Healthcare lockdown may lead to flood of postponed surgeries

The healthcare industry could experience further strain once lockdown rules are relaxed due to the growing backlog of non-emergency surgeries, which could see surgical units overloaded by patients on waiting lists.

The country is in its fourth week of the extended lockdown period, which has seen a list of strict regulations to try and combat the spread of the coronavirus. These regulations include the cancellation of elective surgeries as hospitals only focus on emergency life-saving procedures, to limit the number of patients at hospitals.

This is meant to limit the risk of elective surgery patients contracting the coronavirus, while being admitted for their procedure, said South African Medical Association’s (Sama) chairperson Dr Angelique Coetzee.

Elective surgeries are procedures which are scheduled in advance, such as a hip or knee replacements, eye cataract procedures, cosmetic procedures and those that can be prolonged with other treatments beside surgery.

The cancellation of such operations during the lockdown was also welcomed and implemented by private sector giants such as the Netcare Group, MediClinic Southern Africa, and Life Healthcare.

“No one requiring elective surgery should be admitted. There’s no dire life and death need… It is a greater risk to admit a patient for elective surgery and have them contracting coronavirus while admitted when the operation was not immediately necessary. The patient could have waited for three months without an envisioned change in condition,” said Coetzee.

But prolonging an eye cataract procedure could lead to harsh risks such as blindness, said Dr Kgao Legodi, president of the World Ophthalmology Congress. “This may lead to multiple consequences related to reduced vision, blindness or extended agony,” he said.

Delaying joint surgeries such as hip or knee replacements could also leave the surrounding bone in such a bad state that surgery would be increasingly difficult, said Sama Gauteng region chairperson Dr Mark Human.

“When patients eventually get to the point of replacing, it is so bad because the bone has collapsed so badly that it is a complicated first-time surgery which is twice as difficult as a re-do procedure.”

But while lockdown may end, the pandemic could continue until a vaccine is found. This could possibly lead to a further postponement of elective surgeries and a backlog on an already long waiting list.

“Those patients must be piling up. If you take eight months of constant work and add it to next year, it will be 20 months in one year,” said Human.

Once lockdown is lifted, hospitals should treat such surgeries on a priority basis. Coetzee said priorities should be based on those required to preserve life, then to function and lastly to form (cosmetics).

– rorisangk@citizen.co.za

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