Comparison of subspecialty major surgical volume in the United States during the COVID-19 pandemic.
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ABSTRACT:
SUBMITTER: Saraswathula A
PROVIDER: S-EPMC9088461 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundIn an effort to help combat the COVID-19 pandemic and preserve essential health care resources, starting in mid-March 2020, surgeons have been instructed to only perform essential surgical procedures. The vast majority of hip and knee arthroplasty surgery does not meet the definition of essential surgery. This study estimated the number of arthroplasty procedures that would be canceled because of these important restrictions.MethodsThe US hip and knee arthroplasty procedure volume projections for 2020 were estimated from four recently published studies. Data from the American Joint Replacement Registry were utilized to determine what percentage of these cases would be considered nonessential surgery. Monthly and weekly estimates of nonessential hip and knee arthroplasty procedures that would have occurred had there not been any restrictions due to COVID-19 were calculated.ResultsAfter excluding essential procedures, it was estimated that approximately 30,000 primary and 3000 revision hip and knee arthroplasty procedures will be canceled each week while COVID-19 restrictions regarding nonessential surgery are in place. If only 50% of nonessential cases were actually canceled across the United States, that would still result in the cancellation of 15,001 primary and 1435 revision hip and knee arthroplasty procedures per week while restrictions are in place.ConclusionThis study highlights the profound impact COVID-19 is having on our current hip and knee arthroplasty volume. The large number of cases canceled because of COVID-19 translates into major financial losses for health care institutions and may have a profound impact on our patients.
| S-EPMC7194697 | biostudies-literature
Project description:Objectives:The paper highlights US health policy and technology responses to the COVID-19 pandemic from January 1, 2020 - August 9, 2020. Methods:A review of primary data sources in the US was conducted. The data were summarized to describe national and state-level trends in the spread of COVID-19 and in policy and technology solutions. Results:COVID-19 cases and deaths initially peaked in late March and April, but after a brief reduction in June cases and deaths began rising again July and continued to climb into early August. The US policy response is best characterized by its federalist, decentralized nature. The national government has led in terms of economic and fiscal response, increasing funding for scientific research into testing, treatment, and vaccines, and in creating more favorable regulations for the use of telemedicine. State governments have been responsible for many of the containment, testing, and treatment responses, often with little federal government support. Policies that favor economic re-opening are often followed by increases in state-level case numbers, which are then followed by stricter containment measures, such as mask wearing or pausing re-opening plans. Conclusions:While all US states have begun to "re-open" economic activities, this trend appears to be largely driven by social tensions and economic motivations than an ability to effectively test and surveil populations.
| S-EPMC7451131 | biostudies-literature
Project description:BackgroundCardiothoracic training during the Coronavirus disease 2019 (COVID-19) pandemic witnessed a dramatic change in the United Kingdom, resulting in changes in surgical provisions, centralization of services, and reduced surgical case volume. The aim of this study was to assess the impact COVID-19 on surgical training and seek opinions regarding the future role of surgical simulation in cardiothoracic training.MethodsA cross-sectional survey was designed and distributed to 200 cardiothoracic national and non-national trainees in the United Kingdom. The survey consisted of 31 questions in 4 sections: Demographics, Service Provision, Training, and Simulation Training.ResultsEighty-three of the 200 trainees (41.5%) completed the survey, including 44 of 129 national trainees (34.1%) and 39 of 71 non-national trainees (54.9%). Sixty-seven respondents (80.7%) agreed that cardiothoracic training had been negatively impacted as a result of COVID-19 (P < .001). In addition, 12% agreed that adequate resources were available for learning/practicing technical skills, 87% agreed that simulation had a role in cardiothoracic training, 81% recognized simulations is an important tool in improving their surgical skills, and 79.5% agreed that simulation should be used to meet the increasing need in training/education moving forward.ConclusionsCOVID-19 has had a significant impact on surgical training, with concerns that these effects could have further implications downstream. Simulation training has been underused thus far, and trainees face an uphill challenge to enhance their skills and technical abilities in the operating room. Simulation is recommended by trainees and may represent a solution to the challenges of safe and effective cardiothoracic surgical training.
