key: cord-255149-mqsk7kiz
authors: Gupta, Nikhil; Agrawal, Himanshu
title: It Will Be a Different World for Surgeons Post-COVID-19 Lockdown
date: 2020-05-26
journal: Indian J Surg
DOI: 10.1007/s12262-020-02392-8
sha: 
doc_id: 255149
cord_uid: mqsk7kiz

nan

It is an unknown, unprecedented situation for everybody including surgeons. India is a country of 1.3 billion people. It is under lockdown since 25 March 2020. All elective surgeries are on hold [1] . This lockdown may extend further or relaxation might be given in a phased manner, we do not know till date.

One thing is for sure, this world will not be the same for surgeons post-COVID-19.

1. All patients posted for elective surgery may have to undergo preoperative COVID-19 testing. Do we have the facilities and infrastructure to test such large number of patients? 2. It takes around 12-36 h for report to come, which means a patient has to be admitted 1 day prior. One extra day of hospital stay plus COVID-19 testing will add on to the patient's bill. 3. What will happen if the report comes out unsatisfactory/ inconclusive? 4. Wearing PPE kit by surgeons, anaesthetists, and nursing staff in doubtful cases will again inflate patient's bill. Quality of PPE kit is another issue. 5. Risk of patient acquiring this infection from hospital and health care workers will have to be informed to patients and it will find its place in consent form also [2] . 6. We will have to be prepared for a scenario in which patient is negative for COVID-19 preoperatively but becomes symptomatic and positive after the surgery. Whether patient can sue the hospital and the doctor? Whether patient can demand test report of surgeon and other health care workers? All these questions may be raised in the court of law.

7. Risk of spread by central air conditioning system [3] and disposal of biomedical waste for suspected/confirmed cases will be another tricky issue. 8. Emergency cases pose another challenge. If a confirmed/ suspected case requiring emergency surgery is brought to a nursing home/small setup which is not well equipped to deal with COVID-19 patients, what should a surgeon do? Should he/she risk his/her and other support staff's life in danger or should he/she refer the patient to higher centre [4] ? If something happens during transfer, who will be responsible?

Association of Surgeons of India, being an umbrella body for all other surgical societies, should come up with detailed guidelines for post-COVID-19 era conducive for both patients and surgeons.

AMASI (Association of Minimal Access Surgeons of India) guidelines for conducting minimal access surgery during COVID-19 Pandemic

Informed consent for surgery during COVID-19

COVID-19 outbreak associated with air conditioning in restaurant

Are surgeons in India prepared for COVID− 19?

Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. * Himanshu Agrawal himagr1987@gmail

Conflict of Interest The authors declare that they have no conflict of interest.