As South Africa continues to focus on ploughing health, financial and human resources into the national response against the Covid-19 coronavirus, there is collateral damage in hospitals.
The pandemic has disrupted routine hospital services globally, and a new study estimates that 146 000 elective surgeries in this country could be cancelled as a result of the crisis – leading to patients facing a lengthy wait for their health issues to be resolved.
Worldwide, the CovidSurg Collaborative, a research network of 5 000 surgeons from 120 countries, has projected that based on a 12-week period of peak distribution to hospital services due to Covid-19, 28.4 million elective surgeries will be cancelled or postponed this year.
The modelling study, published in the British Journal of Surgery this week, shows that each additional week of disruption to hospital services will result in a further 2.4 million cancellations.
Led by researchers from the University of Birmingham, UK and the University of Cape Town (UCT), they collected detailed information from surgeons in 359 hospitals across 71 countries on plans for the cancellation of elective surgery.
This data was then statistically modelled to estimate the total number of cancelled surgeries across 190 countries.
The researchers projected that worldwide 72.3% of planned surgeries will be cancelled during the peak period of Covid-19 related disruption.
Most cancelled surgeries will be for non-cancer conditions. Orthopaedic procedures will be cancelled most frequently, with 6.3 million orthopaedic surgeries cancelled worldwide over a 12-week period. It is also projected that globally 2.3 million cancer surgeries will be cancelled or postponed.
In South Africa, more than 146 000 operations will be cancelled, including 12 000 cancer procedures. These cancellations will create a backlog that will need to be cleared after the Covid-19 disruption ends.
Professor Bruce Biccard, second chairperson in the department of anaesthesia and perioperative medicine at UCT, said: “Each additional week of disruption to hospital services results in an additional 12 000 surgeries being cancelled. Following the surge in the epidemic, we are going to need a continuous assessment of the situation, so that we can plan a safe resumption of elective surgery at the earliest opportunity.
DURING THE COVID-19 PANDEMIC ELECTIVE SURGERIES HAVE BEEN CANCELLED TO REDUCE THE RISK OF PATIENTS BEING EXPOSED TO THE VIRUS IN HOSPITAL
Aneel Bhangu, consultant surgeon and senior lecturer at the National Institute for Health Research
“Clearing the backlog of elective surgeries created by Covid-19 is going to result in a significant additional cost for the national health department. Government will have to ensure that the department is provided with additional funding and resources to ramp up elective surgeries to clear the backlog.”
Aneel Bhangu, consultant surgeon and senior lecturer at the National Institute for Health Research unit on global surgery at the University of Birmingham, said: “During the Covid-19 pandemic elective surgeries have been cancelled to reduce the risk of patients being exposed to the virus in hospital, and to support the wider hospital response, for example by converting operating theatres into intensive care units.
“Although essential, cancellations place a heavy burden on patients and society. Patients’ conditions may deteriorate, worsening their quality of life as they wait for rescheduled surgery. In some cases, for example cancer, delayed surgeries may lead to a number of unnecessary deaths.
COVID-19 was first identified late last year as a cluster of pneumonia cases caused by a new coronavirus. Doctors have since learned that it’s a respiratory disease, one that especially reaches into your respiratory tract, which includes your lungs.
COVID-19 can cause a range of breathing problems, from mild to critical. Older adults and people who have other health conditions like heart disease, cancer, and diabetes may have more serious symptoms.
Here’s what the new coronavirus does to your lungs.
Coronavirus and Your Lungs
SARS-CoV-2, the virus that causes COVID-19, is part of the coronavirus family.
When the virus gets in your body, it comes into contact with the mucous membranes that line your nose, mouth, and eyes. The virus enters a healthy cell and uses the cell to make new virus parts. It multiplies, and the new viruses infect nearby cells.CONTINUE READING BELOW
Think of your respiratory tract as an upside-down tree. The trunk is your trachea, or windpipe. It splits into smaller and smaller branches in your lungs. At the end of each branch are tiny air sacs called alveoli. This is where oxygen goes into your blood and carbon dioxide comes out.
The new coronavirus can infect the upper or lower part of your respiratory tract. It travels down your airways. The lining can become irritated and inflamed. In some cases, the infection can reach all the way down into your alveoli.
COVID-19 is a new condition, and scientists are learning more every day about what it can do to your lungs. They believe that the effects on your body are similar to those of two other coronavirus diseases, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).
Mild and Moderate Cases
As the infection travels your respiratory tract, your immune system fights back. Your lungs and airways swell and become inflamed. This can start in one part of your lung and spread.
Doctors can see signs of respiratory inflammation on a chest X-ray or CT scan. On a chest CT, they may see something they call “ground-glass opacity” because it looks like the frosted glass on a shower door.
About 14% of COVID-19 cases are severe, with an infection that affects both lungs. As the swelling gets worse, your lungs fill with fluid and debris.
You might also have more serious pneumonia. The air sacs fill with mucus, fluid, and other cells that are trying to fight the infection. This can make it harder for your body to take in oxygen. You may have trouble breathing or feel short of breath. You may also breathe faster.
If your doctor takes a CT scan of your chest, the opaque spots in your lungs look like they start to connect to each other.
In critical COVID-19 — about 5% of total cases — the infection can damage the walls and linings of the air sacs in your lungs. As your body tries to fight it, your lungs become more inflamed and fill with fluid. This can make it harder for them to swap oxygen and carbon dioxide.
You might have severe pneumonia or acute respiratory distress syndrome (ARDS). In the most critical cases, your lungs need help from a machine called a ventilator to do their job.
Some people had a cough even after they recovered from COVID-19. Others had scarring in their lungs. Doctors are still studying whether these effects are permanent or might heal over time.
Source Credit: webMD Medical Reference Reviewed by Neha Pathak, MD on March 25, 2020 https://www.webmd.com/lung/what-does-covid-do-to-your-lungs#1