| S-EPMC8282444 | biostudies-literature
Project description:Currently, the world is facing its 3rd coronavirus outbreak of the 21st century, which has turned to a pandemic recently. Starting on December 2019, coronavirus disease (COVID-19) was first detected in Wuhan City, Hubei province, China. As of 31st March, 2020, more than 900,000 COVID-19 cases have been reported across the globe involving more than 200 countries. The first case of the United States (US) was confirmed on 20th January, 2020 in a 35-year-old male who had a travel history to Wuhan, China, before returning to the U.S. Since then, the SARS-CoV-2 virus has spread to all the 50 states of US, with more cases being reported every day. New York, New Jersey, Michigan, and California are the worst-hit states. As COVID-19 is growing, every day has been marked by novel developments and updates. We hereby talk about how the U.S. is leading the multiagency effort to fight against this pandemic and the steps that have been taken so far.
| S-EPMC7346962 | biostudies-literature
Project description:Despite calls for political consensus, there is growing evidence that the public response to the COVID-19 pandemic has been politicized in the US. We examined the extent to which this polarization exists among the US public across two national studies. In a representative US sample (N = 699, March 2020) we find that liberals (compared to conservatives) perceive higher risk, place less trust in politicians to handle the pandemic, are more trusting of medical experts such as the WHO, and are more critical of the government response. We replicate these results in a second, pre-registered study (N = 1000; April 2020), and find that results are similar when considering partisanship, rather than political ideology. In both studies we also find evidence that political polarization extends beyond attitudes, with liberals consistently reporting engaging in a significantly greater number of health protective behaviors (e.g., wearing face masks) than conservatives. We discuss the possible drivers of polarization on COVID-19 attitudes and behaviors, and reiterate the need for fostering bipartisan consensus to effectively address and manage the COVID-19 pandemic.
| S-EPMC8631569 | biostudies-literature
Project description:BackgroundAlthough the direct toll of COVID-19 in the United States has been substantial, concerns have also arisen about the indirect effects of the pandemic. Hospitalizations for acute cardiovascular conditions have declined, raising concern that patients may be avoiding hospitals because of fear of contracting severe acute respiratory syndrome- coronavirus-2 (SARS-CoV-2). Other factors, including strain on health care systems, may also have had an indirect toll.ObjectivesThis investigation aimed to evaluate whether population-level deaths due to cardiovascular causes increased during the COVID-19 pandemic.MethodsThe authors conducted an observational cohort study using data from the National Center for Health Statistics to evaluate the rate of deaths due to cardiovascular causes after the onset of the pandemic in the United States, from March 18, 2020, to June 2, 2020, relative to the period immediately preceding the pandemic (January 1, 2020 to March 17, 2020). Changes in deaths were compared with the same periods in the previous year.ResultsThere were 397,042 cardiovascular deaths from January 1, 2020, to June 2, 2020. Deaths caused by ischemic heart disease increased nationally after the onset of the pandemic in 2020, compared with changes over the same period in 2019 (ratio of the relative change in deaths per 100,000 in 2020 vs. 2019: 1.11, 95% confidence interval: 1.04 to 1.18). An increase was also observed for deaths caused by hypertensive disease (1.17, 95% confidence interval: 1.09 to 1.26), but not for heart failure, cerebrovascular disease, or other diseases of the circulatory system. New York City experienced a large relative increase in deaths caused by ischemic heart disease (2.39, 95% confidence interval: 1.39 to 4.09) and hypertensive diseases (2.64, 95% confidence interval: 1.52 to 4.56) during the pandemic. More modest increases in deaths caused by these conditions occurred in the remainder of New York State, New Jersey, Michigan, and Illinois but not in Massachusetts or Louisiana.ConclusionsThere was an increase in deaths caused by ischemic heart disease and hypertensive diseases in some regions of the United States during the initial phase of the COVID-19 pandemic. These findings suggest that the pandemic may have had an indirect toll on patients with cardiovascular disease.
| S-EPMC7800141 | biostudies-literature
Project description:We document large-scale urban flight in the United States during the COVID-19 pandemic. Regions that saw migrant influx experienced greater subsequent new COVID-19 cases, linking urban flight (as a disease vector) and coronavirus spread in destination areas. Urban residents fled to socially connected areas, consistent with the theory that individuals sheltered with friends and family, or in second homes. Populations that fled were disproportionately younger, whiter, and wealthier. The association between migration and subsequent new cases persists when instrumenting for migration with social networks.
