The myth of pre-operative isolation during the COVID-19 pandemic

Abstract

The SARS-CoV-2 (COVID-19) pandemic called for the restructuring of National Health Service (NHS) surgical departments across the country. Initial guidance advised that patients undergoing elective surgery isolate for 14 days prior to their operation. As we learnt more about COVID-19 and its incubation period, at the Princess Royal University Hospital this guidance has been decreased to 72 h. We collected retrospective data for two patient cohorts that underwent elective surgery in June and September 2020, isolating for 14 days and 72 h, respectively. We followed-up these patients with several questions allowing us to categorise the cohorts into three groups based on their compliance with isolation measures and also to assess their satisfaction with the isolation process. Our data shows that only 16% of the June cohort and 53% of the September cohort isolated in accordance with the guidelines whilst patient satisfaction was 16% and 64% respectively. These results highlight a suboptimal compliance to pre-operative guidelines as well as an adverse effect on patient mental health and raise the issue of both patient and NHS staff safety. With the possibility of a COVID-19 second wave and for future pandemics, a clear evidence-based plan for pre-operative isolation is vital. Furthermore, consideration of patient adherence and satisfaction is key in deciding which guideline will be most effective.