With severe limitations in manpower, facilities, and equipment, and the concern for nosocomial transmission, operating in a pandemic is fraught with danger from multiple fronts.
Strategies to mitigate nosocomial spread include prioritization of existing patients, triaging and treatment of new patient encounters, infection control protocols, perioperative considerations, manpower management, and novel strategies for interdisciplinary interaction and education.
The decision to proceed with or postpone surgery should be based on the urgency of the surgical procedure and the physiological health of the patient.
When performing an operation on a patient who has suspected or confirmed infection with novel coronavirus disease 2019 (COVID-19), personal protection equipment should include hair covers, face shields or goggles, N95 respirator masks, a blood-borne pathogen-resistant surgical gown, shoe covers, and double-gloving with single-use gloves.
Loose-fitting, powered air-purifying respirators should be considered for prolonged surgeries.
An astutely formulated and comprehensive business continuity plan is an orthopaedic unit’s best strategy for maintaining critical standards, discipline, and morale in severe and prolonged outbreaks.