Skip to main content
search
Tag

Pandemic Archives - Page 2 of 2 - Neurosurgery Blog

Neurosurgery, COVID-19 and Health Disparities: Perspectives from a Minority Provider

By COVID-19, Faces of Neurosurgery, Guest Post, HealthNo Comments

COVID-19 has had a tremendous global impact and has taken the lives of many people. It has halted economies and disrupted our educational system. It has strained health care resources and has expedited health policy reforms. One particular impact of COVID-19 that troubles me as a minority provider is the disproportionate burden of illness and death among racial and ethnic minority groups. COVID-19 has further illuminated existing health disparities in our society.

Before becoming a neurosurgery resident at Massachusetts General Hospital, I played football at Florida State University and with the Tennessee Titans. My athletic experience taught me valuable lessons that apply to my life as a physician. One of those lessons is awareness. If an offense breaks the huddle with a new personnel grouping in a never-before-seen formation, as the safety on the defense, I have to be aware of this new wrinkle and call it out, so my teammates are ready to make a play.

If there is a new highly contagious infectious disease disproportionately disrupting and taking the lives of a specific subset of people in a never-seen-before fashion, as a black neurosurgery resident volunteering to help fight COVID-19, I have to be aware of this fact and call it out, so my health care and public health teammates are ready to make a play.

In my opinion, the delivery of hospital care is not the principal problem. Regardless of race, you will be treated with quality outstanding care if you enter the Massachusetts General Hospital doors of most hospitals in the US. Hospitals have the resources and providers to treat patients with COVID-19. Unfortunately, the problem is further upstream before a person becomes our patient. Here are some key points to consider:

  • Emerging non-communicable diseases like hypertension, obesity, and diabetes are prevalent in minority communities, and these pre-existing conditions place this population at higher risk for contracting COVID-19 and developing life-threatening complications of infection;
  • Living quarters are tighter in poor neighborhoods, which limits social distancing in these communities;
  • Getting to work often involves public transportation, another close-proximity activity permitting easier human-to-human transmission; and
  • Access and affordability of primary care physicians often are out of the reach for many of these families; thus, diagnoses can be missed, and the costs/effort to manage medical problems may be too much to bear given other financial demands.

How do we solve these problems? That is a complicated question. Key elements include evaluating social determinants of health, providing education and development to children and families, as well as income enhancements in these communities. Tracking equity measures, implementing quality improvement initiatives, building a culturally competent health care system and fostering and encouraging better relationships between clinicians and patients may also be solutions. No matter the methodology, a multi-layered approach between the health system stakeholders and affected communities will be at the core of the answer to this problem.

COVID-19 is hurting all of us; it just has shown a propensity to target more impoverished, underserved populations more. As in football, we see the COVID-19 opponent lining up to attack us with an offense we haven’t seen before. It’s our responsibility to be aware as a team, to respond to that attack, and defend our goal — in this case, the health of the most vulnerable members of our community.

Editor’s note: We hope that you will share what you learn from our posts. We invite you to be part of the conversation on Twitter by following and using the hashtag #COVID19.

Myron L. Rolle, MD, MSc
Massachusetts General Hospital
Boston, Mass.

May 11, 2020
Love0

Answering the Call: From Neurosurgeon to Critical Care Physician During COVID-19

By COVID-19, Faces of Neurosurgery, Guest Post, HealthNo Comments

With the coronavirus pandemic sweeping the nation, some regions of our country are encountering a shortage of health care providers to look after the surge of hospitalized patients. As personnel resources are strained, neurosurgeons are being asked to care for critically ill patients — including ones that do not have neurological diagnoses.

Beyond a robust foundation in neurocritical care during training and daily practice, some neurosurgeons have additional training in critical care to become full-time neurointensivists. As such, neurosurgeons of all subspecialties may be tapped to care for patients in the intensive care unit (ICU). This is not surprising because of the skills all neurosurgeons develop to monitor patients closely and act swiftly and decisively when the need arises. The complexity of neurosurgical patients demands an extensive understanding of how the body’s organ systems interact and must be treated when acute multi-organ dysfunction exists. Patients with ruptured aneurysms, traumatic brain injuries, strokes and spinal cord compression may also have respiratory failure, cardiac disease and acute kidney injury.

