The COVID-19 pandemic impacted healthcare in all specialties, including neurosurgery according to Payam Toobian.
At the beginning of the COVID-19 pandemic, the world went quiet in waves as the virus spread, and the collective cessation of so many activities sent both short- and long-term side effects through healthcare. Dr. Payam Toobian advises even the practice of neurosurgery saw a shift.
The reasons are due to restrictions on procedures that could be deferred being pushed back on the calendar and a cause-and-effect decline in major accidents.
Dr. Payam Toobian on emergency procedures
According to a study published via the National Library of Medicine, 27% of neurological procedures are emergency surgery. Dr. Payam Toobian advises these could be the result of a car wreck, a fall, severe injuries or the sudden escalation of a chronic condition. Most, however, are related to accidents.
During the COVID-19 pandemic, and particularly at the start, most areas slowed down entirely. Scientists and audiophiles were able to record the sounds of wildlife and silence in cityscapes, and sources of major accidents, such as transportation services and private vehicles, were moving at a reduced rate and slowing incidents, Payam Toobian advises.
An analysis at Nature.com examining neurosurgical trends and outcomes in Central Europe — where many countries employed lockdown measures much more strict than the U.S. — demonstrates a general decline in the need for surgical intervention for a variety of procedures, including traumatic brain injuries, spinal conditions and blood clots on the brain.
The study offers mobility restrictions were a key contributor. A possible delay in patients seeing referrals from other physicians and care facilities is also noted.
The long-term effects of delayed primary care and referrals to specialty care during the healthcare shortages in the COVID-19 pandemic were of particular concern to dedicated care providers like Dr. Payam Toobian.
The Nature.com analysis suggests that while a portion of reduced neurosurgical cases could be attributed to delays in care, there was not a significant increase in negative outcomes for patients in surgical procedures in the year following the most stringent lockdown measures. This further suggests urgent cases were moved forward appropriately while other patients were able to sustain a delay without increasing procedure or recovery risk.
In the future, any new strains placed on the healthcare system globally by disease or locally due to natural disasters and other elements should be expected to impact neurosurgical procedures again. Some could even lead to an increased need for surgery. Toobian advises it is important for hospitals and care facilities to develop contingency plans and supply back-ups that make it possible to respond adequately whether the world goes quiet or not.