Western University Associate Professor Janet Martin is part of the CovidSurg Collaborative which has projected that, based on a 12-week period of peak disruption to hospital services due to COVID-19, 28.4 million elective surgeries worldwide could be cancelled or postponed in 2020.
The modelling study, published in the British Journal of Surgery, indicates that each additional week of disruption to hospital services could be associated with a further 2.4 million cancellations.
“This has never happened before on a global basis in an era where we have the volume of surgery we have today,” said Martin, Associate Professor of Anesthesia & Perioperative Medicine at Western’s Schulich School of Medicine & Dentistry. “Surgery is a critically important part of health care globally. This study was essential to define the global impact of surgical cancellations.”
In collaboration with lead researchers at the University of Birmingham, the team collected detailed information from surgeons across 359 hospitals and 71 countries on plans for cancellation of elective surgery. This data was then statistically modelled to estimate totals for cancelled surgery across 190 countries.
The researchers project that worldwide 72.3 per cent of planned surgeries would be cancelled through the peak period of COVID-19 related disruption. Most cancelled surgeries will be for non-cancer conditions. Orthopaedic procedures are cancelled most frequently, with an estimated 6.3 million orthopaedic surgeries cancelled worldwide over a 12-week period. It is also projected that globally 2.3 million cancer surgeries will be cancelled or postponed.
In Canada, most elective surgeries have been cancelled since mid-March. It is estimated that if this continues for a peak of 12-weeks total, it will result in 394,576 cancelled surgeries, including 27,390 cancer procedures. These cancellations will create a backlog that will need to be cleared after the COVID-19 disruption ends.
The study shows that after the disruption ends if the number of surgeries performed each week is increased by 20 per cent compared to pre-pandemic activity, it will take 11 months to clear the backlog in Canada.
“The cancellations were necessary in order to ensure sufficient capacity for COVID-19 demand, and also to allow time to evaluate whether usual volumes of surgery could continue safely in the context of COVID-19 without risk of infection to patients," said Martin. "Understanding these numbers will help to prepare for post-peak-pandemic in order to start a plan for reopening elective surgery in a way that is safe and manageable.”