While learning about critical care is a part of neurosurgical training, many neurosurgeons have not been practicing critical care medicine since leaving training. One strength of organized neurosurgery is its ability to draw neurosurgeons together for a common purpose. To aid neurosurgeons in their new mission, the Joint Section on Neurotrauma & Critical Care (Trauma Section) of the American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS) developed A Neurosurgeon’s Guide to Pulmonary Critical Care for COVID-19, a presentation that includes:

  • A review of pulmonary physiology;
  • Protocols to promote the safety of caregivers;
  • Basics of ventilator management;
  • Recommendations from multiple professional societies for the care of COVID-19 patients; and
  • A review of techniques to optimize patient care.

This presentation is available on the COVID-19 resource hubs of the AANS, the CNS and the American Board of Neurological Surgery.

The Trauma Section has also developed additional guidance, A Neurosurgeon’s Guide to Cardiovascular and Renal Critical Care for COVID-19, which is available from the AANS and the CNS.

While our nation faces a new challenge in the COVID-19 pandemic, organized neurosurgery is rising to meet it. The educational efforts of the AANS and the CNS, along with health care policy advocacy from the AANS/CNS Washington Committee, are helping to prepare neurosurgeons in all stages in their career to answer this call.

Editor’s note: We hope that you will share what you learn from our posts. We invite you to be part of the conversation on Twitter by following and using the hashtag #COVID19.

Alan Hoffer, MD, FAANS
Chair, Critical Care Committee of the AANS/CNS Joint Section on Neurotrauma & Critical Care
University Hospitals of Cleveland
Case Western Reserve University

May 6, 2020
Love0

The COVID-19 Challenge from a Health System Perspective

By CNS Spotlight, COVID-19, Guest Post, HealthNo Comments

It’s hard to believe that just over a month ago, the first case of COVID-19 was reported in Michigan. We were all aware that it was coming, but really couldn’t imagine the profound impact this virus would have and the rapidity of the viral spread. Many reasons have been postulated for why Detroit in particular turned into one of the country’s most serious COVID-19 hotspots, including the fact that our international airport, Detroit Metropolitan Airport, is one of the 5 busiest hubs in the country. The resurgence of Michigan’s economy in the last few years also resulted in a dramatic rise in international industry business travel, including to China, Korea, Japan and Italy.

In anticipation of the surge in Michigan, Henry Ford Health System (HFHS) took many key steps at early points in the crisis. A month prior to the first detected COVID-19 case in the state, HFHS began holding daily infection prevention calls to start COVID-19 related education and training amongst the staff, and we activated our Incident Command structure where all physician and administrative teams across all business units were included. In an effort to keep staff and patients safe, business travel and HFHS events were cancelled prior to the state’s mandates.

At the onset of increased COVID-19 admissions in mid-March, HFHS stopped all elective surgeries, which helped create the immediate and much-needed capacity to accommodate any surge. We temporarily closed many ambulatory clinics and redeployed resources — including not only supplies but also over 550 physicians, nurses and staff — to the inpatient settings. In accordance with Accreditation Council for Graduate Medical Education (ACGME) guidelines, HFHS declared a Stage 3 Pandemic Crisis, transitioning most residents and fellows to patient care areas in the most immediate need of clinical support. In taking these steps, we were able to quickly create ICU and general inpatient capacity.

To expedite diagnosis at the HFHS’s five acute care hospitals, the laboratory services became Michigan’s first same-day results lab for COVID-19, having the ability to process 1,000 tests per day with 93% processed in 12 hours or less. We also chose to be very proactive in testing our employees to safeguard our patients and our community, and we were also very transparent in our reporting of employee COVID-19 positive results to highlight the need for testing, and the need for aggressive prevention measures, throughout our region and beyond.

Like hospitals throughout the world, we experienced some supply disruptions for personal protective equipment (PPE) as global demand far exceeded production capabilities. Maintaining the safety of our health care professionals on the front lines remains a critical focus for the System. Thus, our supply chain team aggressively responded to the global constraints for these items by actively sourcing PPE from alternative sources, like TD Industrial Coverings, Inc., and we received more than 250,000 PPE donations from area businesses, including Ford Motor Company and the DTE Energy Foundation. The HFHS also implemented conservation policies aligned with the Centers for Disease Control and Prevention (CDC) recommendations to ensure the frontline workers continued to have the protection they needed. To help address the high demand for PPE, the photomedicine and photobiology unit in our Department of Dermatology rapidly developed an innovative process to sterilize N95 respirators using a special form of ultraviolet C (UVC), so the respirators can be reused. Ultimately, we were able to secure adequate PPE supplies to mandate a universal mask policy for all staff, employees, patients and visitors to any Henry Ford facility, and N95 respirators were made available to all staff in contact with suspected COVID-19 patients and for those performing any procedure at risk for aerosolization of bodily fluids.

