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Area of Science:

  • Medicine
  • Infectious Diseases
  • Public Health

Background:

  • Resuming elective surgery during the COVID-19 pandemic presented challenges due to test and PPE shortages.
  • Universal preoperative testing for SARS-CoV-2 was common but questioned due to low positive rates in asymptomatic individuals.
  • Ensuring patient and staff safety during surgical procedures was paramount.

Purpose of the Study:

  • To evaluate an alternative preoperative strategy to universal COVID-19 testing for elective surgeries.
  • To assess the noninferiority of a risk mitigation approach involving patient self-quarantine and targeted testing.
  • To determine the impact on postoperative COVID-19 detection and staff exposure.

Main Methods:

  • Implemented a preoperative program emphasizing 14-day patient self-quarantine and social distancing.
  • Utilized targeted rapid polymerase chain reaction testing within 2 days of surgery for high-risk cases or non-compliant patients.
  • Compared outcomes with historical data from universal preoperative testing protocols.

Main Results:

  • The alternative strategy was noninferior to universal testing in preventing postoperative COVID-19 detection.
  • Postoperative COVID-19 cases among patients did not increase with the new approach.
  • Staff exposure-related COVID-19 cases remained comparable, suggesting safety was maintained.

Conclusions:

  • A preoperative program combining self-quarantine and targeted testing is a viable alternative to universal COVID-19 screening for elective surgery.
  • This strategy effectively mitigates risk without compromising patient or staff safety.
  • The findings support a more resource-conscious approach to preoperative infectious disease screening.