Covid impact: 5.8 lakh elective surgeries postponed in India

More than 5.8 lakh elective surgeries have been delayed or cancelled in India due to the lockdown to prevent the spread of covid-19, according to an international research consortium.

In March, the Union health ministry had urged hospitals to postpone elective surgeries to reduce the risk of patients being exposed to the novel coronavirus. The study’s findings were recently published in British Journal of Surgery.

The CovidSurg Collaborative, a research network of surgeons and anaesthetists in 77 countries, including India, has estimated that 5,05,800 non-emergency surgeries, 51,100 cancer surgeries, and 27,700 obstetric surgeries could have been delayed across India during the three-month period before and after the peak of the viral outbreak.

Doctors say the pace of normal surgical procedures should now return to normal, albeit with proper precautions to clear the mounting backlog. Dr P Raghu Ram, president of The Association of Surgeons of India, stressed on the need to start operating on urgent cases. “We’ve been in lockdown almost two months, and have started urgent surgical cases for cancer and cardiac patients. We cannot defer surgeries any further as a patient’s disease can progress to an advanced stage,” he said.

Worldwide, around 28 million surgeries could have been cancelled or delayed, the study says, adding that it would take an average of 45 weeks to clear the backlog, if countries boost their normal surgical volume by 20%.

In the new situation, each case needed to be weighed differently and necessary precautions taken, said Dr Nandakumar Jairam, Group CEO of Columbia Asia Hospitals. “The virus is here to stay. We in the healthcare sector must re-align ourselves,” he said.

“Everyday matters for a patient with cancer. I am hoping the cancer mortality rate in India does not rise due to this delayed treatment of life threatening diseases. Hospitals must resume normal business with adequate protocols in place,” said Dr B S Ajai Kumar, Chairman and CEO HCG Cancer Group of hospitals.

Dr Ram suggested that surgeons go ahead with procedures “taking all precautions and presuming the patient is covid-19 positive” in case the person is asymptomatic.

Dr Harit Chaturvedi, Chairman, Institute of Cancer Care at Delhi’s Max Super Speciality Hospital, said he had seen two dozen patients with cancer in March but could not take the next step in their treatment due to the lockdown. “Last month we did just one third of the number of surgeries we did in April 2019, which means two thirds were postponed. In Delhi-NCR, approximately 5,000 cancer surgeries happen every month but last month less than 500 happened. We are opening up to semi-urgent surgeries soon. The issue now is how to handle the huge backlog of patients awaiting surgery,” he said.

At Narayana Netralaya , a chain of eye hospitals, over 300 surgeries had to be put off for two months. “It is dangerous to delay eye surgeries for long. We have developed new protocols to ensure eye conditions do not deteriorate,” said Dr K Bhujang Shetty, chairman Narayana Netralaya.

For hospitals too, they have to revamp their old processes. “Protocols will change and wearing proper PPE all the time will become the new norm. All this will gradually happen,” said Dr Rajan Sharma, President, Indian Medical Association.