The Henry Ford Research Team also embarked upon dozens of studies either underway or under development to understand disease progression and outcomes, and to treat or prevent COVID-19. With assistance from Vice President Michael R. Pence and Food and Drug Administration Commissioner Stephen M. Hahn, MD, Henry Ford launched the country’s largest randomized controlled, double-blinded study to determine the effectiveness of hydroxychloroquine in preventing COVID-19 in health care workers and first responders. Another study is underway on the antibody assessment and treatment in preparation for a potential vaccine that focuses on collecting convalescent plasma and using it in a clinical trial format for newly infected patients. We are also testing anti-viral agents, agents that inhibit the cytokine storm, convalescent patient serum and other novel approaches to treatment.

As the number of new COVID-19 cases decrease in Michigan and we extubate more patients from ventilators than we intubate, we’re beginning to perform time-sensitive ambulatory surgeries and procedures that were postponed due to the pandemic. We are starting with cases that can reasonably be accomplished on an outpatient basis using existing and available staff so as not to overburden the current inpatient needs for the hospitals. In our first week of restarting these ambulatory procedures, 80% of patients called were willing to be scheduled, while 20% preferred to wait given ongoing fear in the community of exposure. We have designated COVID-19-free operating rooms and teams, specifically assigned to these time sensitive non-COVID-19 cases to help reassure patients and families. Of 8,000 cases postponed since the start of the pandemic in mid-March, we hope to reschedule and perform 2,000 prioritized cases by mid-May in a staged way, taking great care to guard against another surge. All along we have been performing emergency cases with immediate threat to “life and limb,” but as we look to expand our inpatient surgical readiness in the weeks ahead, we plan to prioritize cancer, cardiovascular, neurosurgical and transplant cases given the risks of further delays to those patient populations.

The COVID-19 pandemic has challenged us to navigate through unprecedented circumstances, but it’s a challenge I strongly believe we will overcome together, and emerge even stronger as a profession, and as a community.

Editor’s note: We hope that you will share what you learn from our posts. We invite you to be part of the conversation on Twitter by following and using the hashtag #COVID19.

Steven N. Kalkanis, MD, FAANS
President, Congress of Neurological Surgeons
Henry Ford Medical Group
Detroit, Mich.

May 5, 2020
Love0

We believe we’re through the peak of the surge, but we’re not ready to declare victory yet.

Steven N. Kalkanis, MD, FAANS
May 1, 2020
Love0

Keeping Neurosurgical Practices Operating During COVID-19 and Beyond

By COVID-19, Faces of Neurosurgery, Guest Post, HealthNo Comments

Altair Health has been providing life-saving care in the state of New Jersey since 1958. We have grown significantly since that time, and Altair Health now employs nearly 150 people —   providing them with health care and retirement benefits, as well as rewarding work taking care of patients with neurosurgical disorders. The current pandemic has been a stark reminder that we are, after all, a small business dependent on professional reimbursement to keep our team and their families safe and employed during this crisis.

New Jersey has been hit hard by COVID-19. The hospitals where we provide care have been forced to convert their intensive care units (ICUs) to accommodate those with respiratory distress from COVID-19. These hospitals have also stopped elective surgical procedures from being performed. We are also unable to accept some emergency cases because of a lack of ICU beds. As of March 2020, per a state executive order, our ambulatory surgical center has been closed for all elective procedures, thereby crippling our ability to perform procedures. As a surgical practice, the vast majority of our revenue comes from elective and emergent surgeries. The current COVID-19 crisis has led to a massive loss of revenue.

Our physicians, nurse practitioners and physician assistants are on the frontlines of dealing with this crisis. We are exposing ourselves and our families to a potentially life-threatening condition every time we provide care to patients infected with COVID-19. Despite the selfless efforts of our health care providers, we are faced with the prospects of the difficult decision of having to lay off the people risking their lives. These practitioners are the very people that are needed during this crisis. With limited revenue coming in from surgical procedures, we are also faced with the difficult decision of what we do with our employees and are considering layoffs or furloughs to maintain liquidity.

