Journal of Clinical Sciences

EDITORIAL
Year
: 2020  |  Volume : 17  |  Issue : 3  |  Page : 51-

Return to work during the epidemic – Implications for surgical care: Caution is the word


Adesoji O Ademuyiwa 
 Department of Surgery, Paediatric Surgery Unit, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria

Correspondence Address:
Prof. Adesoji O Ademuyiwa
Department of Surgery, Paediatric Surgery Unit, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Lagos
Nigeria




How to cite this article:
Ademuyiwa AO. Return to work during the epidemic – Implications for surgical care: Caution is the word.J Clin Sci 2020;17:51-51


How to cite this URL:
Ademuyiwa AO. Return to work during the epidemic – Implications for surgical care: Caution is the word. J Clin Sci [serial online] 2020 [cited 2020 Aug 6 ];17:51-51
Available from: http://www.jcsjournal.org/text.asp?2020/17/3/51/288906


Full Text



The COVID-19 pandemic has taken a huge toll on the world. As of June 19, 2020, there have been over 8.6 million infections around the world with almost half a million deaths.[1] In Africa, there are over 260,000 cases and over 7000 deaths and the cases are still rising.[2] There have also been several collateral damages including shrinking economy, stalling of educational programs, postponement, or outright cancellations of noncritical health care. There has also been ban on religious gathering as well as social gatherings including parties, etc., It has been estimated that the world economy may shrink up to 3.2%.[3]

All these have led several governments to be eager to ease lockdowns and encourage the economy to pick up. Some countries that have not carefully considered the consequences of such action have led to a second wave of infection that has sometimes led to reversal of such policy. The case of school closure in South Korea after initial reopening readily comes to mind.[4] It is against this backdrop that the Editors of the Journal of Clinical Sciences, the journal of the flagship faculty in the University of Lagos have come to a careful conclusion that caution should be watchword for policy makers as they seek to ease the lockdown.

A modeling study suggests that not <28 million surgeries must have been cancelled over a 3-month period due to the pandemic[5] including over 100,000 surgeries in Nigeria. It has been estimated that it could take close to a year to clear this backlog with increased work volume by 20%. These figures have also put pressures on hospital managements to start to seek ways of resuming noncritical care in the hospital. However, this needs to be done with caution. A recent study of over 1000 patients published in the Lancet last month showed that mortality from elective surgeries in COVID-19 patients is associated with high mortality and about 1 in 2 patients had pulmonary complications.[6] One of the main messages from this study is that return of noncritical surgeries may be associated with higher mortality and morbidity and hence the gradual return of surgical services has to be done with great caution for the best of both patients and health-care workers. This is also the opinion of the editors of this journal going forward.

This edition of the journal has some very interesting articles that I am sure will interest our readers. Tasew M and colleagues from Addis Ababa in Ethiopia discussed the predictors of outcome in patients with diuretic resistance and heart failure while Ajani et al., from the University College Hospital in Ibadan discussed a rare neoplasm of the appendix.[7],[8] There is also an interesting case report that complete the menu for our readers. I hope you find this issue interesting. Happy reading.

References

1Available from: https://www.worldometers.info/coronavirus/#countries. [Last accessed on 2020 Jun 19].
2Available from: https://www.africanews.com/2020/06/18/coronavirus-in-africa-breakdown-of-infected-virus-free-countries/. [Last accessed on 2020 Jun 19].
3Available from: https://www.aa.com.tr/en/economy/covid-19-to-shrink-global-economy-by-32-in-2020-un/1839844. [Last accessed on 2020 Jun 19].
4Available from: https://www.bbc.com/news/world-asia-52845015. [Last accessed on 2020 Jun 19].
5COVIDSurg Collaborative. Elective surgery cancellations due to the COVID -19 pandemic: Global predictive modelling to inform surgical recovery plans. Br J Surg 2020. [doi.org/10.1002/bjs. 11746].
6COVIDSurg Collaborative. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: An international cohort. Lancet 2020. pii: S0140-6736(20)31182-X.
7Tasew M, Aklilu TM, Abdissa SG. Diuretic resistance in patients with heart failure: Clinical characteristics and predictors of outcome. J Clin Sci 2020;17:66-73.
8Ajani MA, Omenai SA, Iyapo O. Neoplasms of the appendix: An experience of a tertiary hospital in Southwestern Nigeria. J Clin Sci 2020;17:57-60.