key: cord-0833393-0oybqw1f
authors: Mishra, Rakesh; Lakhan, Ram; Andres Florez Perdomo, William; Shrivastava, Adesh; Rafael Moscote-Salazar, Luis; Agrawal, Amit
title: Letter to Editor: The Return Back to Typical Practice from the ‘Battle Plan’ of the COVID-19 Pandemic: A Comparative Study
date: 2020-08-01
journal: World Neurosurg
DOI: 10.1016/j.wneu.2020.07.184
sha: 5c0cc7ebe9c19e0c328267caf3cb02976e473bb0
doc_id: 833393
cord_uid: 0oybqw1f

nan

Dear Editor, In the article by Pressman et al 1 , the authors describe their experience on a very relevant subject i.e. "The Return Back to Typical Practice…". They have focussed on the handling of neurosurgical caseloads and their spectrum. The also share their experience with neurosurgical sub-specialties amidst the COVID-19 outbreak. In the initial days of the pandemic, medical and surgical societies worldwide prepared guidelines and adopted protocols to ensure safe healthcare delivery. [2] [3] [4] [5] This study which was conducted over four weeks found that the number of neurosurgical interventions did eventually increase in the post battle plan period, with a particular surge in functional neurosurgery and neurooncosurgery. 1 D'Amico et al. 6 have shared their concerns while reopening the neurosurgical services and provide suggestions for performing elective procedures including endoscopic neurosurgery. In various web-based surveys, suspension of elective cases has been noted more in public Institutes than by private practitioners with an increase in telemedicine based outpatient services. 5, 7 World Federation of Neurosurgical Societies (WFNS) conducted a web-based survey to assess changes in global neurosurgical practice during the COVID-19 pandemic and found major changes in surgical planning by over 90% of the responders. 8 Though they have found that this impact was maximal for elective procedures, emergency and lifesaving neurosurgical procedures constituted the major chunk overall.

This resulted in a postponement of neurooncological cases in 71% responses. 8 This also explains the delayed increase in brain tumour surgeries in the article by Pressman et al. 1 It is interesting to note that there was no significant change in the endoscopic interventions in the present study. 1 It is in contrast to the studies where it is being highlighted that neurosurgical procedures having a high propensity of aerosol generation were particularly avoided and changed during the pandemic. 4 It will be an adjunct if the authors can elaborate regarding their experience to safely handle these procedures in their practice. In summary the world is going through phase of uncertainty in the current pandemic and the neurosurgical practice is not immune to it. We agree with the authors that now the neurosurgical speciality and sub-specialty needs to prepare itself to deliver the services in the post COVID-19 era. Though we expect changes in routine and emergency neurosurgical practice, however the effect of such changes is not yet known in the current pandemic situation. The article by Pressman et al. 1 can be considered as a beginning of an excellent debate and can be a yardstick to develop strategies which can be extended to address the needs of lager geographical and socio-economic areas.

The Return Back to Typical Practice from the 'Battle Plan' of the COVID-19 Pandemic: A Comparative Study

Coronavirus disease 2019 (COVID-19) in neurology and neurosurgery: A scoping review of the early literature

Impact of the COVID-19 Pandemic on Neurosurgical Practice at an Academic Tertiary Referral Center: A Comparative Study

Neurosurgery and Neurology Practices during the Novel COVID-19 Pandemic: A Consensus Statement from India

Adapting Neurosurgery Practice During The Covid-19

A Roadmap to Reopening a Neurosurgical Practice in the Age of COVID-19

Impact of the COVID-19 Pandemic on Neurosurgical Practice in India: Results of an Anonymized National Survey

Neurosurgical Practice During the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Pandemic: A Worldwide Survey

☒ The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.☐The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: