Why surgeons don’t want to operate right now - 20 Bloomberg

Bron: 24-03-2020; https://www.bloomberg.com/opinion/articles/2020-03-24/the-coronavirus-crisis-is-putting-surgeons-at-risk-too

By: Therese Raphael

Summary

• To date, 24 Italian doctors died of covid19 which indicates doctors in frontline are vulnerable for severe cases of covid19
• Sourcing of personal protective equipment (ppe) is not the only problem. In addition; the absence of frequent testing increases the chances of doctors falling ill. Third; doctors, when exposed, have increased chance of severe covid19.
• Extra distribution of PPE is not the solution, especially for surgery where normal PPE does not suffice. The OR is can be seen as “viral labs in a wind tunnel.”
• Why is the OR extra contaminated?
  • Virus spreads via aerosols → intubation
  • Also spreads via blood and other body fluids which frequently get exposed during surgery
  • Virus particles can linger outside the patient on metal, plastic etc.
  • Constant ventilation in the OR blows aerosols around and contaminating all OR surfaces (including ceiling) which is impossible to properly clean
  • Proper protocols for surgical PPE do not exist, full hazmat might be best but availability is limited. 
  • Viral load in OR might be high
• In Italy positive patients were operated on using normal surgical masks since others were unavailable leading to an unsafe doctor environment and therewith imposing big problems on the healthcare system.