Experience from a Singapore tertiary hospital with restructuring of a vascular surgery practice in response to national and institutional policies during the COVID-19 pandemic

J Vasc Surg. 2020 Oct;72(4):1166-1172. doi: 10.1016/j.jvs.2020.05.026. Epub 2020 May 23.

Abstract

Singapore was one of the first countries to be affected by COVID-19, with the index patient diagnosed on January 23, 2020. For 2 weeks in February, we had the highest number of COVID-19 cases behind China. In this article, we summarize the key national and institutional policies that were implemented in response to COVID-19. We also describe in detail, with relevant data, how our vascular surgery practice has changed because of these policies and COVID-19. We show that with a segregated team model, the vascular surgery unit can still function while reducing risk of cross-contamination. We explain the various strategies adopted to reduce outpatient and inpatient volume. We provide a detailed breakdown of the type of vascular surgical cases that were performed during the COVID-19 pandemic and compare it with preceding months. We discuss our operating room and personal protective equipment protocols in managing a COVID-19 patient and share how we continue surgical training amid the pandemic. We also discuss the challenges we might face in the future as COVID-19 regresses.

Keywords: COVID-19; Coronavirus disease 2019; Segregation; Surgical practice; Vascular surgery.

MeSH terms

  • Ambulatory Care / legislation & jurisprudence
  • Ambulatory Care / organization & administration
  • Betacoronavirus / pathogenicity
  • COVID-19
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / therapy*
  • Coronavirus Infections / virology
  • Delivery of Health Care, Integrated / legislation & jurisprudence*
  • Delivery of Health Care, Integrated / organization & administration
  • Health Policy / legislation & jurisprudence*
  • Health Services Needs and Demand / legislation & jurisprudence*
  • Health Services Needs and Demand / organization & administration
  • Hospital Departments / legislation & jurisprudence
  • Hospital Departments / organization & administration
  • Host-Pathogen Interactions
  • Humans
  • Infection Control / legislation & jurisprudence
  • Infection Control / organization & administration
  • Occupational Health / legislation & jurisprudence
  • Pandemics
  • Patient Care Team / legislation & jurisprudence
  • Patient Care Team / organization & administration
  • Patient Safety / legislation & jurisprudence
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / therapy*
  • Pneumonia, Viral / virology
  • Policy Making*
  • Program Evaluation
  • SARS-CoV-2
  • Singapore / epidemiology
  • Tertiary Care Centers / legislation & jurisprudence*
  • Tertiary Care Centers / organization & administration
  • Vascular Surgical Procedures / legislation & jurisprudence*
  • Workload / legislation & jurisprudence