Becker's Hospital Review

76 CMO / CARE DELIVERY COVID-19 surgical backlogs persist: 4 things for hospital leaders to know By Erica Carbajal A new study from researchers at Massachusetts General Hospital in Boston found that even well into 2021, surgical procedure volumes had not fully recovered to pre-pandemic levels. This has contributed to ongoing backlogs that could result in more advanced disease and higher costs in the future. "We've seen inconsistent recovery rates in surgical procedures across subspecialities and case classes, which could mean growing morbidity and death rates going forward, along with higher costs to hospitals and the healthcare system," said Marc Succi, MD, attending radiologist at Massachusetts General and senior author of the study, published Aug. 18 in JAMA Network Open. Researchers analyzed changes in the volume of surgical procedures at the 1,017-bed hospital between Jan. 6, 2019, and Dec. 31, 2021. Nearly 130,000 procedures were included in the study and analyzed according to subspecialty and case class: elective, emergent, nonurgent or urgent. Four things to know: 1. Overall weekly surgical procedure volumes fell nearly 45 percent from pre-COVID-19 levels during the height of the pandemic in 2020. This weekly volume decrease was seen across all subspecialties. 2. From May 2020 to January 2021, considered the post-COVID peak period, weekly surgical volumes recovered to only 85.8 percent of peak volumes pre-pandemic. 3. Researchers found a "full recovery of nonurgent procedure volumes" from January 2021 through the end of the year, considered the post-vaccine period. Still, overall surgical procedure volumes remained much lower than pre-pandemic levels. 4. Subspecialties that saw the greatest drop in volume during the height of the pandemic in 2020 through 2021 were cancer, cardiac, urology, orthopedic and general surgery. When analyzed by surgical class, urgent and elective procedural volumes have not made significant rebounds. "Hospitals need to thoughtfully and strategically consider which surgical subspecialties and classes of surgery to defer or not to defer in response to the next viral outbreak, realizing those decisions could have a profound impact on the health and survival of their patients later on," Dr. Succi said. n Surge in infectious diseases was inevitable, Dr. Michael Osterholm says By Mackenzie Bean F rom COVID-19 to polio to monkeypox, infectious disease threats have dominated the headlines and public discourse in recent weeks. Monkeypox has sickened more than 10,000 Americans, New York recently reported the nation's first polio case in nearly a decade, and COVID-19 is still spreading nationwide. And Chinese researchers just discovered a new virus, Langya henipavirus, that appears to have jumped from animals to humans for the first time. This uptick in infectious disease activity is no coincidence, but rather the result of a culmination of global factors that define the new, modern world of infectious disease that we live in now, Michael Osterholm, PhD, an epidemiologist and director of the Center for Infectious Disease Research and Policy at the University of Minnesota in Minneapolis, told Becker's Aug. 11. "That is a theme today. We have to expect this," he said, pointing to the rise of international travel and trade, household overcrowding and the increased movement of animals around the world as factors contributing to rising infectious disease risks. At the same time, the growing threats of antibiotic resistance and vaccine hesitancy are complicating efforts to fight these diseases, according to Dr. Osterholm. In the last few years, hundreds of public health officials across the globe have resigned due to stress, burnout and harassment, contributing to a weakened public health infrastructure. "So many things that could go wrong are going wrong," Dr. Osterholm said. "Any one of them by themselves are a problem, but when you add them all together, you've got a real problem." Dr. Osterholm cited the polio situation in New York as a key example. Health officials confirmed polio in an unvaccinated man in Rockland County, N.Y., July 21, and a subsequent investigation detected the virus in wastewater samples, suggesting further spread of the disease. Now, health officials are suggesting the single case may just be the "tip of the iceberg." Hundreds of other cases may havegone undetected in the community, where only 60 percent of residents are vaccinated against the virus, state data shows. Nationwide, polio vaccination coverage sits at about 93 percent, according to the CDC. "We were talking about polio eradication just a few years ago, and today, we're trying to hold on by the skin of our teeth so that this does not continue to spread around the world," Dr. Osterholm said. n

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