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Published on: February 12, 2021
Impact of COVID-19 on Cardiothoracic Surgery: Experience of Alexandria (Egypt) Main University Hospital
Hanan M Hemead1, Mohamed H Elsayed1, Wael Hassanein1
1Department of Cardiothoracic Surgery, Alexandria University of Medicine, Alexandria, Egypt.
Insights
The coronavirus pandemic severely impacted cardiothoracic surgeries in Egypt, particularly cardiac procedures, leading to cancellations and longer waiting lists. A strategic plan is in development for gradual service recovery, addressing backlogs and resource shortages.
Area of Science:
- Cardiothoracic Surgery
- Public Health
- Healthcare Management
Background:
- The COVID-19 pandemic has significantly strained healthcare resources globally.
- High-cost cardiothoracic surgeries face sustainability challenges in low-income countries like Egypt.
Purpose of the Study:
- To evaluate the impact of the COVID-19 pandemic on cardiothoracic surgery workflow and waiting lists in Egypt.
- To assess the disruption of surgical training and exposure for residents.
Main Methods:
- Review of hospital databases and patient records.
- Telephone follow-up with postoperative and cancelled preoperative patients.
- Evaluation of residents' logbooks and virtual meetings to discuss challenges.
Main Results:
- Thoracic surgeries remained viable, but cardiac surgeries experienced severe consequences.
- Cardiac surgeries faced cancellations, expanded waiting lists, and impaired surgical exposure for junior residents.
- Patients' non-compliance with follow-up care was also noted.
Conclusions:
- A phased recovery plan for cardiac surgery services in Alexandria, Egypt, is being developed.
- The plan addresses case backlogs and screening kit shortages.
- Key strategies include tiered patient management by a multidisciplinary team and alternative assessment tools for trainees.
Introduction:
The current coronavirus pandemic has greatly strained the limited resources that had previously maintained the sustainability of the high-cost cardiothoracic surgeries in low-income countries like Egypt.
Methods:
Hospital databases and patients' records were reviewed to evaluate the impact of the pandemic on the workflow and waiting lists. Postoperative patients were contacted by telephone for follow-up, as well as preoperative patients whose operations were cancelled. Regular virtual meetings were held, and residents were asked to discuss the stresses, challenges, and their suggestions for the gradual resumption of services. Residents' logbooks were evaluated to assess the disruption of the surgical exposure compared to 2019.
Results:
While thoracic surgeries have continued to thrive, cardiac surgeries have witnessed the worst consequences, including cancellation of all surgeries, expansion of waiting lists, patients' non-compliance with follow-up, and impaired surgical exposure of junior residents.
Conclusion:
The gradual recovery of cardiac surgery services in Alexandria (Egypt) is being carefully planned, taking into consideration the backlog of cases and the shortage of screening kits. Careful tiering and triaging of patients by a multidisciplinary team, as well as seeking alternative assessment tools for trainees, are the main lines of our action plan.
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