The COVID-19 pandemic presents significant challenges to healthcare professionals. The widespread effect of this pandemic has had an impact on the practice of health workers .
We invited orthopedic surgeons form different parts of the world to participate in this study.
1163 orthopedic surgeons representing 84 countries have confirmed their participation. The purpose of this study was to assess the impact of COVID-19 pandemic on the orthopedic surgeons’ activities. The mean age of participants was 44,6 ± 11 years. Apart from the information shared by healthcare institutions, healthcare professionals used various other sources of information such as television, social media and World Health Organization website (table 3) . This study demonstrated high level of awareness amongst orthopedic surgeons about the risk of infection in healthcare professionals and patients as well as the preventive measures for stopping or minimizing spread of the disease. Given the increased risk for transmission COVID-19 virus in hospitals in general and operating theaters in particular, special personal protective measures must be provided. As surgeons, utmost care must be given to patients in the preoperative, intraoperative, and postoperative settings to minimize the risks of contamination. The risks and benefits of surgical management should be rationalized for each patient [3,5–7]. COVID-19 has shown more infectivity and a higher fatality rate than the H1N1 epidemic [2,5]. In addition, important clinical features of COVID-19 are currently unknown. These two elements may explain the number of interviewees (44%) who expressed reluctance to treat or operate non-urgent conditions in COVID-19 positive patients. Notably, the most common reason for their unwillingness to treat COVID-19 positive patients is due to their concern of getting the infection and transmitting the virus to their family members. With a better understanding of COVID-19 characteristics, we would expect a gradual increase in the number of medical staff who will be willing to treat infected patients [2,5]. The COVID-19 crisis has resulted in people working outside their speciality, providing support to infectiologist, pneumologist and intensive care physicians [1,8]. Orthopedic practice has been markedly affected by the emergence of the COVID-19 outbreak. Changes to clinical practice have been largely guided by clinical urgency, patients and medical staff protection and conservation of health-care resources. Having said that, changes to inpatient and outpatient care have been accordingly tailored to reduce the risk of contamination in patients, medical staff and to allow hospitals to free up beds for treatment of patients with positive or suspected COVID-19 [3,8]. All elective surgical procedures should be cancelled and deferred until an opportune time . Trauma cases surgeries should continue to proceed. Intraoperatively, full personal protection including surgical shields and goggles should be used. Operative times should be reduced whenever feasible, and surgical team should be kept to the minimum, whenever possible [3,8,10]. The reported decrease in the number of road accidents is due to the lockdown policy imposed by several countries worldwide and remote work adopted by a large number of institutions and organizations. Further measures may also be implemented. Hospitals should be in lockdown with no visitors allowed, social distancing at work (between coworkers) and at home (between cohabiting health-care workers). Physicians have also been advised to prolong the duration between non-urgent follow-ups to reduce patient overcrowding in hospitals [3,8,10]. Although non-urgent clinics and surgical procedures have been postponed until the situation improves, we must ensure that appropriate quality of care given to our patients is maintained. The emergence of such a crisis provides a timely opportunity for us to reflect and evaluate the use of novel technologies in the workplace. This includes the adoption of telemedicine and telerehabilitation initiatives, allowing patients to be consulted and followed-up in the comfort of their own homes [3,8,11–13]. We know that virus is likely to cause minor symptoms in majority (more than 80%) of infected people. Many healthcare workers are likely to fall into this category . Orthopaedic surgeons have a reputation built on their versatility and strength. Emotional support is necessary for ourselves, colleagues, patients and families [1,14,15]. Most interviewed practitioners estimated appropriate protective measures have been provided at work (table 4). Provision of personal protective equipment to healthcare professionals has been a huge challenge in many countries [1,10,16]. Personal protective equipment included medical masks, respirator N 95 or FFP2 masks, face shields, gloves, gowns, and protective glasses [5,17,18]. Given the extent of the pandemic, a shortage of a widely used equipment has been reported with FFP2 masks arrive in the top of the list -reported by 53% of the interviewed participants- (table 5). Institutions and governments have put in place different strategies to face this shortage, notably, support increasing production capacity and accelerating approval of protective equipment during this crisis [18,19]. To help prevent spread of COVID-19, orthopedic surgeons recommendations were frequent hand washing for a minimum 20 seconds, use hydro-alcoholic sanitizer, social distancing, use of face masks, gloves and of course confinement while waiting to discover a specific treatment and to make a specific vaccine.
Our study has limitations. First, the severity of the outbreak was not the same in all countries, so the measures taken by governments and health institutions were different [6,7]. Second, the experience of the person who fills out the questionnaire may affect the results.