- Department of Neurosurgery, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India.
Manpreet Singh Banga, Department of Neurosurgery, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India.
DOI:10.25259/SNI_1179_2021Copyright: © 2022 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, transform, 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: Lavadi RS, Sandeep BV, Banga MS, Halhalli S, Kishan A. Neurosurgical experiences of a Bengaluru teaching hospital during the COVID-19 pandemic. Surg Neurol Int 05-Jan-2022;13:3
How to cite this URL: Lavadi RS, Sandeep BV, Banga MS, Halhalli S, Kishan A. Neurosurgical experiences of a Bengaluru teaching hospital during the COVID-19 pandemic. Surg Neurol Int 05-Jan-2022;13:3. Available from: https://surgicalneurologyint.com/surgicalint-articles/11331/
We have read with great interest the letter titled “Experiences of a neurosurgical center in the United Kingdom during the coronavirus disease 2019 (COVID-19) pandemic,”[
COVID-19 is a deadly pandemic first isolated in Wuhan, China, in December 2019.[
A total of 9,119 new cases in the past 24 hours, a cumulative of 34,544,882 cases, and 466,980 deaths due to COVID-19 from January 3, 2020, to November 25, 2021.
The second wave of COVID began in the middle of March 2021.[
On March 8, 2020, the first case of COVID-19 was reported in the state of Karnataka.[
Our 1,600 bedded multispecialty institute is located in the center of a busy IT hub in Bengaluru. A couple of months into the pandemic, our institute was configured to accommodate the needs of COVID-19. The outpatient departments (OPDs) of all specialties, previously spread across five floors, were crowded into the ground floor to convert the remaining floors into COVID-designated wards and ICUs. The neurosurgery ward and ICU patients were merged into the first-floor wards, where patients from other surgical departments were also placed. Although the initiative created hundreds of beds for COVID-19 patients, the lack of social distancing in the OPD and surgical wards put medical personnel and patients at risk for contracting the virus. Gradually, the departments’ OPDs were back in their original locations after a couple of months of achieving a degree of control of the COVID cases within the first wave itself.
We immediately noticed that our department was pushed to its limits in terms of workforce. Before the pandemic, in February 2020, our department had four neurosurgery residents. Now, we are left with only one resident due to a delay in entrance examinations because of COVID. In view of this, the staff surgeons have helped the resident take night calls. With the next superspecialty entrance examination in January 2022,[
Even when we had more residents, they were often diverted from their departmental responsibilities and gave up their operating time to assist the residents of anesthesiology and internal medicine to manage COVID-19 patients. Contributions from disciplines nonspecific to COVID-19 were made mandatory by our institute. When our residents performed their COVID-19 duties, they were considered the senior physicians of that ward and had internal medicine along with anesthesiology residents report to them. After performing one week of duty in the COVID-19 wards, they were allowed to quarantine for seven days before returning to the department. This was reduced to three days of working followed by one day of quarantine during the second wave.
Working in a hospital during such a time also created great fear and anxiety. A recent article stated that more than 1000 Indian doctors have died due to COVID.[
Before COVID-19, our department would operate on 40– 50 patients/month with a spinal to cranial surgery ratio of 7:3. Surgeries of peripheral nerve lesions are performed to a minimal extent in our institute. The pandemic reduced our daily patient volume from approximately 20–25 patients to just 2–3 patients presenting to our OPD. After the initiation of the national lockdown,[
In our initial assessment, we now included questions about the patient’s travel history, common and uncommon symptoms of COVID,[
Concerning ruptured intracranial aneurysms, Goyal et al.[
These patients had poor Glasgow Coma Scale scores, and thus, conservative treatment was opted for by the relatives. Two of our patients, without emergency indications (one meningioma and one chronic subdural hematoma), had their surgeries postponed because they tested positive while admitted to the hospital.
During the first wave, several eager interns (5th year medical students) interested in neurosurgery could not experience any operations during their brief one week rotation. An opportunity that came with less operating was that more time was dedicated to resident didactics such as journal clubs, presentations, and research. As something that previously happened less frequently due to operating or being at the bedside, we now have academic sessions almost five times/week. We also spend more time with our interns teaching them neurosurgery basics and are more active in conducting various types of research. Interns posted with us during the second wave have gotten good exposure to both spinal and cranial cases.
COVID-19 transformed neurosurgical practices across the world in more ways than one. This temporal but prolonged stunting of operating on elective cases only means that we expect our OPD and operating theaters to be filled very soon. As a result, patients may have to wait longer to get the surgery they need, creating a dilemma for the surgeon to prioritize the elective cases. Balancing elective cases with emergency cases will require an advanced level of organization, especially with a short-staffed team. We hope to maintain our commitment to didactics and continue research projects going forward.
Patient’s consent not required as there are no patients in this study.
There are no conflicts of interest.
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