Impact on elective ophthalmic surgery caused by the COVID-19 pandemic after the lockdown at the Clinical Institute of Ophthalmology of the Hospital Clinic de Barcelona

Dear Sir,

The current situation of health emergency gave rise to the state of alarm in our country from March 14 to June 21, 2020^1,2. This regime declared by the Government in view of the lack of control of the pandemic and the evidence that the most effective way to reduce transmission is through social isolation and contact tracing³ led to a halt in our healthcare activity, with the exception of emergencies, from March 16 to May 30, 2020.

Our center, a third level hospital that provides care 24 h a day, 365 days a year for a population of 520,000 inhabitants, performs an average of 23,198 operations a year, 4000 in ophthalmology.

The purpose of this paper is to report on the impact of the pandemic on our elective surgical activity from the resumption of activity on May 30 through November 1, 2020.

As established by the Ministry of Health^4–6 our hospital performs a preoperative epidemiological screening of all scheduled patients. This consists of a series of questions about the general condition, presentation of symptoms related to COVID-19, contact with infected people and personal protection habits, as well as a nasopharyngeal smear and PCR analysis in the 48 h prior to surgery. Only those patients with negative PCR are suitable for elective surgery.

Between May 30 and November 1, 2020, 1877 surgeries have been performed in our service: 1868 scheduled and 9 urgent. 19 have been suspended (10 in the last fortnight of October) because the patient presented a PCR + for SARS-CoV-2. In addition, we have detected a voluntary increase in cancellations during the second half of October (second wave).

The data reflected allows us to affirm that our Dept. has had very few patients suspended between May 30 and November 1, 2020 for presenting the COVID-19, even though the number of surgeries was higher than usual. This fact shows that our patients, most of them in advanced age, continue to come to the hospital.

On the other hand, we know that the impact of SARS-CoV-2 among Spanish ophthalmologists has been high (overall infection rate of 12.6% between April 21 and May 9, 2020) due to the characteristics of our specialty that requires considerable proximity to the care and surgical field. This shows the need for protective measures also among professionals.

Thus, without truly effective antiviral treatment⁷ and the likelihood that a vaccine will be available at an early date, the COVID-19 outbreak will continue to challenge the health ecosystem for the foreseeable future. From the Clinical Institute of Ophthalmology of the Hospital Clinic of Barcelona, we consider it essential to maintain and implement measures that allow us to project a future of health care related to standardized and safe ophthalmic elective surgery, which guarantees the provision of correct attention and care of visual health as well as the protection of our professionals.