COVID-19 PANDEMIC EXPERIENCE IN THE UNITED KINGDOM – A NATIONAL SURVEY ABOUT CARDIAC CASES, WORK PATTERNS OF CARDIAC ANAESTHETISTS AND SUPPORT

Abstract

IntroductionThe COVID-19 pandemic started in Hubei Province, China in 2019 with the first confirmed cases in the UK in January 2020. On May 21st 2020, there were 158,488 confirmed cases in England and Wales with 33,081 deaths in SARS-CoV-2 positive patients (1). From March 2020 onwards, emergency cardiac operations were prioritised and individual work patterns adjusted. The skill set of cardiac anaesthetists, often including an expertise in critical care medicine, extracorporeal membrane oxygenation and echocardiography, was useful for the multidisciplinary medical care of COVID-19 patients in critical care units. The aim of this survey was to assess individual cardiac anaesthetic experiences during the first wave of the COVID-19 pandemic in the UK.MethodsWe conducted a survey, supported by the Association for Cardiothoracic Anaesthesia and Critical Care (ACTACC). A 16-question survey related to the first UK COVID-19 surge in April and May 2020 was sent to the membership of ACTACC in 36 cardiac centres in July 2020. Data was collected and collated using the web-based survey platform “Survey Monkey” (Palo Alto, CA).ResultsThere were 80 completed responses, indicating a response rate of about 20%. The majority of anaesthetists continued cardiac anaesthesia with emergency cases (53%) and urgent cases (65%) only at their centres. Every 5th cardiac anaesthetist (22%) was re-deployed to a different unit in their hospital or to a different hospital. The clinical work pattern changed at least moderately for the majority of cardiac anaesthetists (86%). The majority of anaesthetists (90%) felt appropriately supported when they stepped outside of their usual clinical role during the pandemic and 95% felt that their existing skillset was appropriately used. The workload increased in a majority of cardiac anaesthetists (53%), but it also decreased for some (35%). Non-resident on-calls increased for about 1/3 (36%) of respondents and resident on-calls increased for 50% of cardiac anaesthetists. A majority of anaesthetists (85%) wore PPE during their clinical work and 95% felt that the supply of PPE was adequate. The most useful source of information during the pandemic was peer discussion, chosen by more than half of cardiac anaesthetists (54%).DiscussionThe results of this national survey for cardiac anaesthetists during the first COVID-19 wave in the UK demonstrate that work patterns for cardiac anaesthetists changed dramatically. These changes may have an effect on psychological wellbeing of cardiac anaesthetists (2). However, the majority of anaesthetists felt well supported in their clinical work. Peer discussions scored high as useful sources of information, suggesting that professional networks are crucial to both, personal wellbeing and good patient care. One limitation of this survey is a low response rate, with potentially more extreme experiences in the non-responder group, emphasising the importance of support measures and the challenge of gauging that they are effective.We conclude, that with subsequent COVID-19 peaks, there is a continued need to address potential effects of major changes of work patterns by cardiac anaesthetists on burnout, psychological wellbeing and resilience.