Table 2 Impact of Coronavirus disease 2019 (COVID-19) pandemic on neurosurgery activity and facilities, education and research
Variable | Number of hospitals (%) |
|---|---|
Annual neurosurgery volume (median [IQR]) | 400 [350; 700] |
Number of neurosurgery beds (median [IQR]) | 63 [45; 116] |
Reduction in neurosurgery case volume due to COVID-19 | |
< 25% | 20 (13.9) |
26–50% | 56 (38.9) |
51–75% | 42 (29.2) |
76–100% | 26 (18.1) |
Reduction in number of dedicated neurosurgery ORs | |
Little to no reduction | 66 (45.8) |
Small reduction (< 1/3 of neurosurgery ORs) | 6 (4.2) |
Moderate reduction (< 2/3 of neurosurgery ORs) | 13 (9.0) |
Major reduction (≥ 2/3 of neurosurgery ORs) | 19 (13.2) |
No dedicated ORs (100% reduction of neurosurgery ORs) | 9 (6.3) |
Reduction in number of neurosurgery ICU beds | |
Little to no reduction | 93 (64.6) |
Small reduction (< 1/3 of total ICU beds) | 8 (5.6) |
Moderate reduction (< 2/3 of total ICU beds) | 11 (7.6) |
Major reduction (≥ 2/3 of total ICU beds) | 15 (10.4) |
No dedicated ICU beds (100% reduction of ICU beds) | 9 (6.3) |
Current number of ventilators (median [IQR]) | 9 [4; 20] |
Number of hospitals with increased ventilators | 42 (29.2) |
Percentage increase in number of ventilators (median) | 0.5% |
Level of personal protection by neurosurgeons operating on COVID-19-negative patients | |
Routine gowning | 73 (50.7) |
Routine gowning with N95 mask | 35 (24.3) |
Gowns with junctions sealed, with air supply or self-contained breathing apparatus | 21 (14.6) |
Completely enclosed gowns with self-contained breathing apparatus | 15 (10.4) |
Scheduled neurosurgeries still being performed as planned on COVID-19 positive patients | 34 (23.4) |
At the peak of the pandemic, was there shortage of COVID-19 related supplies/PPE in the hospital? | |
Little or no disruption | 40 (27.8) |
Moderate disruption | 71 (49.3) |
Severe disruption | 20 (13.9) |
Level of personal protection by neurosurgeons operating on COVID-19-positive patients | |
Routine gowning | 14 (9.7) |
Routine gowning with N95 mask | 17 (11.8) |
Gowns with junctions sealed, with air supply or self-contained breathing apparatus | 11 (7.6) |
Completely enclosed gowns with self-contained breathing apparatus | 101 (70.1) |
Changes to pre-operative COVID-19 screening guidelines for CNS tumor patients | 120 (83.3) |
If yes, what changes? | |
Confirmation of COVID-19 status by laboratory test as negative | 58 (48.4) |
Screening for COVID-19 based on history, clinical manifestation, and imaging | 62 (51.6) |
Suspension of post-operative adjuvant therapy | 52 (36.1) |
If no, what measures have been taken to administer post-operative adjuvant therapy? | |
Home-based assisted treatment | 4 (2.8) |
Strict isolation, single room treatment | 14 (9.7) |
Intensive screening for COVID-19 | 29 (20.1) |
Improving the protection level of doctors and patients | 12 (8.3) |
Referral to other hospitals | 35 (24.3) |
Staff training to operate ventilators? | 93 (64.6) |
Number of neurosurgeons/fellows per hospital (median [IQR]) | 16 (9; 30) |
Personnel relocation from neurosurgery to other departments | 91 (63.2) |
Relocation of: | |
Neurosurgeons | 68 (47.2) |
Operating room nurses/technicians | 35 (24.3) |
Trainees | 75 (52.1) |
ICU nurses | 91 (63.2) |
Floor nurses | 91 (63.2) |
Routine continuation of research | 21 (14.6) |
Suspension of research | 85 (59.0) |
Modifications of research | 31 (21.5) |
Research personnel working from home | 14 (9.7) |
Clinical research continuing but basic science research suspended | 3 (2.1) |
Segregation of research personnel | 14 (9.7) |
Trainees permitted to perform cases | 67 (46.5) |
Trainees required to stay at home unless on call or critically needed | 78 (54.2) |
Medical students mandated to stay at home | 104 (72.2) |