key: cord-1029946-18eoqv7s
authors: Rahman, Moshiur; Chowdhury, Muhtamim; Garcia-Ballestas, Ezequiel; Florez, William; Agrawal, Amit; Moscote-Salazar, Luis Rafael
title: COVID 19 and Resilience: Neurosurgical perspectives
date: 2020-05-21
journal: World Neurosurg
DOI: 10.1016/j.wneu.2020.05.125
sha: 425e7edae32082ccd62253a5dc421dcbd2b4a1ca
doc_id: 1029946
cord_uid: 18eoqv7s

nan

Letter to the Editor COVID 19 and Resilience: Neurosurgical perspectives As the world economy is in a stand-still and the people are practising social distancing and maintaining life at the bare minimum, it is bound to have an impact on the operational implication of our commonly practised form of neurosurgery (1) . For the past few months, there has been a substantial decrease in elective surgeries due to mobilization of hospital staff and equipment to the battle of the pandemic and needless to say fewer trauma cases due to the restricted movement of people amidst the lockdown. Due to the critical nature of the patients of neurosurgery urgent care has and shall always be dispatched worldwide due to its aggressive progression. Many centres still are practising their traits under strict measures of physical protection and quarantine measures. The dwindling supply of personal protective equipment (PPE) is a global issue as governments scramble to get their hands on this material's precious and in their proper dispense, there seems to be a greater discrepancy in sharing PPE with the surgical staff (2).

Many hospitals around the globe have seemingly avoided surgical faculties in maintaining proper quarantine measures. As the number of asymptomatic carriers increases; the potential of subclinical spread shall increase many folds from patients to neurosurgical staffs. In our field of neurosurgery, those practising the art of endoscopic intervention is more vulnerable to the actual contamination. Few of our ENT colleagues has given substantial evidence of their faculties getting more infected than other surgical specialities (3). Given the continued contamination of the masses and the increase in the asymptomatic carriers there shall be a good deal of impact on the field of neurosurgery.

The reopening of common Out department patient and fast track health care shall take time and requires systemization to maximize protection and minimize the possibility of spread. Our usual method of practice shall also need substantial changes. As telemedicine is rising in ranks we need to utilize its technologies to bring our care to the patients (4). The patient can systematically fill up a common questionnaire that deals with a directed history that we commonly try to explore. In these trying times, we might need to rethink about the traditional physical evaluation of patients and its necessity and increase our dependence on radiology and subsidiaries to reach our desired diagnosis. As time progresses standard neurosurgery shall return to its glorious days, but in the meantime where resources are limited and electives are avoided we need to rethink our conventional strategies to battle this calamity, to maintain the limited care we are providing to our patients.

We strongly suggest everyone stratify the patient in the moderates of TRIAGE and serve them on a need to do basis (5) . Limiting patient visitation for consult needs to be enforced for the time being. Things shall and will change for good and as proven' in times earlier neurosurgeons had adapted to that need. It is to bypass the shortcomings and rebuilding on a newer base.

The impact of COVID-19 on neurosurgeons and the strategy for triaging non-emergent operations: a global neurosurgery study

Are high-performing health systems resilient against the COVID-19 epidemic?

Endonasal neurosurgery during the COVID-19 pandemic: the Singapore perspective

Virtually Perfect? Telemedicine for Covid-19

Khalid Bajunaid er all, Consensus Statement of the Saudi Association of Neurological Surgery (SANS) on Triage of Neurosurgery Patients During COVID-19 Pandemic in Saudi Arabia