Impact of COVID-19 varied regionally among spine surgeons
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A worldwide survey of spine surgeons revealed overall and regional variations in the impact of COVID-19 on surgical and personal domains, and highlighted the need for international guidelines to manage patients during a pandemic.
To identify the impact of COVID-19 on spine surgeons, Dino Samartzis, DSc, Philip K. Louie, MD, and colleagues distributed a survey to all AO Spine members. Researchers categorized the survey questions into demographics, COVID-19 observations, preparedness, personal impact, patient care and future perceptions.
The 902 spine surgeons who completed the survey represented 91 distinct countries and seven global regions, with the greatest number of responses from Europe followed by Asia and North America, according to results.
One of the biggest results of the study was the amount of uncertainty felt by physicians about the future, according to Louie, who was at Hospital for Special Surgery at the time of the study and will soon be at the Virginia Mason Neuroscience Institute.
“How is this pandemic going to change how we care for our patients, especially in the spine world, once this is over and how are we going to resume?” Louie told Healio Orthopedics. “What is the new normal going to look like? How are we going to decide which patients to be treated first once everything comes back? How are we going to protect ourselves and protect our patients in how we treat them in the future as well?”
Anxieties among surgeons
Samartzis noted spine surgeons reported high anxiety levels, with family health concerns reported as the greatest stressor globally (76%).
“Of course, loss of income, we saw how this affects clinical practice, surgical management,” Samartzis, associate professor in the department of orthopedic surgery and director of the International Spine Research and Innovation Initiative at Rush University Medical Center, told Healio Orthopedics. “These things were also region dependent, so we did see variations in a lot of these domains based on where surgeons lived.”
Researchers also noted variations in quarantining, hospital/government interventions, personal protective equipment availability and type, and medical staff employment.
“There were a couple of differences in how people thought the media and the government were handling [the pandemic], but that may be a difference of how those countries tolerate the government more so than other countries,” Louie said.
COVID-19 also had an impact on research, as well as teaching and training, with 96.9% of respondents interested in online medical education, according to results. While some respondents found the COVID-19 pandemic to be a time to focus on research, Samartzis noted future research may be impacted if researchers cannot access data or gather new data.
“Of course, if you do not have access to certain data or gathering new data moving ahead or if clinical trials and other clinical research has been halted or slowed down, that is going to become a problem in the long term,” Samartzis said.
Change after COVID-19
As a result of COVID-19, the survey showed 82.3% of respondents envisioned a change in their clinical practices.
“Looking at it from a different perspective, about 20% did not think their practice was going to change moving ahead, which to me is a bit alarming because it seems that you need to be a little bit more cautious nowadays moving forward,” Samartzis said.
Louie added there were little differences geographically in terms of preparedness for COVID-19. Overall, 94.7% of respondents expressed a need for formal, international guidelines to manage patients with COVID-19, according to results.
In the future, Louie and colleagues plan to release another survey to capture the post-thoughts of spine surgeons as a way to develop more specific guidelines.
“Let’s start at the staff level of the hospital, then the hospital administration, hospital leadership and city, state and national leadership and develop guidelines and protocols on how we deal with epidemics so when something like this hits again, there is not as much disarray when people are trying to think at the edge of their feet with so much going on,” Louie said.
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