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The Return Back to Typical Practice from the "Battle Plan" of the Coronavirus Disease 2019 (COVID-19) Pandemic: A
Elliot Pressman1, Mohammad Hassan A Noureldine2, Jay I Kumar1
1Department of Neurosurgery, University of South Florida Morsani College of Medicine, Tampa General Hospital, Tampa, Florida, USA.
Insights
Neurosurgical case volumes increased after the COVID-19 pandemic battle plan eased, but clinic visits decreased. Anticipating these shifts in neurosurgery, particularly for brain tumors and spine, aids resource allocation during recovery.
Area of Science:
- Neurosurgery
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic significantly disrupted healthcare, including neurosurgical services.
- Academic medical centers developed specific protocols (e.g., "Battle Plans") to manage the pandemic's impact.
- Transitioning back to standard practice post-pandemic requires understanding changes in patient care demands.
Purpose of the Study:
- To analyze neurosurgical case and clinic visit volumes after the COVID-19 pandemic "Battle Plan" was discontinued.
- To provide data-driven insights for neurosurgical departments navigating the transition back to pre-pandemic operational levels.
- To identify specific subspecialty trends in neurosurgical practice during the post-pandemic recovery phase.
Main Methods:
- Retrospective and prospective data collection of neurosurgical interventions and clinic visits.
- Comparison of data from a 4-week period post-"Battle Plan" with pre-pandemic baseline data.
- Analysis focused on case load, types of surgeries, and clinic appointment volume.
Main Results:
- 161 patients underwent neurosurgical interventions, and 701 patients attended clinic appointments in the 4 weeks following the "Battle Plan" cessation.
- Neurosurgical case load returned to above-average levels within a week of discontinuing the "Battle Plan."
- Clinic appointments, particularly for elective spine procedures, continued to decrease during the 4-week observation period.
Conclusions:
- Resource allocation for neurosurgical services can be optimized by anticipating increased surgical volumes and decreased clinic visits post-pandemic.
- Functional/epilepsy and brain tumor subspecialties are expected to see increased neurosurgical demand.
- Elective spine procedures may experience a continued decline in clinic volume during the transition phase.
Background:
Every aspect of the medical field has been heavily affected by the coronavirus disease 2019 (COVID-19) pandemic, and neurosurgical services are no exception. Several departments have reported their experiences and protocols to provide insights for others impacted. The goals of this study are to report the load and variety of neurosurgical cases and clinic visits after discontinuing the COVID-19 Battle Plan at an academic tertiary care referral center to provide insights for other departments going through the same transition.
Methods:
The clinical data of all patients who underwent a neurosurgical intervention between May 4, 2020, and June 4, 2020 were obtained from a prospectively maintained database. Data of the control group were retrospectively collected from the medical records to compare the types of surgeries/interventions and clinic visits performed by the same neurosurgical service before the COVID-19 pandemic started.
Results:
One hundred sixty-one patients underwent neurosurgical interventions, and seven-hundred one patients were seen in clinic appointments, in the 4-week period following easing back from our COVID-19 "Battle Plan." Discontinuing the "Battle Plan" resulted in increases in case load to above-average practice after a week but a continued decrease in clinic appointments throughout the 4 weeks compared with average practice.
Conclusions:
As policy-shaping crises like pandemics abate, easing back to "typical" practice can be completed effectively by appropriately allocating resources. This can be accomplished by anticipating increases in neurosurgical volume, specifically in the functional/epilepsy and brain tumor subspecialties, as well as continued decreases in neurosurgical clinic volume, specifically in elective spine.
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