Many surgical and medical practices are faced with similar challenging circumstances as they face cash flow shortages. To maintain practice liquidity, the following actions may be deployed:

  • Hold board meetings on a nearly daily basis;
  • Monitor key metrics weekly to understand the impact on the practice — for example, we currently have a 65% or higher cancellation rate for surgery and a 90% or higher cancellation rate for pain management;
  • Create a de novo Virtual Health Program for new and established office visits — we have gone from zero virtual visits to a 90% rate of virtual visits;
  • Implement virtual physical therapy to keep patients as conditioned as possible while adhering to mandatory stay at home policies;
  • Screen patients to prevent potential COVID-19 positive patients from entering our facilities;
  • Follow the Centers for Disease Control and Prevention (CDC), state and hospital recommendations regarding best practices for screening patients and staff to ensure a safe clinical environment for all;
  • Use risk algorithms to triage patients to emergent, urgent, essential and elective status to ensure patients are treated as appropriately as possible;
  • Develop a 13-week cash forecast model to monitor our liquidity position;
  • Request a 6-month deferral on medical malpractice insurance premiums;
  • Reduce all non-essential expenses;
  • Pursue rent abatement from landlords;
  • Delay pension contributions in the short-term;
  • Defer all bonuses to maintain cash flow;
  • Pursue multiple financial relief programs to enhance liquidity, including the Small Business Administration (SBA) Paycheck Protection Program (PPP), the U.S. Department of Health and Human Services (HHS) grant program and the Medicare Accelerated and Advance Payment Program; and
  • Evaluate partial furlough/layoffs, but try to make this the last option.

Looking beyond the current pandemic, there are lessons we have learned that may help us overcome future challenges. Principal among those is the potential for greater utilization of virtual health care visits. We have been able to rapidly increase virtual health to provide comfort and continued care to our patients at a time when direct patient care is not possible. While physical exams remain an integral part of our evaluation, the ability to provide patients with access to virtual care will be an essential part of our armamentarium to address similar challenges in the future.

Hopefully, the lessons we learn during this crisis will allow us to strengthen our practices going forward.

Editor’s note: We hope that you will share what you learn from our posts. We invite you to be part of the conversation on Twitter by following and using the hashtag #COVID19.

Scott A. Meyer, MD, FAANS
Treasurer, Altair Health
Morristown, N.J.

April 29, 2020
Love0

A Memorial Tribute to The Most Interesting Man in the World: James T. Goodrich, MD, PhD

By COVID-19, Faces of Neurosurgery, PediatricsOne Comment

The passing of James T. Goodrich, MD, PhD on March 30, 2020, was a devastating blow — not only to the neurosurgical community, but to his many friends throughout the world. Jim was a kind and compassionate man who was revered by many. He was always willing to help others and traveled extensively to help those who needed his expertise. He was a great teacher, surgeon and student of medical history. His accomplishments were many and varied.

  • He is probably best known for his technique for separating craniopagus twins. See, from the Journal of Neurosurgery: Pediatrics, “Craniopagus twins.” Jim was an advocate for the staged separation technique and brought it to new heights with his development of a multidisciplinary approach and the use of modern neuroimaging.
  • Jim was also an expert in craniofacial surgery. He was sought after for many national and international courses and conferences for his knowledge and teaching abilities. He was a frequent faculty member at the European Pediatric Training courses. He then helped developed these same courses in Asia, Latin and South America, and other locations throughout the world.
  • He had a life-long love of medical history. As a young neurosurgeon in training, he started a business collecting and selling medical artifacts and books of historical significance.
  • Jim was the recipient of multiple awards, including Best Doctors in America. He received the New York City Mayors Award in Science and Technology. He was a former marine and received the Marine of the Year Award for his contribution to society.

Colleagues, friends and family recently held a moving memorial tribute, which tells the story of Jim’s life and times.

He will be greatly missed.

Editor’s note: We hope that you will share what you learn from our posts. We invite you to be part of the conversation on Twitter by following and using the hashtag #COVID19.

Marion L. Walker, MD, FAANS
Professor Emeritus
Department of Neurosurgery
University of Utah School of Medicine

April 27, 2020
Love0

The Global Impact of the COVID-19 Pandemic on Neurosurgical Practice (Part III)

By AANS Spotlight, COVID-19, Faces of Neurosurgery, HealthNo Comments

The American Association of Neurological Surgeons (AANS) and the Journal of Neurosurgery (JNS) Publishing Group are pleased to announce the publication of four editorials on the impact of the COVID-19 pandemic on neurosurgical practice. This batch of editorials concludes our rapid-response collection on this topic. Altogether the collection boasts 19 papers, an introduction and 18 editorials, published in the Journal of Neurosurgery, Journal of Neurosurgery: Pediatrics or Journal of Neurosurgery: Spine. All of the articles are posted online, and they will also be accessible by PubMed Central as part of the Public Health Emergency COVID-19 Initiative.

