Effect of Strict Lockdown on Pediatric Surgical Services and Residency Programme during COVID-19 Pandemic.

Abstract

To document the measures adopted during the COVID-19 pandemic strict lockdown on pediatric surgical services and residents' training at a tertiary care hospital. Cross-sectional descriptive study. Department of Pediatric Surgery, National Institute of Child Health, Jinnah Sindh Medical University, Karachi, from April 2020 to June 2020. Data from the Outpatient Department, Emergency Department, and Operation Theatre records were collected. The number of patients seen in the outpatient department, surgeries performed, index emergency cases dealt with, and the residents' duty roster and teaching methodology were documented. Descriptive statistics were used for reporting. During the strict lockdown period, outpatient services continued; however, elective cases were not operated. A total of 2,930 patients were seen in clinics, and 1,316 surgical procedures were performed. The index cases managed included anorectal malformation (n=35), esophageal atresia with and without tracheoesophageal fistula (n=13), small bowel atresia (n=11), omphalocele (n=6), acute appendicitis (n=35), intestinal obstructions (n=23), intussusceptions (n=18), and intestinal perforations (n=16). On-call days of residents were reduced from every third to the fifth day, and online educational sessions were added. During the pandemic, 13 members of surgical and anaesthesia teams got infected with COVID-19. COVID-19 pandemic elective surgical services were restricted; however, emergency cases were managed as per routine. In clinical teaching, virtual technologies were incorporated. Working hours of residents were limited to decrease the exposure to infected persons. Key Words: COVID-19, SARS-CoV-2 pandemic, Healthcare workers, Residency programme.