Influence of COVID-19 on general surgical practice in India
Author(s): Dr. Manjula Yasam and Dr. Y Dineh Reddy
Abstract: The coronavirus disease 2019
(COVID-19) pandemic is a global health crisis, and surgeons are at increased occupational
risk of contracting COVID-19. The impact of the disease on prevalent general
surgical practice is uncertain and continues to evolve. The study aimed to study
the impact of COVID-19 on general surgical practice in India and the future implications
of the pandemic. A survey questionnaire was designed and electronically
circulated 1 month after India entered a national lockdown during COVID- 19
pandemic, amongst members of Indian Association of Gastro-intestinal
Endo-surgeons (IAGES), a surgical association with nearly eight thousand members
from across the country. Survey questions pertaining to pre-COVID era surgical practices,
impact on current practice, and financial implications were asked. Responses were
collected and statistically analyzed. One hundred fifty-three surgeons completed
the survey, of which only 9.2% were women. Majority (41%) were into practice for
more than 20 years; 36.6% were into private practice at multiple hospitals (free-lancers).
Amongst the respondents, 41.8% had mainly laparoscopic practice with mean outpatient
consultation of 26 patients/day and elective surgeries of 43 cases/month prior to
lockdown. Post-lockdown, daily outpatient consults reduced to 4 patients per day,
and 77% had not performed a single elective procedure. Hydroxychloroquine (HCQ)
chemoprophylaxis was reported by 52% surgeons. Personal protective equipment
(PPE) was used by 52% for all cases, while 71.5% stated there are insufficient guidelines
for future surgical practice in terms of safety. A drop of more than 75% of their
monthly income was experienced by 52% surgeons, while 22% faced 50–75% reduction.
One third (33%) of respondents own a hospital and are expecting a monthly financial
liability of 2.25 million rupees (nearly 30,000 US dollars). COVID-19 has led to
a drastic reduction in outpatient and elective surgical practices. There is a definite
need for guidelines regarding safety for future surgical practices and solutions
to overcome the financial liabilities in the near future.