The following articles cover neurosurgeons’ experiences and lessons learned thus far during the COVID-19 pandemic:

Xiaoguang Tong, MD, and Yuanfan Yang, MD, discuss precautions taken at Huanhu Hospital in Tianjin, China, for performing emergency cerebrovascular procedures during the pandemic. All patients entering the emergency department are assumed to have COVID-19 until proven otherwise. The hospital rearranged equipment and facilities to isolate patients throughout their treatment. Full personal protective equipment (PPE) — including N95 masks, face shields, goggles and full gown — were worn by all health care workers. Extra layers of face protection were worn during emergency intubation. Whenever possible, minimally invasive procedures were performed. Additional steps to protect health care workers and patients are also covered in this editorial. The authors state the precautions resulted in no infections among the health care workers and patients.

Sepideh Amin-Hanjani, MD, FAANS, and coauthors representing multiple academic institutions throughout the U.S. and Canada weigh in on the overall impact of COVID-19 on neurosurgical practice. The authors discuss the conservation of skilled staff, the heightened risk of some neurosurgical approaches, postponement of elective cases, the necessity of wearing appropriate PPE and the need to convert some specialty facilities into treatment sites for COVID-19 patients. The authors also share resources for neurosurgeons during the pandemic offered by the AANS, Congress of Neurological Surgeons, Centers for Medicare & Medicaid Services, the American College of Surgeons and additional societies.

Adair Prall, MD, FAANS, FACS, John D. Davis, IV, MD, FAANS, and N. Ross Jenkins, MD, FAANS, share their insights on changes in community practice during the COVID-19 pandemic. As independent private practitioners, these authors describe how disorienting it has been to suddenly have “many decisions made for them and [be] required to limit, change, or stop altogether their workflow.” The authors mention new ways of treating patients using phone or video conversations. They also discuss how hospital or ambulatory surgery center administrators may view urgent and elective surgeries differently from surgeons, and how neurosurgeons must advocate for patients whose conditions may not appear urgent but indeed are so. Lastly, the authors speak to the issue of small business ownership during the pandemic, dealing with a reduced caseload and income while trying to retain skilled employees.

A neurosurgical resident at Massachusetts General Hospital, Victoria Clark, MD, PhD, describes the experience of being locked out of the lab during the pandemic. Being unable to continue lab benchwork, she evaluates other avenues of research that can be followed by the resident at this time — such as working on bioinformatics-based projects or chart-based/clinical analyses or focusing on scientific writing. Laboratory research is extremely important overall, and an integral part of residency training, and Dr. Clark offers several suggestions on how labs can be reopened and neurosurgical research can continue using safe, socially distant methods.

Join us in reading these free articles.

Editor’s note: We hope that you will share what you learn from our posts. We invite you to be part of the conversation on Twitter by following and using the hashtag #COVID19.

April 24, 2020
Love0

The Global Impact of the COVID-19 Pandemic on Neurosurgical Practice (Part II)

By AANS Spotlight, COVID-19, Faces of Neurosurgery, HealthNo Comments

The American Association of Neurological Surgeons (AANS) and the Journal of Neurosurgery Publishing Group are pleased to announce the publication of eleven new editorials on the impact of the COVID-19 pandemic on neurosurgical practice. The series kicked off last week with three editorials and an introduction on the subject, which were published in the Journal of Neurosurgery and the Journal of Neurosurgery: Pediatrics.

Last week we heard from neurosurgeons in the United States, Canada, Italy and China on the impact of the pandemic on neurosurgical practice. This week’s installment adds editorials from the U.S., Republic of Korea and Singapore.

The editorials cover a wide variety of important areas demonstrating the impact of COVID-19 on the practice and training of neurosurgeons. Although other fields of medicine more readily come to mind when considering the battle against the virus known as SARS-CoV-2, neurosurgical practice has also had to adapt swiftly in response to the COVID-19 pandemic.

The following articles cover neurosurgeons’ experiences and lessons learned thus far during the COVID-19 pandemic:

Join us in reading these free articles.

Editor’s note: We hope that you will share what you learn from our posts. We invite you to be part of the conversation on Twitter by following and using the hashtag #COVID19.

