Philadelphia Medicine Fall 2020 - 18

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POINT OF VIEW

ELECTIVE SURGERIES
ON THE MEND
By Andy Andrews, Editor

n mid-March, the COVID-19 pandemic
brought elective surgeries to a sudden and
pervasive halt for most health-care organizations.

The deepening concerns at the beginning of the
coronavirus crisis - that hospitals were about to be
flooded by emergency-care victims of COVID-19
- brought elective surgeries to a standstill.
Following the easing of quarantine restrictions
in May, elective surgeries resumed: some on a
limited basis and some on a near-normal schedule.
And even with a fall resurgence of the pandemic,
as of press time, there were no indications that surgeries would return to a pre-March-type lockdown.
"Elective surgeries are full-bore," said Dr. George
A. Poporad, Infectious Disease Associates PC,
Southampton, Pa.
During the lockdown, many health-care workers
saw their hours reduced or they were furloughed.
A 38-year veteran of infectious disease work,
Poporad spoke to Philadelphia Medicine about his
experience with pandemics over the years.
"I've been through a lot of epidemics, but none
like this," he said. "Legionnaires back in the '70s.
HIV, obviously, back in the early '80s. MRSA
(Methicillin-resistant Staphylococcus aureus),
multiple flu epidemics, some severe and some
not so severe. Flesh-eating bacteria, Ebola, but
during none of them have I been afraid for my
own health, like this."
Poporad mentioned that the sheer scope and
the contagiousness of COVID-19, which he views
as less contagious than measles but more contagious than influenza,
will continue to be on the minds of health-care administrators for
quite some time.
18 Philadelphia Medicine : Fall 2020

A safe time?
Is this a safe time for elective surgeries?
"The safe situation is when there are no new
recorded cases, but that's not happening," Poporad
said. "What allowed the political people, the governors and the mayors, to open up surgery centers,
probably the bulk of the elective surgeries, is that
at the time they were allowed to open, there was
a decrease in the number of active, reported cases.
That curve was coming down, and then as you
know, they were going through different stages of
opening up, to the yellow phase, and they opened
up the surgery centers. As the number of infections
decreased, then surgery centers opened up with
modifications."
In the short-term, for those choosing elective
surgery and the professionals performing the
procedures, nothing is going to change, according
to Dr. Caroline Johnson, acting deputy health
commissioner, Philadelphia Department of Public
Health, an infectious-disease physician.
"Prescreening, it's the social distancing, it's the
mask-wearing, within the operating room itself:
these are protocols that they've used which are
not going to change anytime soon," Johnson said.
While experts believe a COVID-19 vaccine
will be released sometime within the next several
months, administering the vaccine before or after
surgery could affect some protocols.
"It depends on the effectiveness of the vaccine,
people's willingness to take the vaccine and any
therapy to combat the virus," Johnson said. "It really depends on
treatment and prevention with the vaccine."

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Philadelphia Medicine Fall 2020

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