Learning from the past: did experience with previous epidemics help mitigate the impact of COVID-19 among spine surgeons worldwide?

Joseph A Weiner,Garrett K Harada,Howard S An,Daniel M Sciubba,Mohammad El-Sharkawi,Jason P Y Cheung,Philip K Louie,Norman B Chutken,Dino Samartzis,Marko H Neva,Daniel J Johnson,Niccole Germscheid,Michael H Mccarthy,Peter R Swiatek,Marcelo Valacco

doi:10.1007/s00586-020-06477-6

Abstract

PurposeSpine surgeons around the world have been universally impacted by COVID-19. The current study addressed whether prior experience with disease epidemics among the spine surgeon community had an impact on preparedness and response toward COVID-19.MethodsA 73-item survey was distributed to spine surgeons worldwide via AO Spine. Questions focused on: demographics, COVID-19 preparedness, response, and impact. Respondents with and without prior epidemic experience (e.g., SARS, H1NI, MERS) were assessed on preparedness and response via univariate and multivariate modeling. Results of the survey were compared against the Global Health Security Index.ResultsTotally, 902 surgeons from 7 global regions completed the survey. 24.2% of respondents had prior experience with global health crises. Only 49.6% reported adequate access to personal protective equipment. There were no differences in preparedness reported by respondents with prior epidemic exposure. Government and hospital responses were fairly consistent around the world. Prior epidemic experience did not impact the presence of preparedness guidelines. There were subtle differences in sources of stress, coping strategies, performance of elective surgeries, and impact on income driven by prior epidemic exposure. 94.7% expressed a need for formal, international guidelines to help mitigate the impact of the current and future pandemics.ConclusionsThis is the first study to note that prior experience with infectious disease crises did not appear to help spine surgeons prepare for the current COVID-19 pandemic. Based on survey results, the GHSI was not an effective measure of COVID-19 preparedness. Formal international guidelines for crisis preparedness are needed to mitigate future pandemics.

Highlights

The COVID-19 pandemic has rapidly become one of the most catastrophic global health crises of our time [1,2,3]
902 spine surgeons responded to the survey, representing 91 distinct countries and 7 global regions (Africa, Asia, Australia, Europe, the Middle East, North America, and South America/Latin America)
Of the 881 surgeons providing their region of practice, the greatest number of responses was from Europe (242/881; 27.5%), followed by Asia (213/881; 24.2%) and North America (152/881; 17.3%)

Summary

Introduction

The COVID-19 pandemic has rapidly become one of the most catastrophic global health crises of our time [1,2,3]. Many initial epidemiologic models predicted tremendous demands on existing hospital resources and staff across the globe [5,6,7,8]. The ability to meet these demands has been variable around the world [9]. The World Health Organization (WHO) and the global health community have made pandemic preparedness one of their main missions [14, 15], and research on pandemic preparedness is plentiful [9, 16,17,18]

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