Over 28 million elective surgeries across the globe could be cancelled or postponed this year as a result of the COVID-19 pandemic. This will lead to patients facing a lengthy wait for their health issues to be resolved, according to a projection by the CovidSurg Collaborative.
The prediction is based on a 12-week period of peak disruption to hospital services due to COVID-19. The modelling study, published in the British Journal of Surgery, indicates that each additional week of disruption to hospital services will be associated with a further 2.4 million cancellations.
Methodology
Led by researchers at the University of Birmingham, researchers collected detailed information from surgeons across 359 hospitals and 71 countries on plans for cancellation of elective surgery. This data was then statistically modeled to estimate totals for cancelled surgery across 190 countries.
The CovidSurg Collaborative is a research network focussed on the impact of COVID-19 on surgical care. Over 5,000 surgeons from across 120 countries are participating in the CovidSurg programme. This study was led by CovidSurg Collaborative members based in the United Kingdom, Benin, Ghana, India, Italy, Mexico, Nigeria, Rwanda, Spain, South Africa, and the United States.
Implications
Most cancelled surgeries will be for non-cancer conditions, notes the study. 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 the United Kingdom, the National Health Service advised hospitals to cancel most elective surgeries for 12 weeks. It is estimated this will result in 516,000 cancelled surgeries, including 36,000 cancer procedures. These cancellations will create a backlog that will need to be cleared after the COVID-19 disruption ends.
If, after the disruption ends, the NHS increases the number of surgeries performed each week by 20% compared to pre-pandemic activity, it will take 11 months to clear the backlog.
However, each additional week of disruption will lead to the cancellation of an extra 43,300 surgeries, significantly extending the period it will take to clear the backlog.
Cost of cancelling surgeries
According to Dr. Aneel Bhangu, Consultant Surgeon and Senior Lecturer at the NIHR Global Health Research Unit on Global Surgery at the University of Birmingham, while cancelling elective surgeries to reduce the risk of patients being exposed to COVID-19 in hospital, and to support the wider hospital response, “for example by converting operating theatres in to intensive care units” is “…essential, cancellations place a heavy burden on patients and society”.
Dr. Dmitri Nepogodiev, Research Fellow at the NIHR Global Health Research Unit on Global Surgery at the University of Birmingham noted: “Each additional week of disruption to hospital services results in an additional 43,300 surgeries being cancelled, so it is important that hospitals regularly assess the situation so that elective surgery can be resumed at the earliest opportunity.
“Clearing the backlog of elective surgeries created by COVID-19 will cost the National Health Service at least £2 billion. The Government must ensure that the NHS is provided with additional funding and resources to ramp up elective surgery to clear the backlog.”
