to and utilization of appropriate PPE was lacking among the one-fifth of neurosurgeons who participated in this survey. To gain the confidence of neurosurgeons, hospitals should address their concerns regarding PPE and testing of patients prior to surgery and admission to the hospital.