COVID 19: From resource restriction to surgical services. How we waived off the waves

Since December 2019, the world is struggling against Coronavirus Disease 2019 (COVID-19) and in the past months, the life of more than one-third of the planet’s population has radically changed.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has shown to be a very contagious virus potentially causing complicated atypical pneumonia and associated with significant mortality. Despite initially confined to Hubei province, China and Asia, COVID-19 promptly spread to western countries, and in March 11, 2020, the World Health Organization (WHO) declared a public health emergency of international concern. By early April, we are counting over 1,500,000 cases and 88,000 deaths worldwide, with 209 countries involved over 4 continents. India recorded its first case of COVID-19 on January 27, 2020 and was certainly the one suffering the most by the

sudden outbreak of the disease. Indeed, SARS-CoV-2 rapidly spread throughout the country by the end of April, challenging the healthcare system toward its collapse, increasing the mortality rate and raising the question concerning the need for special measures to contain the crisis. The Indian Government announced extraordinary measures to contain the spread of the pandemic, by means of nationwide lockdown. COVID-19 outbreak seriously stressed the healthcare system worldwide, with the urgent need of extra ICU beds, dedicated hospital paths, personnel training, and infection control

measures. Care of diseases outside the COVID-19 has rapidly changed, and healthcare providers are currently adapting to maximize and properly allocate resources. Surgical activity has shifted to pursue only emergency and elective cancer cases as described in different specialties. Furthermore, the big picture and the full impact was still unknown as its effects on economy, hospital infrastructure, healthcare strategy, and prognosis of oncologic patients. Indeed, people with cancer suffered the most by this worldwide outbreak as the access to surgery is limited by the significant reduction in available resources, eventually influencing the decision making and the  therapeutic allocation of patients. With a nationwide lockdown starting on March 25, 2020 there is severe disruption of health care services being provided to non-COVID patients. This problem was intensified when Medical College and Hospital, Kolkata was declared as tertiary level COVID hospital on May 07, 2020 with reservation and diversion to resources to COVID affected patient care services. Resumption of non COVID non-emergency patient care began in our institute from June 16, 2020.