Journal of Translational Neurosciences

Description

The coronavirus 2019 (COVID-19) pandemic has changed the practice of neurosurgery. Significant resources have been dedicated to the disease. The pandemic in the Indian subcontinent, compared with the rest of the world, is relatively delayed. The neurosurgical practice cannot remain unaffected by hugely disruptive measures such as a lockdown. The inevitable increase in COVID infections with the gradual relaxation of lockdown continues to pose a risk for health care providers. Therefore, it is imperative to evaluate whether the pandemic has had a discernible effect on health care providers, especially in terms of practice modifications in private establishments and publicly funded hospitals, the emotional impact on the surgeon, and the influence of social media on the psyche of the surgeon. The coronavirus 2019 (COVID-19) pandemic has irrevocably challenged the traditional perspectives and practices of neurosurgery. Medical services have been heavily scaled down during the lockdown as a huge amount of resources have been deployed to face the emerging epidemic. Hospitals rapidly reduced scheduled clinical and surgical activities and were forced to postpone nonemergent procedures. During this period, a significant shrinkage in access to the emergency department for both minor and major diseases has been observed, together with a precipitous decline in outpatient appointments. 

Effect of the Disease and Its Influence on the Health Care System

Perhaps the fear of contagion prevented patients, even with severe symptoms, from seeking care. Alternatively, patients may also have experienced difficulties in accessing medical services given the extraordinary commitment to treating the new disease and curbs on mobility of people. The lockdown imposed to contain the contagion had some unavoidable adverse consequences for health care delivery. In this context, the effect of the disease and its influence on the health care system continue to be felt daily. Neurosurgical practice is not untouched by the situation. There are reports from various parts of the world including Europe and North America regarding the change in neurosurgical practice during the COVID pandemic. Neurosurgical patients needing intensive care may have been affected because most of the resources such as intensive care unit beds, ventilators, and intensivists were diverted to the care of patients with COVID. However, there are some major differences in the developed and developing world (e.g., the Indian subcontinent): A large and dense population, limited resources, and already strained health infrastructure. 

Perception of Neurosurgeons about the Pandemic and Changes in Neurosurgical Practice

Recently, a few reports from the developing world have described the perception of neurosurgeons about the pandemic and changes in neurosurgical practice in the pandemic but there have been none from the Indian subcontinent. Hence, there was a need to understand the effect of the COVID epidemic on neurosurgical practice in the Indian subcontinent. Moreover, there is a fear of an alarming increase in the number of cases of violence against medical personnel as a result of a fear of contagion or frustration with the increasingly hamstrung health care system in the Indian subcontinent. The neurosurgical community in developing countries cannot insulate itself from the implications of the COVID pandemic and must adapt rapidly to the changed scenario in health care delivery. Suspension of elective procedures, severe curtailment of regular outpatient appointments, drastic modifications of the normal OPD/operating room practices and apprehensions related to inadequacy of safety provided by PPE use and financial losses of private establishments were some of the visible themes.