Impact of COVID-19 response on global surgical volumes: an ongoing observational study

• Type of Material: Article
• Authors: Vikas O'Reilly-Shah, Emory University; Wil Van Cleve, University of Washington; Dustin R. Long, University of Washington; Vanessa Moll, Emory University; Faye M. Evans, Harvard Medical School; Jacob E. Sunshine, University of Washington; Nicholas J. Kassebaum, University of Washington; Ewen M. Harrison, University of Edinburgh; Craig Jabaley, Emory University
• Language: English
• Date: 2020-10-01
• Publisher: WORLD HEALTH ORGANIZATION
• Publication Version: Final Published Version
• Copyright Statement: 2020 The authors; licensee World Health Organization.
• License: Creative Commons Attribution 3.0 IGO License
• Final Published Version (URL): http://dx.doi.org/10.2471/BLT.20.264044
• Title of Journal or Parent Work: BULLETIN OF THE WORLD HEALTH ORGANIZATION
• Volume: 98
• Issue: 10
• Start Page: 671
• End Page: 682
• Grant/Funding Information: DRL received financial support from the National Institutes of Health/National Institute of General Medical Sciences, USA (grant no. T32 GM086270-11).
• Keywords: Public, Environmental & Occupational Health; ACCESS; SURGERY; Life Sciences & Biomedicine; Science & Technology
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Public Health

Abstract

Objective To determine whether location-linked anaesthesiology calculator mobile application (app) data can serve as a qualitative proxy for global surgical case volumes and therefore monitor the impact of the coronavirus disease 2019 (COVID-19) pandemic. Methods We collected data provided by users of the mobile app“Anesthesiologist”during 1 October 2018–30 June 2020. We analysed these using RStudio and generated 7-day moving-average app use plots. We calculated country-level reductions in app use as a percentage of baseline. We obtained data on COVID-19 case counts from the European Centre for Disease Prevention and Control. We plotted changing app use and COVID-19 case counts for several countries and regions. Findings A total of 100 099 app users within 214 countries and territories provided data. We observed that app use was reduced during holidays, weekends and at night, correlating with expected fluctuations in surgical volume. We observed that the onset of the pandemic prompted substantial reductions in app use. We noted strong cross-correlation between COVID-19 case count and reductions in app use in low-and middle-income countries, but not in high-income countries. Of the 112 countries and territories with non-zero app use during baseline and during the pandemic, we calculated a median reduction in app use to 73.6% of baseline. Conclusion App data provide a proxy for surgical case volumes, and can therefore be used as a real-time monitor of the impact of COVID-19 on surgical capacity. We have created a dashboard for ongoing visualization of these data, allowing policy-makers to direct resources to areas of greatest need.