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Published on: August 12, 2014
Co-Operative Vascular Intervention Disease (COVID) Team of Greater Philadelphia
Keith D Calligaro1, Matthew J Dougherty1, Krystal Maloni1
1Section of Vascular Surgery, Pennsylvania Hospital, Philadelphia, Pa.
Insights
Vascular surgeons in Philadelphia adapted practices for COVID-19, restricting non-urgent vascular lab studies and dialysis access operations. Telemedicine was adopted, and surgeons reported anxiety about personal exposure to the virus.
Area of Science:
- Vascular Surgery
- Infectious Disease Epidemiology
Background:
- National COVID-19 guidelines may not be universally applicable due to geographic variations in virus penetrance.
- The Co-Operative Vascular Intervention Disease (COVID) Team of Greater Philadelphia was formed to address local challenges.
- Understanding regional adaptations in vascular surgery practice during the pandemic is crucial.
Purpose of the Study:
- To survey vascular surgeons in the Greater Philadelphia area regarding their experiences and strategies during the COVID-19 pandemic.
- To assess practice modifications implemented by vascular surgeons in response to the evolving crisis.
- To identify challenges and anxieties faced by vascular surgeons related to COVID-19.
Main Methods:
- A 10-question survey was emailed to 58 vascular surgeons in the Greater Philadelphia area on April 10, 2020.
- Responses were collected from 54 vascular surgeons across 18 surgical groups and 28 hospitals.
- Data analysis focused on reported changes in clinical practice, patient management, and surgeon concerns.
Main Results:
- All responding surgical groups accepted patient transfers due to available ICU beds.
- Most groups restricted noninvasive vascular laboratory studies to those requiring intervention within 2-3 weeks.
- Dialysis access operations were limited to urgent revisions, telemedicine was adopted for clinic visits, and surgeons reported significant anxiety about personal COVID-19 exposure.
Conclusions:
- The majority of vascular surgeons in the Philadelphia area significantly adjusted clinical practices proactively before the peak of the COVID-19 crisis.
- These adaptations included prioritizing urgent interventions, limiting non-essential procedures, and embracing telemedicine.
- Surgeons experienced considerable anxiety regarding personal risk of COVID-19 infection in the hospital setting.
Abstract:
We established the Co-Operative Vascular Intervention Disease (COVID) Team of Greater Philadelphia because national guidelines may not apply to different geographic areas of the United States owing to varying penetrance of the virus. On April 10, 2020, a 10-question survey regarding issues and strategies dealing with COVID-19 was e-mailed to 58 vascular surgeons (VSs) in the Greater Philadelphia area. Fifty-four VSs in 18 surgical groups covering 28 hospitals responded. All groups accepted transfers because of continued availability of intensive care unit beds. Thirteen groups were asked to "redeploy" if the need arose to function outside of the usual duties of a VS. None imposed age restrictions regarding older VSs continuing clinical hospital work. The majority restricted noninvasive vascular laboratory studies to those studies for which findings might mandate intervention within 2 or 3 weeks, restricted dialysis access operations to urgent revisions of arteriovenous fistulas or grafts that were failing or had ulcerations, converted from in-person to telemedicine clinic interactions, and experienced moderate-severe anxiety or fear about personal COVID-19 exposure in the hospital. The majority of VSs in the Philadelphia area dramatically adjusted their clinical practices before the COVID-19 crisis reached peak levels experienced in other metropolitan areas.
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