- Department of Neurosurgery, Neurosurgery Teaching Hospital, Baghdad, Iraq.
- Medical Student, College of Medicine, University of Baghdad, Baghdad, Iraq.
Zahraa F. Al-Sharshahi
Department of Neurosurgery, Neurosurgery Teaching Hospital, Baghdad, Iraq.
DOI:10.25259/SNI_143_2020Copyright: © 2020 Surgical Neurology International This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
How to cite this article: Hoz SS, Al-Sharshahi ZF, Albanaa SA. Neurosurgery in Iraq at the Time of Corona. Surg Neurol Int 09-May-2020;11:103
How to cite this URL: Hoz SS, Al-Sharshahi ZF, Albanaa SA. Neurosurgery in Iraq at the Time of Corona. Surg Neurol Int 09-May-2020;11:103. Available from: https://surgicalneurologyint.com/surgicalint-articles/10008/
On December 31, 2019, the World Health Organization (WHO) country office in Wuhan city, China, was informed of a “case of unknown pneumonia.”[
The first confirmed case of COVID-19 in Iraq was reported on February 22, 2020. Soon after, case reporting was coming from all the 18 governorates, with a total death toll of 42 and 547 confirmed cases, as of March 30, 2020 data.[
The health-care systems across the globe are struggling to meet the new challenges imposed by the new pandemic. Even the most efficient of systems are stricken by the urgent need to re-allocate and mobilize human and technical resources. Case-triaging recommendations are being constantly updated by professional societies to lessen the unprecedented decision-making burden on health-care providers.[
Despite having no direct pathological effects from a neurosurgical point of view, the COVID-19 pandemic is significantly impacting the neurosurgical practice worldwide. In anticipation of the next exponential phase of the pandemic, many neurosurgical centers have curtailed the performance of non-emergency surgeries in an attempt to limit the spread of the virus and conserve vital resources.[
The Neurosurgery Teaching Hospital (NTH) in Baghdad/ Iraq provides neurosurgical care for 4.2 million people – approximately 50% of the population in Baghdad – with a total capacity of 102 beds, 16 neurosurgical intensive care unit beds, and 7 operating rooms. The hospital hosts 17 neurosurgeons and 10 residents. On January 6, 2020, the NTH declared a delay in all elective and semi-elective cases until further notice to curb the spread of the virus. From January to April 2020, 180 operations performed, as compared to 538 cases over this same period in 2019; a net decrease of 67%. Elective spinal and peripheral nerve surgeries were mostly affected with a total decrease of 91% (from 209 to 18 cases). The number of elective cranial operations went from 128 to 52; a total decrease of 59%. Trauma and other emergency operations were reduced to a lesser extent, from 201 to 106; a decrease of 47%. At present, only 2 operating rooms are available for trauma and emergency cases.
While not yet a COVID-burdened area, cases are getting imported into the hospital and in-patient cross-contamination will be inevitable, especially in the absence of basic hygiene and infection-control measures and the lack of terminal cleaning supplies. As of March 29, 2020, a total of 8 hospital personnel (four doctors and four paramedics) have been home-quarantined due to possible contact with two COVID- positive cases that were accidentally identified in the hospital.
This trend is alarming for multiple reasons: First, with the lack of sufficient testing kits, the hospital will quickly become a COVID-hub. Second, the hospital is already limping with the minimum number of trained personnel and is unlikely to survive the challenges posed by further staff shortages. Third, there is a serious supply deficit in terms of personal protective equipment (PPE). Indeed, only 10% of hospital needs of standard PPEs are currently being met and hospital staff is working exposed under minimum protection. Fifth, the hospital provides care to a critically-ill patient group who is extremely vulnerable to the fatal complications of the infection.
It is inevitable that health-care resources and infrastructure will be strained over the forthcoming months. However, to survive this public health crisis, a strategic, inter-sectorial action plan that involves international experience sharing is urgently called for.
1. . Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019 [Last accessed on 2020 Mar 30].
2. . Available from: https://www.facs.org/covid-19 [Last accessed on 2020 Mar 30].
3. . Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports [Last accessed on 2020 Mar 30].