key: cord-1030041-k8hz7df7
authors: Roslani, April Camilla; Vythilingam, Ganesh; Seevalingam, Kanesh Kumaran; Xavier, Ruben Gregory; Idris, Muhammad Syafiq; Karuppiah, Ravindran
title: Focused Surgical Pandemic Response in a Malaysian Hybrid COVID-19 Hospital
date: 2020-11-28
journal: Asian J Surg
DOI: 10.1016/j.asjsur.2020.10.012
sha: dd605979716b1c0ea3fca6a6fe5d893db3cfb588
doc_id: 1030041
cord_uid: k8hz7df7

nan

Hospital To i. disease transmission to HCWs ii. operative morbidity and mortality of patients, which is higher in COVID-19 patients [3, 4] iii. judicious use of appropriate of PPE J o u r n a l P r e -p r o o f By 23 March 2020, UMMC declared an access block, to allow containment and decanting activities. Our departments bed capacity went from 136 beds to 24 beds in 72 hours. All elective surgeries were cancelled, and most emergencies were diverted. Emergent, semi-urgent and category 1 elective surgeries resumed in a limited way on 10 April 2020. In 2019, for the same period, we had done an average of 700 cases per month, which included both elective and emergency cases, of which the emergencies formed approximately 80 per month. In 2020, this had reduced to 105 emergency surgeries collectively for both March and April 2020 (66% of baseline). By the last week of April, we were allocated 2 semi-elective lists, and 18 semi-urgent or category 1 elective cases were done. A limited number of elective lists were subsequently made available in May 2020. This allowed for a total of 175 cases to be done. Although this implies an overall cancellation rate of 75%, consistent with global cancellation rates [5] , it should be noted that our cancer surgery waiting list has only increased by 2-4 weeks, as a result of external decanting to non-COVID-19 hospitals. Elective surgeries for non-cancer cases have been more adversely affected, with waiting lists extending 3-6 months over baseline. We will need to strategize on measures to overcome this backlog in the months to come. All pre-surgical swabs have been negative thus far. Most patients had been designated no-or low-risk following risk assessment. This suggests that the screening questionnaire is effective in identifying highrisk patients, thus, potentially not all patients need to be swabbed pre-operatively. However, numbers are too small to be conclusive. Fortunately, none of our department's HCWs have been infected or have required extended psychosocial support. As of 7 th September 2020, the number

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