April 17, 2020
Love0

The Global Impact of COVID-19 on Neurosurgical Practice

By AANS Spotlight, COVID-19, Faces of Neurosurgery, HealthNo Comments

The COVID-19 pandemic has significantly impacted medical practice across the globe. The effects are most notable in the fields of infectious disease, virology, emergency and critical care medicine, and epidemiology. Other medical specialties, including neurosurgery, however, are also impacted.

To highlight the effect of the pandemic on the neurosurgery practice, the Journal of Neurosurgery Publishing Group (JNSPG), the scholarly journal division of the American Association of Neurological Surgeons, is releasing a series of editorials on the impact of the COVID-19 pandemic on the practice of neurosurgery.

Douglas S. Kondziolka, MD, FAANS; William T. Couldwell, MD, PhD, FAANS; and James T. Rutka, MD, PhD, FAANS, introduce the series and highlight the impact the pandemic has had on neurosurgical practice. Three editorials are available, and additional papers on this topic will appear each Friday, so be sure to check back weekly.

Yirui Sun, MD, PhD, and Ying Mao, MD, PhD, provide an update on the pandemic in China. They speak of colleagues lost and the efforts of neurosurgeons to treat emergency cases regardless of the viral status of their patients. The authors also discuss how COVID-19 has given them “pause to reinforce [their] skillsets and redesign [their] mindsets to perform roles not only as neurosurgeons but also as executive officers.”

Marco Cenzato, MD, and colleagues speak from the Lombardy region of Italy. They describe a reorganization of neurosurgical facilities to expand the number of ICUs available to COVID-19 patients. Fifteen neurosurgical departments were temporarily consolidated into three locations, with neurosurgeons and patients shifted as well. As a result, “opening the hospital doors to neurosurgeons coming from other institutions has offered an unprecedented opportunity of collaboration and integration of teams.”

Leaders of the American Society of Pediatric Neurosurgeons address current management of COVID-19 in the pediatric neurosurgery community and provide recommendations on the preparation and response to the pandemic. Crucial areas addressed in their recommendations include children’s hospitals as a whole, operating rooms, pediatric neurosurgery clinical teams, and patients. Serious illness remains relatively rare among children with COVID-19. Nevertheless, the authors warn against complacency and stress the need for urgency in preparation and response to the pandemic.

Neurosurgeries must be prioritized, delaying less urgent cases so that increased hospital facilities and equipment can be made available for patients with COVID-19.

The COVID-19 pandemic has wreaked havoc in the lives of people across the world. The numbers of cases and deaths from the disease continue to climb at a rapid pace. Many deaths have occurred among health care workers. On both a personal and professional level, the JNSPG editors acknowledge, with sadness, the passing of fellow neurosurgeon James T. Goodrich, MD, Chief of Pediatric Neurosurgery, Montefiore Medical Center, New York City, from complications related to COVID-19 on March 30, 2020.

April 10, 2020
Love0

The Coronavirus Disease 2019 Global Pandemic: A Neurosurgical Treatment Algorithm

By CNS Spotlight, COVID-19, Faces of Neurosurgery, HealthNo Comments

The COVID-19 pandemic is disrupting neurosurgical care at medical centers throughout the United States. Institutional and governmental recommendations are not specific to neurosurgery. Protocols are urgently needed to help neurosurgeons triage cases based on acuity, and also to minimize the risk of infection for both patients and peri-operative medical staff. In many academic tertiary care hospitals, there is limited personal protective equipment and staffing shortages.

Given that there is insufficient data to create formal guidelines, physicians from the University of California San Francisco (UCSF) Department of Neurological Surgery and Department of Anesthesia have presented their institutional neurosurgical treatment algorithm during the California COVID-19 shelter in place order. The UCSF protocols are based on outbreak “surge levels,” and using these levels to guide operating room utilization based on the acuity of neurosurgical cases. The protocols and checklists from UCSF, which are published online in Neurosurgery — the official journal of the Congress of Neurological Surgeons (CNS) —  offer some guidance to neurosurgeons in other centers.

Click here to read “Letter: The Coronavirus Disease 2019 Global Pandemic: A Neurosurgical Treatment Algorithm.”

The CNS also offers a related webinar presentation, “UCSF’s Experience with COVID-19 in the Midst of the California Shelter-in-place Order.”  Click here to view the webinar.

John F. Burke MD, PhD
Resident, Neurological Surgery
University of California San Francisco
San Francisco, California

 

 

Praveen V. Mummaneni, MD
Professor, Neurological Surgery
University of California San Francisco
San Francisco, California

April 3, 2020
Love0