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August 3 2020 Update Regarding Elective Surgery and COVID-19

The hospitals are open for all essential elective surgery again in San Antonio.  Essential includes people who have substantial pain or neurological complaints or problems with painful arthritis limiting their daily activities and causing disability.  As you may know nonessential inpatient surgeries were postponed due to the COVID-19 pandemic for July. We were able to do outpatient surgery only. Now the strain on the hospitals from the recent spike has been relieved hospitals again are allowing all essential elective surgeries requiring hospital stay.

For those that are wondering about the status of the treatment of COVID and the recent spike in the number of new cases reported I reviewed the Texas data up to August 1, 2020.  Here in Texas we have done over 4 million tests of symptomatic people.  90% of the tests were negative for COVID.  The positive rate is 10% and this is down from a high of 15% last month.  In Texas we have had 430,000 cases of COVID-19 with more than half (282, 000) recovered from this since the first reported cases in March.  Today we have over 20% of hospital beds available.  We now have ample ICU beds.  We have had 6800 fatalities for a 0.02% death rate or 22 deaths per 100,000 Texans. The average age is 78 for all fatalities. The case fatality rate has dropped 70% over 65 years and 85% in under 65 since March.  

I wanted to answer questions and concerns you may have about the impact of COVID-19 on scheduled spine surgical procedures. I first wrote of these questions and concerns last month and I refer you back to that blog post on spinepainbegone.com .

If you are scheduled for spine surgery, your doctor will talk with you about the specific protocols at the hospital or surgical facility.

All patients will be tested for COVID-19 with the swab molecular test before surgery.  All providers and patients will wear mask and face shield and gloves as appropriate. Operating room and other facility personnel will typically be screened routinely, with the frequency depending on local conditions. Personnel will likely be tested for the virus if there is any question of illness. These precautions are in place at the facility where you will be having surgery so that you and your family are as safe and surgery as successful as possible

Your safety is our primary concern.

All surgical facilities will follow federal, state, and local guidelines in guiding your surgical care.

 Our experience with patients during the pandemic allow us to assure that your spinal surgery is as safe and successful as possible.

Many precautions are taken to make sure the facility is safe. Your facility will follow extensive sterilization and procedures in line with both government and industry recommendations. Our facilities have a high air flow and sanitization rate in the operating rooms, which helps to decrease potential disease transmission.  Sometimes this may mean that the time between surgical procedures will be longer than normal.  We ask for your patience as we all work under the increased sterilization and sanitization procedure requirements.

The facility may also place limitations on whether visitors may come into the facility or may provide a designated waiting area away from the operating suite. Social distancing will be practiced in waiting areas.

 

If I am having surgery, will I require screening and/or testing?

Screening and/or testing of all patients having surgery will be required to make sure you have had no known exposure to COVID-19 and you have had no symptoms consistent with the disease.  No test or screening in 100% accurate, so you may be screened or tested more than once to help safeguard you during your surgery.

 

Your surgical facility, whether it is a hospital or surgery center, will have a protocol for both screening and testing.

 

Can I bring a family member?  Can they wait with me before and after my surgery?

Usually 1 family member may be with the patient at the hospital.  The rules for friends and family may change and are different for each surgical procedure facility. All spinal procedures usually require general anesthesia and intubation. That means that someone will need to take you to the facility and someone will need to drive you home. A friend or family member will also need to receive your discharge instructions.

 

Depending upon the facility, your friend or family member may be able to wait in a specially designated area or may only be able to drop you off and pick you up at the entrance to the facility. Some exceptions may be made if you are a parent bringing a pediatric patient for surgery.

I cover the following questions in my previous question and answer blog on the website spinepainbegone.com

Should I quarantine before my surgery?

What can I do at home before and after surgery to decrease my risk of contracting the virus?

What happens to me if I develop symptoms of COVID- 19 after my surgery?

Please see my previous question and answer blog.

The pandemic has been heart-wrenching and at times may have seemed chaotic as we all have come to know about the Sars2CV19 virus and how it acts. Now we can see hope for the future of elective spinal surgery arising from the pandemic. Sure there will be masks, testing, and more than a few new precautions for your safety at the facility. We can manage all of it because we know this will best preserve the safety and success of the surgical procedure for you.

Author
GUY R. FOGEL MD Orthopedic Spine Surgeon San Antonio Texas

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