| S-EPMC9344811 | biostudies-literature
Project description:IntroductionInternational studies have demonstrated increasing rates of sexual dysfunction amidst the coronavirus disease 2019 (COVID-19) pandemic; however, the impact of the pandemic on female sexual function in the United States is unknown.AimTo assess the impact of the COVID-19 pandemic on female sexual function and frequency in the United States.MethodsA pre-pandemic survey containing the Female Sexual Function Index (FSFI) and demographic questions was completed by adult women in the United States from October 20, 2019 and March 1, 2020. The same women were sent a follow-up survey also containing the FSFI, as well as the Patient Health Questionnaire for Depression and Anxiety with 4 items (PHQ-4), and questions pertaining to mask wearing habits, job loss, and relationship changes. Risk for female sexual dysfunction (RFSD) was defined as FSFI < 26.55.Main outcome measureDifferences in pre-pandemic and intra-pandemic female sexual function, measured by the FSFI, and sexual frequency.ResultsNinety-one women were included in this study. Overall FSFI significantly decreased during the pandemic (27.2 vs 28.8, P = .002), with domain-specific decreases in arousal (4.41 vs 4.86, P = .0002), lubrication (4.90 vs 5.22, P = .004), and satisfaction (4.40 vs 4.70, P = .04). There was no change in sexual frequency. Contingency table analysis of RFSD prior to and during the pandemic revealed significantly increased RFSD during the pandemic (P = .002). Women who developed RFSD during the pandemic had higher PHQ-4 anxiety subscale scores (3.74 vs 2.53, P = .01) and depression subscale scores (2.74 vs 1.43, P = .001) than those who did not. Development of FSD was not associated with age, home region, relationship status, mask wearing habits, knowing someone who tested positive for COVID-19, relationship change, or job loss and/or reduction during the pandemic.ConclusionIn this population of female cannabis users, risk for sexual dysfunction increased amidst the COVID-19 pandemic and is associated with depression and anxiety symptoms. Bhambhvani HP, Chen T, Wilson-King AM, et al. Female Sexual Function During the COVID-19 Pandemic in the United States. Sex Med 2021;9:100355.
| S-EPMC8360920 | biostudies-literature
Project description:Surveys indicate US residents spent more time outdoors in 2020 than in 2019, but fewer tick bite-related emergency department visits and Lyme disease laboratory tests were reported. Despite ongoing exposure, Lyme disease case reporting for 2020 might be artificially reduced due to coronavirus disease-associated changes in healthcare-seeking behavior.
| S-EPMC8462321 | biostudies-literature
Project description:Background and purposeThe magnitude and drivers of excess cerebrovascular-specific mortality during the coronavirus disease 2019 (COVID-19) pandemic are unknown. We aim to quantify excess stroke-related deaths and characterize its association with social distancing behavior and COVID-19-related vascular pathology.MethodsUnited States and state-level excess cerebrovascular deaths from January to May 2020 were quantified using National Center for Health Statistic data and Poisson regression models. Excess cerebrovascular deaths were analyzed as a function of time-varying stroke-related emergency medical service (EMS) calls and cumulative COVID-19 deaths using linear regression. A state-level regression analysis was performed to determine the association between excess cerebrovascular deaths and time spent in residences, measured by Google Community Mobility Reports, during the height of the pandemic after the first COVID-19 death (February 29).ResultsForty states and New York City were included. Excess cerebrovascular mortality occurred nationally from the weeks ending March 28 to May 2, 2020, up to a 7.8% increase above expected levels during the week of April 18. Decreased stroke-related EMS calls were associated with excess stroke deaths one (70 deaths per 1000 fewer EMS calls [95% CI, 20-118]) and 2 weeks (85 deaths per 1000 fewer EMS calls [95% CI, 37-133]) later. Twenty-three states and New York City experienced excess cerebrovascular mortality during the pandemic height. A 10% increase in time spent at home was associated with a 4.3% increase in stroke deaths (incidence rate ratio, 1.043 [95% CI, 1.001-1.085]) after adjusting for COVID-19 deaths.ConclusionsExcess US cerebrovascular deaths during the COVID-19 pandemic were observed and associated with decreases in stroke-related EMS calls nationally and mobility at the state level. Public health measures are needed to identify and counter the reticence to seeking medical care for acute stroke during the COVID-19 pandemic.
| S-EPMC7834664 | biostudies-literature