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COVID-19 and cardiac surgery: The perspective from United Kingdom.

ABSTRACT: The emergence of severe acute respiratory syndrome coronavirus 2 in December 2019, presumed from the city of Wuhan, Hubei province in China, and the subsequent declaration of the disease as a pandemic by the World Health Organization as coronavirus disease 2019 (COVID-19) in March 2020, had a significant impact on health care systems globally. Each country responded to this disease in different ways, however this was done broadly by fortifying and prioritizing health care provision as well as introducing social lockdown aiming to contain the infection and minimizing the risk of transmission. In the United Kingdom, a lockdown was introduced by the government on March 23, 2020 and all health care services were focussed to challenge the impact of COVID-19. To do so, the United Kingdom National Health Service had to undergo widespread service reconfigurations and the so-called "Nightingale Hospitals" were created de novo to bolster bed provision, and industries were asked to direct efforts to the production of ventilators. A government-led public health campaign was publicized under the slogan of: "Stay home, Protect the NHS (National Health Service), Save lives." The approach had a significant impact on the delivery of all surgical services but particularly cardiac surgery with its inherent critical care bed capacity. This paper describes the impact on provision for elective and emergency cardiac surgery in the United Kingdom, with a focus on aortovascular disease. We describe our aortovascular activity and outcomes during the period of UK lockdown and present a patient survey of attitudes to aortic surgery during COVID-19 pandemic.

SUBMITTER: Harky A

PROVIDER: S-EPMC7537188 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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COVID-19 and cardiac surgery: A perspective from United Kingdom.

Harky Amer A Harrington Deborah D Nawaytou Omar O Othman Ahmed A Fowler Catherine C Owens Gareth G Torella Francesco F Kuduvalli Manoj M Field Mark M

Journal of cardiac surgery 20200927 5

The emergence of severe acute respiratory syndrome coronavirus 2 in December 2019, presumed from the city of Wuhan, Hubei province in China, and the subsequent declaration of the disease as a pandemic by the World Health Organization as coronavirus disease 2019 (COVID-19) in March 2020, had a significant impact on health care systems globally. Each country responded to this disease in different ways, however this was done broadly by fortifying and prioritizing health care provision as well as in ...[more]

PMID: 32981073

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Project description:The UK implemented a lockdown in Spring (2020) to curtail the person-to-person transmission of the SARS-CoV-2 virus. Measures restricted movements to one outing per day for exercise and shopping, otherwise most people were restricted to their dwelling except for key workers (e.g. medical, supermarkets, and transport). In this study, we quantified changes to air quality across the United Kingdom from 30/03/2020 to 03/05/2020 (weeks 14-18), the period of most stringent travel restrictions. Daily pollutant measurements of NO2, O3 and PM2.5 from the national network of monitoring sites during this period were compared with measurements over the same period during 2017-19. Comparisons were also made with predicted concentrations for the 2020 period from business-as-usual (BAU) modelling, where the contributions of normal anthropogenic activities were estimated under the observed meteorological conditions. During the lockdown study period there was a 69% reduction in traffic overall (74% reduction in light and 35% in heavy vehicles). Measurements from 129 monitoring stations, identified mean reductions in NO2 of 38.3% (-8.8 μg/m3) and PM2.5 of 16.5% (-2.2 μg/m3). Improvements in NO2 and PM2.5 were largest at urban traffic sites and more modest at background locations where a large proportion of the population live. In contrast, O3 concentrations on average increased by 7.6% (+4.8 μg/m3) with the largest increases at roadside sites due to reductions in local emissions of NO. A lack of VOC monitoring limited our capacity to interpret changes in O3 at urban background locations. BAU models predicted comparable NO2 reductions and O3 gains, although PM2.5 episodes would have been more prominent without lockdown. Results demonstrate the relatively modest contribution of traffic to air quality, suggesting that sustained improvements in air quality require actions across various sectors, including working with international and European initiatives on long-range transport air pollutants, especially PM2.5 and O3.

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COVID-19 and cardiac surgery: The perspective from United Kingdom.

Publications

COVID-19 and cardiac surgery: A perspective from United Kingdom.

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